Missouri Still Forbids Free Health Care from Outside the State

Protectionism trumps the needs of patients.

In the aftermath of the tornado that devastated Joplin in 2011, Remote Area Medical, a Tennessee-based charity that provides free health care, sent its mobile eyeglass laboratory to Missouri to help.

But it wasn't allowed to assist because Missouri law makes it extremely difficult for doctors, nurses and other health-care professionals to offer free services.

"We did send the vehicle up there," said RAM founder Stan Brock. "Unfortunately, it was not allowed to do anything because we did not have a Missouri-licensed optometrist and opticians available to do the work."

In May, state legislators passed the Volunteer Health Services Act, which would have allowed health professionals licensed in other states to offer free care in Missouri and also would have relaxed medical malpractice liability for volunteer health workers.

Gov. Jay Nixon vetoed the bill last month, writing that the VHSA "is unnecessary given that Missouri already has a system in place that encourages volunteerism."

Missouri-licensed health workers can volunteer in free clinics, and the attorney general provides legal representation in the event of a malpractice claim.

But even with the free clinics, there is still a massive need for medical services that goes unmet.

"Existing Missouri clinics are enough to meet the needs of the needy?" asked Patrick Ishmael, a policy analyst at free market think tank Show-Me Institute, in an e-mail. "Would the needy agree with the governor?"

Hundreds of health care professionals provide free dental, vision and general medical care to more than 1,000 people who would otherwise go without treatment at a typical RAM event. Sometimes patients arrive 24 to 36 hours early to reserve a place in line.

"It is really a tragedy to see these people in the condition that they are," Brock said. "We get a lot of requests from folks in Missouri."

But providing volunteers with "blanket immunity" from liability would be "bad public policy," Nixon wrote in his veto message.

Sharon Jones, deputy director of the Missouri Association of Trial Attorneys, which initially opposed the bill, said "even in times of emergency people need to be careful and they need to be responsible. If you harm someone, you should still be held responsible for the harm that you've caused."

But the bill doesn't actually grant blanket immunity. Trial lawyers stopped actively working against the legislation after language was added providing for civil penalties if health workers engage in "willful misconduct" or a "gross deviation from the ordinary standard of care," Jones said.

At least seven other states, including Tennessee, Virginia and Illinois, have eased regulatory hurdles that prevent volunteers from providing medical services. If the quality of health care in those states has suffered, no one has noticed.

"Remote Area Medical has seen over half a million — way over half a million — patients," Brock said. "We've had something like 80,000 volunteers in the field and we've done 700 of these special events — we've got one in progress down in Texas as we speak — and we've never identified an incompetent practitioner. How many more patients do we have to see … before somebody will believe that it really is safe to allow doctors to cross state lines? We're talking free care here at no cost to the government or the taxpayer. So what's the big problem?"

Sen. David Sater, R-Cassville, sponsor of the bill, said he knows plenty of retired physicians who'd love to donate their time and expertise.

"But right now they would have to have medical liability malpractice insurance, so it's just not feasible for, especially a retired physician, to pay thousands of dollars [to provide free care]," he said.

Sater, a pharmacist by trade, said he will soon assess whether a veto override is possible.

"Evidently the governor still favors litigation rather than trying to help people with their medical care," he said. "And I find that very interesting since he has gone around the state promoting Medicaid expansion, but yet he feels just the opposite on a bill like mine which would increase care to thousands of people throughout the state."

Perhaps Nixon should visit an event in East St. Louis, Ill., RAM plans to hold later this year.

"If the governor wanted to talk to us about it, I'd be very happy to go and see him because the need is so tremendous," Brock said.

This article originally appeared at Watchdog.org.