Rural physician on health reform: With BCRA, 'We'd be going from bad to slightly worse'

The only hospital in Clay County, Ga., closed its doors in 1983. Today, Karen Kinsell, MD, now in her sixties, is the county's only physician.

"It's a bad place to live," Dr. Kinsell told The New Yorker, "which is why I moved here. I was looking for a place that needed me."

Dr. Kinsell runs Clay County Medical Center in Fort Gaines, Ga., a former Tastee-Freez that was converted into a four-exam-room medical office. With her two other full-time staff members, Dr. Kinsell sees about 30 to 35 patients a day. Monty Veazey, president of the Georgia Alliance of Community Hospitals, said "Kinsellcare" is the only healthcare that's had a positive effect in the county.

"She's going bankrupt treating everyone that comes in," Mr. Veazey said, according to the report. "Most have no money, no internet access, no other basic care. Many don't have insurance. How much longer can she do that? I don't know, but she's their only hope."

Forty percent of Dr. Kinsell's patients have no health insurance. "[W]e just ask them for 10 dollars to cover the visit. If they can't pay, then it's free," she said, according to the report. "We do that because this is one of the poorest places in Georgia, with some of the sickest people, and we're adjoined by counties that are just as bad."

Because of the widespread poverty and lack of healthcare access in the county, Dr. Kinsell said most people "don't expect anything. They mostly just expect to not have insurance." And although she supported the ACA, she said the insurance and accessibility gains it promised to achieve had no measurable effect in Clay County. "The first year it came out, southwest Georgia had the second-highest premium costs in the nation, after Vail, Colorado. And because not many people make enough to be allowed to buy into it, very few people around here signed up for it," she said. She also attributes the high percent of uninsured patients to the state's decision not to expand Medicaid.

Dr. Kinsell is not hopeful that Congressional Republicans' healthcare bill will help alleviate the situation. "With Trumpcare, we'd be going from bad to slightly worse, especially with the proposed Medicaid limits," she said. "There's talk of, down the road, pregnant women might not be covered. Disabled people, too. Reduced special services. We'd have more limited funding."

"The uncertainty of whether Trumpcare will or won't pass is disturbing for us at the medical center, though," she said. "I expect, if it goes through, we'll have more patients come in for the free or discounted healthcare. And we don't have any more capacity. I'm here until 7 p.m. every night as it is. It's just, how much more can you do?"

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