N.H. Town's Experiment With Universal Health Care

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A tiny New Hampshire town is practicing its own version of universal health care. For more than 80 years, the nurses of Tamworth have provided free care to every resident.

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STEVE INSKEEP, host:

A tiny town in New Hampshire is practicing its own version of universal health care. For more than 80 years, the nurses of Tamworth have provided free care to every resident.

New Hampshire Public Radio's Elaine Grant joined one of the nurses for a house call.

Ms. JOANNE RAINVILLE (Director, Tamworth Community Nurse Association): Isn't this beautiful? This is the area they call Wannalancit.

ELAINE GRANT: JoAnne Rainville is driving up a winding mountain road in Tamworth, a town of 2,500. Rainville is the town's full-time nurse and director of the Tamworth Community Nurse Association. We're headed to visit Marjorie Mather(ph). At 92, Mather lives alone in a white house hidden by towering pines.

(Soundbite of knocking)

Ms. RAINVILLE: Hello there.

GRANT: Rainville is here to give Mather a seasonal flu shot and just to make sure the tiny, blue-eyed retired librarian is okay.

Ms. RAINVILLE: How's your walking doing?

Ms. MARJORIE MATHER: Oh, I can - if I concentrate on it, I can walk.

GRANT: For the last nine years, this has been the rhythm of JoAnne Rainville's days. It's an old-fashioned kind of job, doing house calls for the sick and healthy alike and never sending a bill.

The Community Nurse Association was born in 1921 when a summer resident decided that Tamworth needed free nursing care. Back then, town nurses who traveled by horse and carriage or sleigh were common throughout the United States. But by the 1980s, town nurses were pretty much extinct, except in Tamworth, where Marjorie Mather can still get her annual flu shot in her own dining room.

Slowly, she clears her lunch dishes off of a cluttered table, sits and gamely holds out a delicate arm.

Ms. RAINVILLE: Okay. One, two, three, a little stick and a little burn. And that's it. You are inoculated.

Ms. MATHER: You haven't lost your touch.

GRANT: Like many rural communities, Tamworth has more than the average share of elderly, many who find it hard to get around. And then there's that other rural problem, not enough doctors. There's one doctor in Tamworth. He's so busy that he can't take walk-in patients. The town nurses do. Last year, Rainville and two part-time nurses fielded 7,000 visits, many in their clinic at the back of town hall.

Ms. RAINVILLE: We have people that come in here Monday through Friday. With lots of folks, it's just keeping a check of their weight, their blood pressure. But we have people come in that need sutures removed or a dressing changed.

GRANT: Susan Chelberg(ph) has brought her four-year-old daughter here since she was born. In this economy it's a lifesaver.

Ms. SUSAN CHELBERG: This winter was a difficult winter. My husband's a builder and our finances were really tight. And this was a Godsend.

GRANT: And not just for the Chelbergs. There's no industry here and the recession's made things even tougher. And so you'd think it would be harder than ever for the nurses to raise their $150,000 annual budget. It's not easy. Rainville writes grants and begs donors for gifts. But she can almost always count on taxpayers for close to a third of her budget. This year, at town meeting, voters said no to cost of living raises for town employees, but they funded the nurses, this time to the tune of $40,000. Selectman John Roberts wasn't surprised.

Representative JOHN ROBERTS (Republican, New Hampshire): Where else can you go Monday through Friday and walk in free of charge and see a nurse or just pick up the phone and call and they'll send somebody out to your home?

GRANT: Where else, indeed.

For NPR News, I'm Elaine Grant in Concord, New Hampshire.

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