Public Policy //
From left: RAM founder Stan Brock; A RAMUSA road crew rolls into Tennessee; A RAM dental clinic operates out of a school gym in Chattanooga,
RAM
Remote Area Medical provides free health care, but a patchwork of state laws limits its reach
T
BY DAVA STEWART
here is an organization that has not been affected by any of the national health care debate or federal legislation in the last few years. Remote Area Medical (RAM) clinics have provided health care services to people who live in areas where such services are not available, or if they are available, are inaccessible. RAM provides dental care, vision care and medical care to patients, for free, no questions asked, and has been doing so since 1985. RAM was founded by Stan Brock, who has led a full, colorful life that
18 RHQ | RuralHealthQuarterly.com
sounds like a movie script. He has worked as a cowboy, was a host on Mutual of Omaha’s Wild Kingdom and has dedicated years to the philanthropic endeavor that is RAM. Brock was injured as a young man while living in Guyana. When he was hurt, he was in a remote part of the country. It was a 26-day journey to the nearest doctor, and there was doubt as to whether or not he would survive. The experience inspired him to get his pilot’s license and begin flying medical personnel to similarly remote places to provide care.
Although originally RAM provided services in places such as Guyana, the organization soon found there was a great need in the United States. Today 90 percent of the work RAM does is in the US, though they still operate clinics in Guyana and provide disaster relief throughout the world. Even in the early days of holding US clinics, RAM faced a problem. The state of Tennessee, at that time, did not allow medical volunteers from out of state to provide care to residents. Brock himself led the movement to change the law, and in 1997, Tennessee passed legislation recognizing medical licenses from other states for volunteers to provide free medical care to the indigent population. Today, 38 states still do not allow volunteers to provide medical care if they are not licensed within the state where the care will be provided. For example, if a physician from Ohio agrees to volunteer with RAM, and wants to attend a clinic being held in Texas, unless the physician goes through the process to become licensed in Texas, it is illegal to provide care there. Although there are some federal standards for medical education, each state operates a medical board which oversees licensure, and the requirements are wildly different stateto-state. The Affordable Care Act (ACA) has not impacted RAM clinics, because the majority of people who attend the clinics are coming for dental and vision care, and the ACA largely does not address those needs. Brock says that none of the recent legislation in the national spotlight is likely to affect the people