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The Last Word

by Fr. John Rausch

After more than 30 years the rural Appalachian community of Paint Lick, Kentucky, has a doctor.   One hundred volunteers helping Dr. John Belanger, a Board Certified Family Practitioner, descended on the town's old red brink warehouse and transformed it by hammers and sweat into the Paint Lick Family Clinic (   with three exam rooms, a lab and administrative offices.

The clinic provides acute and chronic care, minor surgical procedures, health maintenance and dietary counseling. Currently about 20 farmers, low-wage workers and area residents of modest means pass through the waiting room each day.

What turns this feel-good story into one of inspiration and instruction flows from Dr. John’s philosophy. For eleven years he worked in a clinic that targeted an under-served population. Noticing the stratospheric rise of health care costs, he looked for an alternative. His solution: cut the paperwork, lower the overhead and work for a reasonable salary.

His cost cutting formula avoids the paperwork of dealing with private insurance companies and Medicare. The Paint Lick Family Clinic does not take insurance cards, but instead charges $20 per visit. If needed, patients can make $5 weekly payments or whatever they can afford. Nationally, about one fourth of health care employees do nothing but paperwork. The Paint Lick Clinic runs with one office manager and one nurse.

Lowering the overhead suggests some creative approaches. With a small grant of $35,000 and local donations the non-profit clinic bought the building and had scores of community volunteers remodel it. And unlike a medical specialty, primary care medicine does not require a large capital investment in sophisticated equipment. Dr. John with low-tech tools like a stethoscope and flashlight monitors heart conditions and a patient’s general health. With lab work he checks cholesterol and possible infections. With generic drugs–"a good therapeutic alternative that can save a significant amount of money for patients"–he can treat the common stress related illnesses of hypertension, depression and back pain. When necessary he offers referrals to other doctors and hospital services.

Finally, an essential cost cutting measure faced the question of the physician’s salary. The clinic could not afford the usual six figure earnings of doctors. Putting service above salary Dr. John works for what economists call a psychic income and what theologians might label Gospel wages. Motivated by his Catholic faith, he earns a much-below doctor’s salary in his dedication to serving the uninsured and under-served.

Currently, over 40 million U.S. residents lack any medical coverage. For some their employers do not provide health insurance; for others their income cannot afford the high premiums. Still, the U.S. healthcare system cures by market forces, and increased pressure to compete is forcing hospitals to treat fewer charity patients. In regards healthcare there are simply limits to the market system.

The Church sees healthcare as a basic human right, not simply a commodity. The Catechism of the Catholic Church teaches that society must help all its citizens attain essential living conditions: "food and clothing, housing, healthcare, basic education, employment and social assistance." To live a dignified and secure life in our society requires universal health coverage, nothing less.

Dr. John Belanger spends about 20 minutes with his patients each visit, twice the national average. He heals by understanding and encouragement as much as by any medical procedure. His dedication leaves no one excluded from healthcare. His common sense can spark creativity for others with a healing ministry.

One doctor of faith responded to the invitation of local people, gathered a dedicated staff and made Paint Lick a healthier community.

Fr. John Rausch, a Glenmary priest, teaches at the Appalachian Ministries Educational Resource Center, Berea, Ky.   His column appears monthly in many Catholic journals and in ours courtesy of the Friends of the Good News.  Join the Friends of the Good News and help spread the Gospel.


Read other articles of Spiritual Enlightenment in the August 2001 edition of The Charismatics or return to the Main Menu by clicking on the blue.