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Who Bought the Farm?October 29, 2005 A year or so ago a medical clinic opened in Edgartown (one of the Vineyard's six towns) billing itself as "Massachusetts' First Rural Health Clinic." Great goats and little chickens, thought I; who managed to boondoggle-hornswaggle the state into this one? Did Martha's Vineyard really harbor a silver-tongued lobbyist who could persuade the members of the Great and General Court of the Commonwealth that this island is rural? Once upon a time, sure, but these days three acres of land sans buildings can easily set a person back $700,000 or so. You'd have to sell a lot of vegetables to pay the mortgage on that, and forget about livestock: even if the neighbors were willing to put up with mooing and bleating at all hours, their designer dogs would probably decimate your poultry. Rural: right. I couldn't help wondering which county in the western part of the state got diddled out of hosting Massachusetts' First Rural Health Clinic. Around the time this clinic opened, talk about a county-wide health insurance plan pretty much vanished from the newspapers. Many working people on Martha's Vineyard, which makes up nearly all of Dukes County, are either self-employed or employed by very small businesses. Those of us who don't manage to marry decent health insurance often go without. Up till about six years ago I shelled out $272 a month for a major medical plan that would have covered me (I think) if I'd been hit by a truck or diagnosed with cancer but didn't do me any good otherwise. Then one corporate giant bought out another and my monthly premium went up to $643. Bye bye, health insurance. Last year I had two detached retinas: same retina, two surgeries. As medical expenses go, these weren't bad. No overnight hospital stay, and I pretty much kept working through the whole one-eyed slog; another month or two and my credit card will be down to $0 balance again. Still, I'd been eagerly following the county's proposed plan because it sounded like my income would be within the guidelines, and short of selling The Mud of the Place for a high-five-figure advance, it looked like my best chance of having health insurance before I hit Medicare age -- not till June 2016. So the county plan seems to have died, and in its place we got this "rural health clinic." I hear OK things about it, but I haven't been to visit, mainly I'm never sick and they don't do eye surgery. The lead story in the Community section of this week's Martha's Vineyard Times was headed "Med students get a look at rural health care." Three medical students and two nursing students spent two weeks on the island studying "mental health and substance abuse issues in a rural, semi-isolated setting." That rural thing again. "I had been to the Island about a dozen times as a summer tourist," said one of the students, "but I never had a feel for the real Vineyard population. I thought of it as a tourist Mecca." Said another: "I thought of the Vineyard as a wealthy island. Now I see that they're not the only ones here. There's a whole group that's really struggling." Got that right. I only wish I could have debriefed those students. "Forget what they've told you: this isn't a rural area. Martha's Vineyard is a seasonally occupied territory, only now the occupying forces don't all leave in the fall. Does that have implications for mental health and substance abuse issues? You betcha. Review the per capita income figures, then take a look at the real estate ads. Get it?"
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