The Mississipi Delta's healthcare blues

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http://www.latimes.com/news/health/healthcare/la-na-mississippi-20100603-34,0,4037964.story

Anne Brooks, a nun and a physician, has struggled for years to treat the poor at a run-down clinic in Tutwiler. The nation's new healthcare law could help – but her state is fighting it.

By Noam N. Levey, Tribune Washington Bureau

June 3, 2010

<snip>"It's a pretty hand-to-mouth existence," said Brooks, 71, a physician with a wry sensibility and a profane streak. Brooks earned a medical degree at age 44 before coming to the Mississippi Delta to open the Tutwiler Clinic with the blessing of the Sisters of the Holy Names of Jesus and Mary.

She sees the nation's new healthcare law as a potentially happy turn in a long, hard journey. The measure provides hundreds of billions of dollars to help states expand medical insurance for the poor and pay doctors like Brooks, nearly half of whose patients have no coverage.

But there's a good chance this story will end with another difficult twist in the road for Brooks and for Tutwiler.

Mississippi has the highest poverty rate in the nation and some of the sickest people, with the country's highest rate of heart disease and the second-highest rate of diabetes.

For every dollar the state spends to expand healthcare for the poor, it stands to get as much as $20 from Washington. But state officials have been making it harder, not easier, to enroll in government-backed healthcare programs.

Republican Gov. Haley Barbour campaigned on a promise to cut the healthcare safety net to balance the state budget. Shortly afterward, Mississippi began requiring Medicaid recipients to submit to in-person interviews once a year, making it the only state with such a sweeping rule. In Tutwiler, the closest registration office is in nearby Sumner. It's open one day a week, on Tuesdays, from 9 a.m. to noon and 1 p.m. to 3 p.m., as well as the third Wednesday of the month.