It’s not yet 5 a.m., but people are emerging from their cars, a few scurrying to pack up tents and camp stoves, bustling to be ready, hoping to have the opportunity to receive health care.

As wisps of pink sunlight began coloring the clouds, the masses huddle at the gate under a misty dawn, waiting for their numbers to be called.

The grassy parking lot is full. Beyond the fence, the cars are stacked up for miles. A snake of headlights is visible in the semi-dark along the curvy length of Hurricane Road, waiting to access the Wise County Fairgrounds.

These are the modern-day breadlines: people desperate not for food, but for health care.

“We are working taxpaying jobs, paying taxes, and we can’t get insurance because we make $6.55 an hour,” said Laura Head, 32, of Rogersville, Tenn., the first person in line Friday for the first day of the Remote Area Medical clinic, an annual three-day event offering free medical care. “This is really a great beneficial thing, but it doesn’t have to be this way; we could all have insurance.”

A single mother of three who mows yards and moves trailers for a living, Head said she arrived at the fairgrounds Tuesday, to camp out at the fairgrounds until the health fair began Friday morning. Her motivation was simple: severe, constant pain.

Close to two years ago, her boyfriend smashed her teeth, she said – but, without the $6,000 needed to have the teeth pulled she has endured infection after infection, making literally 100 visits to the emergency room for antibiotics and pain medication.

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The lack of access to health and dental care is not an Appalachian problem, he said – it’s a problem all across the nation.

“Emergency rooms act as the safety net in this system,” he said, “and that’s at the breaking point.”

Even as a national health care reform bill is prepared for debate in Congress, more than 1,400 volunteers descended on Wise on Friday, with hundreds more signed up for the weekend – but even they were not enough to help everyone seeking care.

“We’ve never had the traffic problem that we had this morning,” said Teresa Gardner, executive director of the Health Wagon, the local organization that coordinates the event. “It’s a record-setting day for sure.”

The work will continue today and Sunday.

Stan Brock, the founder of RAM, said 1,600 numbers were given out Friday to people seeking care – compared with 1,200 last year on the first day. He said the event here has grown every year.

“It’s been like this for years and years and years,” Brock said. “This is not a recent phenomenon, and it’s not peculiar to Southwest Virginia. … Two weeks from now we’ll be in Los Angeles, Calif. – same problem.”

Approximately 2.7 million people in Los Angeles County (or about 28% of the population) have no health insurance. It is the third highest uninsured rate of 85 metropolitan areas in the nation. About 31% of all Los Angeles County residents age 64 or less are uninsured. Two million of Los Angeles County uninsured persons are adults, ages 18 to 64 (about 34% of the county adult population).