Around 28 million Americans do not have health insurance, with over a third of these people belonging to the Hispanic community. This statistic will no doubt be reflected when they cast their votes in the US presidential election on November 3.

Matilde Ríos is one of the primary care physicians at the CommunityHealth centre in Chicago, the largest free clinic in the United States, a safety net for people without medical coverage in the third most populous city in the country. Around 60% of his patients are Latino.

It is no coincidence that the Hispanic community has the highest percentage of people without health insurance in the country – here Euronews examines why.

Originally from Uruguay, Ríos specialised in cardiology and now has more than three decades of experience. She also has the advantage of being able to address her patients in their mother tongue, without the need for a translator.

For non-Spanish-speaking doctors, the clinic has a team of interpreters to facilitate communication between healthcare personnel and patients. Polish translators are also available, with Poles constituting the second-largest linguistic group after Spanish and English.

“You can see the change in their faces when they arrive at the counter and someone speaks to them in Spanish and opens the door and says ‘come in, Mrs Hernández or Mr García’,” Sergio González, a medical student at CommunityHealth and the son of Mexican immigrants, told Euronews.

He began volunteering at CommunityHealth as a Spanish translator six years ago.

Fear of going to the doctor

To be cared for at CommunityHealth, patients must show that they do not have health insurance and that their household income is below the state poverty line. Most work but do not have access to insurance via their employers. Half suffer from chronic diseases.

“Many of the patients who arrive have not received any medical attention,” says Dr Ríos. “They are diabetic and they don’t know it. They have high blood pressure and they don’t know it. So we find out and started treating the condition.”

This Uruguayan doctor says a common profile that comes through her doors is that of an immigrant who has been living in the country for some time but still does not have a residency permit.

“People who have been here for years, who have all their family here, whose children were born here, but the parents remain undocumented, segregated,” she explained.

They are often people who have not visited a doctor for a long time. González says people have often not been to the doctor for years.

“They are afraid of resorting to medical services in the United States because they think that if they do not have documentation, they will leave a trace of their names,” the medical student said.

They fear that if they register at a clinic, they will hinder their children’s chances of obtaining US citizenship in the future, that’s why patient confidentiality is vital CommunityHealth, González said.

These individuals are just some of over 11 million Latinos without health insurance in the country – a figure that the coronavirus pandemic will inevitably increase due to job losses.

“This is a clear drama. To have good insurance you have to have a good job,” explains Dr Ríos. “If you lose your job, you lose insurance and that is what has happened to a large percentage of our patients.”

‘I have more freedom than when I worked in private medicine’

Dr Ríos is clearly proud of the services that the CommunityHealth clinic provides for free, including medical and dental visits, a pharmacy and psychological support. She describes this as “incredible” adding: “There is no one in America who has free dental service, cavities, extraction, cleaning.”

“We have a pharmacy and all medicines are free and we have excellent pharmacists who help us. If the medicine I want is not there, they will give me a very similar one,” continues the doctor. “We have a laboratory. I can order all the tests I want… I have more freedom than when I worked in private medicine. “

The clinic is financed by donations from private foundations, companies, hospitals, and individuals. The staff consists of 1,000 volunteers – Doctor Ríos and González are two of them.

Ríos began her studies in her native Uruguay but decided to leave the country when it was a military dictatorship. She settled with her husband and daughters in Chicago in 1984, after living in Rochester and New York, where she earned her medical degree and began practising in the private sector.

“It was very frustrating,” Ríos recalls. “Not patient-friendly and doctors just wanted numbers.” She says that she studied medicine because she wanted to help people, which she feels like she is doing at CommunityHealth.

González participates in the ‘Promotores de Salud’ programme, in association with the University of Illinois to educate and assist patients on issues related to their health, such as explaining a diagnosis or how to improve their diet. “They saw us in the white coat and said ‘wow’, that could be my grandson, my son or my nephew,” explains the reception of Hispanic patients.

Healthcare’s influence on ballots

Health, the coronavirus crisis and the economy form the triad of issues that will inform Latino votes.

“These three things are connected – the second two determine health,” González says. “If the patient is affected by the pandemic at work, then they will be worried and it will affect his mental health. It is a chain of things that are impacting one another.”

Access to healthcare worries 76% of Latino voters – almost 10% more than the average American voter – according to data from the Pew Research Center.

This could be costly for President Donald Trump given his repeated attacks on the Affordable Care Act (ACA), better known as “Obamacare”.

The Latino population benefited greatly from the health law approved by former President Barack Obama – four million adults and 600,000 children in the community received health coverage through it.

But this law has been Trump’s bête noire after he promised to annul it in the previous election campaign, “to repeal it and replace it with something great,” in his own words. But he has returned to the campaign trail after being in office for four years with Obamacare still in force.

“It could be eliminated if the Republican Party wins and this represents a huge problem for all those minorities living through a pandemic,” virologist Xiomara Mercado López told Euronews.

An October 14 poll from pollster Latino Decisions indicated a majority of the Hispanic community (59%) was very concerned that the Supreme Court may abolish Obamacare after the death of the iconic Judge Ruth Bader Ginsburg and the Republican nomination of conservative Catholic Amy Coney Barrett.

“The Latinos in Chicago are very concerned about what their medical services will look like, depending on who wins the election,” González said – a concern that he says will also be reflected on his ballot.

The pandemic has made healthcare an even more predominant theme of this election.

“More and more people are coming in who have lost their jobs, lost their insurance,” said Dr Ríos. “It is very sad. A very difficult time is coming for our population.”

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