'Vacuum Project' Gives a Face to the Uninsured

Last spring, Congress passed a health care bill that will reduce the number of uninsured Americans.  That's not enough for a group of medical students who are working on a project to make health care accessible to all people -- regardless of their ability to pay.

"Fifty million are uninsured," said Richard Bruno, now in his second year at Oregon Health and Sciences University. "Forty-four thousand die each year because they don't have insurance. These are powerful numbers … but it didn't touch home, it didn't resonate. It's not like your next door neighbor or cousin is dying."

Bruno and his colleagues at OHSU started The Vacuum Project in 2009 hoping to persuade a divided electorate to support health care reform. The idea is simple. People who don't have health insurance tell their stories to medical students on camera. But the project didn't stop after the health care bill was signed, because, as Bruno pointed out, the need has not gone away.

View the videos at www.thevacuum.org or at http://vimeo.com/thevacuum. Contact the project if you want to schedule an interview at brunor@ohsu.edu.

Students partnered with the Poverty Action Council and visited low-income medical clinics. They talked with people who had lost their jobs, and subsequently their insurance, due to a medical condition. They talked with people who couldn't get insurance because of pre-existing conditions. And they spoke with others who simply couldn't afford insurance.

One man's story in particular stuck with Bruno. A man lost his job due to a seizure disorder he developed. In turn, he lost his insurance. He's been relying on the charity of a neurologist ever since.

"(His story) encapsulates the frailty of the system," Bruno said. "It could happen to anyone at any point."

Central to the mission of the Vacuum Project was a desire to change people's feelings about providing health care to people regardless of their ability to pay. To do that, they proposed a study on medical students across the country. In the process, they point out that they do not put their support behind any specific ideological policy change.

Dr. Paul Gorman, an advocate of universal healthcare, helped mentor and assist the students in their project and the study. What the students found, says Gorman, surprised him in ways he didn't entirely expect.

"I was struck by how high a proportion of students support health care (for all)," he said.

Nearly 86 percent of medical students supported some form of national health insurance. When medical students viewed the videos, it didn't seem to make much of an impression into their previously held beliefs. Gorman and Bruno call this the "ceiling effect."

Essentially, when such a high number of people already believe in something, it's nearly insurmountable to get the remaining 10 percent to change their minds.

Gorman said he was also struck at how many students would be willing to forgo higher incomes in order to provide health care to their patients. He says medical students disagree about just how a national health care system should operate.

Jay Thiemeyer, an interviewee, said he felt empowered and respected when speaking with the students.

"You certainly don't get respect when you see a doctor for 10 minutes and it costs $800," he said.

Allen Andrews, one of the project's founders, says the next goal of the project will be to reach doctors and nurses across the state of Oregon-- starting with doctors at OHSU. He hopes to screen the videos for elected officials and publish their findings in medical journals.

"It's really working for people like you," he said. "We live in an age of images."

Gorman says he hopes the video interviews can be screened in front of people opposed to a national health care plan. In January, many of the students involved in the vacuum project are organizing a Single Payer Conference for Jan. 29, 2011. Speaking at the event will be U.S. Rep. John Conyers, along with a number of panel discussions and lectures and breakout sessions. Andrews says the conference and the video project share many of the same goals.

Despite the rigors of medical school, Andrews and Bruno say they're committed to ensuring the project continues. Gorman says it's part of his job to make sure his students are keeping up with their studies, but he also is a tireless advocate of universal health care.

"For me, it's a medical problem," Gorman says.

Like prostate cancer or a virus, covering the uninsured is simply about finding the right solution.

"Most people don't confront the problem directly," Gorman said. "Where the Vacuum Project fits in … it gives people a greater awareness and realistic understanding of (the insurance system)."  For Single Payer Conference Info visit www.singlepayeroregon.org