美国国家公共电台 NPR When Sleeping In The Car Is The Price Of A Doctor Visit

 

STEVE INSKEEP, HOST:

Here's one big reason that Democrats¹ and many Republicans express doubts about repealing² the Affordable³ Care Act - the law allows states to expand their Medicaid coverage⁴ - many did, and millions of people received coverage. A proposed Republican replacement⁵ would take hundreds of billions of dollars out of Medicaid, making it unclear how the coverage would change in state after state.

To understand what it all means, it helps to visit a state that never expanded Medicaid in the first place to see what happens there. NPR's Sarah McCammon traveled to Tennessee.

SARAH MCCAMMON, BYLINE⁶: Missing teeth are all too often a punchline⁷ in conversations about poor people in rural places. But when your teeth need attention, it's not funny.

HEATHER WALLACE: Basically, it's just like a nerve pain. Your whole body locks up, it - you have to stop for a second to try to breathe. And sometimes, if it hurts bad enough, you might cry (laughter).

MCCAMMON: That's Heather Wallace. She and her husband James are both in their 20s. They traveled about two hours from Knoxville, Tenn., to a free medical clinic in Chattanooga earlier this month. James Wallace says they each earn around $8 or $9 an hour working in hotels. Health insurance and dental care aren't part of the deal.

JAMES WALLACE: We don't have it. We can't afford it. And we don't make enough to be penalized⁸ at the end of the year. So either which way it goes, we don't have the money to pay for it.

MCCAMMON: The Wallaces were camped out on a blanket outside Red Bank High School in Chattanooga on a Friday afternoon, hours before the clinic was set to open Saturday morning. The nonprofit group Remote Area Medical puts on dozens of these clinics around the country each year. Founder¹⁰ and President Stan Brock says even under the ACA, many of these patients still lack health insurance, let alone dental and vision. Those who have some kind of insurance often can't afford the co-pays and deductibles.

STAN BROCK: That is something that we hear all the time. It's costing me so much money before my insurance kicks in.

MCCAMMON: The Wallaces say they make too much money for Medicaid. And they looked into an Obamacare exchange plan but couldn't afford the premiums¹¹.

H. WALLACE: Obamacare was not what they said it was going to be.

MCCAMMON: Heather Wallace says maybe we should have a system like Canada, where everyone is covered. James Wallace agrees.

J. WALLACE: Making it to where everybody can have health insurance and they'd have more productive members of society...

H. WALLACE: Exactly.

J. WALLACE: ...And maybe drop the percentage of Americans on food stamps.

MCCAMMON: During the campaign, President Trump¹² often promised to replace the ACA with something much better. But the Congressional Budget Office estimates a plan passed by the House of Representatives would leave 23 million more Americans uninsured. And Senate Republicans have not revealed the details of their plan.

On Saturday morning, after a long night spent reading and trying to doze⁹ off in the car, 55-year-old Sabra Howard finally got to see a dentist. She has several health issues, but she's most concerned about her teeth.

UNIDENTIFIED MAN: Sabra, what brings you over today?

SABRA HOWARD: I wanted to see about cleaning and any fillings that I may need.

UNIDENTIFIED MAN: OK.

HOWARD: I don't have any top teeth anymore. I just have bottom.

UNIDENTIFIED MAN: OK.

MCCAMMON: Howard, who lives just outside Chattanooga, loves her work-from-home customer service job, but it doesn't offer benefits. And she can't afford the premiums for plans offered through the exchange. She says she voted for Trump.

HOWARD: Well, I wanted change.

MCCAMMON: And she hopes he can follow through on his promise to reform the health care system, though she's not sure about the details.

HOWARD: I just want him to sit down and talk with, you know, the people that are smarter than me and come up with a good plan that will help everybody.

MCCAMMON: You seem pretty smart. What do you think - what do you want to do? I mean, do you think that there should be more government support for it, or is there some other parts that you think would be better?

HOWARD: I don't really think government should be all in it, but I think that a lot of people need someone to speak for them.

MCCAMMON: Howard says she just wants to be able to take care of herself. She spent years prioritizing her children's care over her own, and now her dental problems are compounding her financial difficulties.

HOWARD: I actually have my insurance license¹³. And I passed up an opportunity to go ahead and do that because of my teeth because I felt like, you know, I'd be sitting there talking to a client. And next thing I know, they realize I don't have teeth. And who wants to buy insurance from somebody that, you know, don't have any teeth?

MCCAMMON: Howard says she's working toward getting a position with benefits. In the meantime, she's hoping to get dentures at another free clinic on another day. Sarah McCammon, NPR News, Chattanooga.

1 democrats   

n.民主主义者，民主人士( democrat的名词复数 )

参考例句：

• The Democrats held a pep rally on Capitol Hill yesterday. 民主党昨天在国会山召开了竞选誓师大会。
• The democrats organize a filibuster in the senate. 民主党党员组织了阻挠议事。 来自《简明英汉词典》

2 repealing   

撤销，废除( repeal的现在分词 )

参考例句：

• In addition, repealing the alternative minimum tax would also help. 此外，废除替代性最低税也会有所帮助。
• Repealing the investment tax credit. 取消投资税款扣除。

3 affordable   

adj.支付得起的，不太昂贵的

参考例句：

• The rent for the four-roomed house is affordable.四居室房屋的房租付得起。
• There are few affordable apartments in big cities.在大城市中没有几所公寓是便宜的。

4 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

5 replacement   

n.取代，替换，交换；替代品，代用品

参考例句：

• We are hard put to find a replacement for our assistant.我们很难找到一个人来代替我们的助手。
• They put all the students through the replacement examination.他们让所有的学生参加分班考试。

6 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

7 punchline   

n.（笑话、故事等的）结尾警语，点睛之笔

参考例句：

• Even then,the magical pause can strengthen the punchline.即使这样，有魔力的停顿依然可以增强笑点。
• A good joke or a mystery novel has along wind up to the final punchline.好的笑话或神秘小说都是一路曲折，直至最后的笑料或真相。

8 penalized   

对…予以惩罚( penalize的过去式和过去分词 )； 使处于不利地位

参考例句：

• You will be penalized for poor spelling. 你拼写不好将会受到处罚。
• Team members will be penalized for lateness. 队员迟到要受处罚。

9 doze   

v.打瞌睡；n.打盹，假寐

参考例句：

• He likes to have a doze after lunch.他喜欢午饭后打个盹。
• While the adults doze,the young play.大人们在打瞌睡，而孩子们在玩耍。

10 Founder   

n.创始者，缔造者

参考例句：

• He was extolled as the founder of their Florentine school.他被称颂为佛罗伦萨画派的鼻祖。
• According to the old tradition,Romulus was the founder of Rome.按照古老的传说，罗穆卢斯是古罗马的建国者。

11 premiums   

n.费用( premium的名词复数 )；保险费；额外费用；（商品定价、贷款利息等以外的）加价

参考例句：

• He paid premiums on his life insurance last year. 他去年付了人寿保险费。 来自《现代英汉综合大词典》
• Moves are afoot to increase car insurance premiums. 现正在酝酿提高汽车的保险费。 来自《简明英汉词典》

12 trump   

n.王牌，法宝；v.打出王牌，吹喇叭

参考例句：

• He was never able to trump up the courage to have a showdown.他始终鼓不起勇气摊牌。
• The coach saved his star player for a trump card.教练保留他的明星选手，作为他的王牌。

13 license   

n.执照，许可证，特许；v.许可，特许

参考例句：

• The foreign guest has a license on the person.这个外国客人随身携带执照。
• The driver was arrested for having false license plates on his car.司机由于使用假车牌而被捕。