Over the years, the rejection letters have piled up for Debra Buckley.
The 59-year-old Vancouver resident has visited about 40 dentists in Washington and Oregon to see if they can perform dental surgery that could have life-saving implications for her.
The problem is her Molina Healthcare insurance isn’t contracted with Washington to cover dental surgeries, so she has to raise money for surgery on her own — all $21,000 of it.
One rejection letter from a dentist in 2009 outlines alternative ways to find funds, while also expressing sympathy: “We sincerely hope these suggestions will help. We are praying for your complete health, dental and physical.”
Another letter from as far back as 2007 reads: “I’ve read your letter and am honored you contacted me. … Unfortunately, I’m not in a position to personally help you with your dental care at no cost.”
The Columbian covered Buckley’s dilemma in 2015. Portland’s ClearChoice Dental Implant Center will perform the work for out-of-pocket payment, but Buckley needs to raise another $15,000 for the most basic, essential surgery that runs to $21,000 — a more comprehensive surgery would cost $48,000.
She needs surgery to prevent possible deadly infections, but is too poor to afford it, and too unhealthy to work, and she’s afraid she might die waiting for care because of that.
In 2004, Buckley had two heart attacks and was placed on medications that included a blood thinner. She encountered gastrointestinal bleeding from one of the drugs she was taking, and underwent intravenous iron treatments because she was losing so much blood from her gastrointestinal bleeding. Those iron treatments have softened the enamel of her teeth, and caused most of her teeth to fall out.
‘In desperate need’
The act of just brushing her teeth can cause teeth to fall out. She mostly eats soups. Buckley’s mouth has become infected and it will continue to worsen with time. Since Buckley has heart disease, her risk of infections is increased. There is risk of the infections spreading to her brain or heart, she said, and people with gum disease have two to three times the risk of having a heart attack, according to Harvard Medical School’s website.
A 2015 letter from Buckley’s cardiology provider, nurse practitioner Kathy Stefan, outlined the importance of dental care for Buckley.
“She is in desperate need of dental work,” Stefan wrote four years ago. “There is a strong association between poor dental hygiene and cardiovascular disease.”
Buckley needs her three remaining teeth to be extracted, and a dental implant and dentures to be put in. Buckley’s prosthodontist at ClearChoice told her the procedure needs to be done “ASAP.”
Yet more than a decade after Buckley started visiting dentists for help, she is still stuck, hoping to find enough charitable donors to fix her health. Molina declined to comment for the story, citing patient privacy.
Buckley once had dental insurance when she worked as an esthetician. But she lost her job because of her heart complications, and can’t work now because of her iron deficiency and infections in the mouth. Now she makes $770 a month from Supplemental Security Income for disability. She can’t afford dental insurance, she said.
It’s a vicious cycle. She needs dental insurance to afford surgery. But she needs a job for dental insurance. But she needs to be healthy for a job. But she can’t get healthy without surgery. And she can’t surgery without dental insurance.
“I feel like there’s nothing I can do,” Buckley said. “It’s a hopeless situation.”
Her story is relevant in 2019 — a time when U.S. presidential candidates are discussing overhauls to America’s medical system so that health care is made more equitable and accessible. According to 2018 research data from the financial website Earnin and a Harris Poll survey of more than 2,000 adults, 54 percent of Americans delayed care for themselves in the past year because of cost.
Without options, Buckley has started a GoFundMe. She had one back in 2015, and only raised a couple hundred dollars. Her mother, Sandy, will take out a loan of close to $6,000, which she can’t really afford to do. Buckley has tried contacting notable wealthy people in the area. The generosity of strangers is her last resort.
It’s a trend that is becoming more and more common each year. In 2018, GoFundMe CEO Rob Solomon told Minnesota Public Radio that medical cost campaigns now account for one in three campaigns on the website. There are more than 250,000 medical campaigns on the website per year, and they raise more than $650 million per year, according to Forbes.
Jeremy Snyder, a professor in the Faculty of Health Sciences at Simon Fraser University in British Columbia, has been researching crowdfunding for medical needs since about 2015. In 2016, he published an article in the Hastings Center Report on ethical issues surrounding crowdfunding.
“Medical crowdfunding is a symptom and cause of, rather than a solution to, health system injustices … policy-makers should work to address the injustices motivating the use of crowdfunding sites for essential medical services,” Synder wrote in the abstract of the report.
Snyder told The Columbian in a phone interview that crowdfunding can “literally save lives” and make a significant positive impact on people. He understands why people need to utilize crowdfunding platforms for medical care, but has concerns.
“We should be happy for people it has worked for, but at the same time aware that this is not an effective solution to the underlying problem of insufficient access to health care,” Snyder told The Columbian.
Snyder said crowdfunding can have its own inequity problems. He explained that people who have larger social networks, more wealthy friends and higher education levels generally did much better with their crowdfunding campaigns than those who didn’t have those things.
He also said crowdfunding can come at a cost to people’s privacy — they have to share vulnerable medical and personal information to not only gain people’s trust, but also engender their sympathy.
When Buckley’s son created her first GoFundMe campaign about four years ago, they encountered online harassment. It only raised about $200, and people wrote derogatory statements about Buckley’s weight. It made her feel like giving up. But Buckley’s son, Anthony Lee, who is now 30, has pushed her to keep going. She takes solace in his love, the love of her mother and her 3-year-old grandson, Ailo Grey.
Buckley could have another uphill battle with crowdfunding this time, but it’s the only option she sees. The last four years have taken a mental and emotional toll, too. Her family is scared to lose her. Buckley has felt depressed through much of her search for help.
“I have to deal with this from when I get up — it’s on me. It’s how I look,” she said. “Even when I try to put on a little bit of makeup, I still feel hopeless.”