Bram Sable-Smith

Reporter, KBIA

Bram Sable-Smith is a reporter with Side Effects and lead reporter on the KBIA Health & Wealth Desk. A native Missourian, he’s documented mbira musicians in Zimbabwe, mining protests in Chile, and a lobstering union in Maine. His reporting from Ferguson, Missouri was honored by the Missouri Broadcasters Association and won a national Edward R. Murrow Award. Bram cut his radio chops at the Salt Institute for Documentary Studies in Portland, Maine.

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Bram Sable-Smith / KBIA/Side Effects Public Media

Earlier this year, 69-year-old Aneita McCloskey needed her two front teeth filed down and capped.

“They were kind of worn down and they were also getting little tears and cavities,” she recalls.

Without dental insurance, McCloskey is on the hook for the full $2,400 cost of the procedure. She was given 18 months to pay it before she gets charged interest. That’ll be hard to do on her fixed income.

In years past she would have had to wait to see the dentist again until she could afford it.

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One year ago, while reporting on infant mortality rates in Kennett, Missouri, I met a 27-year-old expectant mother named Marylouisa Cantu. She was pregnant with her seventh child.

Her sixth child, a daughter named Alyssa, was born two years earlier and had spent two weeks in a neonatal intensive care unit due to complications from premature birth.


Bram Sable-Smith / KBIA/Side Effects Public Media

At Richard Logan’s pharmacy in Charleston, Missouri, prescription opioid painkillers are locked away in a cabinet. Missouri law requires pharmacies to keep schedule II controlled substances—drugs like oxycodone and fentanyl with a high addiction potential—locked up at all times.

Logan doesn’t stop at what the law requires.


The rise in opioid drug abuse and gun violence have led to recent calls to overhaul the nation’s mental health care system. But a law passed by the U.S. Congress in 2014 is already driving a big new experiment in mental health care.  

Bram Sable-Smith / KBIA/Side Effects Public Media

Before you buy a computer, or a used car or even a pair of pants, you probably know the price you'll pay. The same is not always true when buying health care.  But as people pay and more of their health care costs—thanks in part to high-deductible health plans—there's growing demand to know prices upfront. It's a concept known as price transparency.

One hospital in rural Missouri is catering to that demand, by developing a price-list for medical procedures. For help, the hospital is turning to a group who've been getting price transparency for years: the Amish and Mennonites. 

Bram Sable-Smith / KBIA/Side Effects Public Media

Missouri psychiatrist Joe Parks remembers working with a patient named Victoria.

For eight years he helped her with PTSD, manic depression and addiction, getting her into drug treatment, and back into school. And then, she died of a blood clot brought on by her poor physical health.

“Her behavioral health treatment had been a complete success,” Dr. Parks recalls. “She was stable, she wasn’t psychotic, she was clean and sober. But she was dead.”


U.S. Department of Agriculture

When 85-year-old retired farmworker and grandmother Amparo Mejia needed surgery on her spine because of a rare form of tuberculosis, she was able to pay for the procedure through emergency Medicaid. She was lucky. For many low-income immigrants – even those authorized to work in the US – it can be challenging or outright impossible to get health insurance. 


Bram Sable-Smith / KBIA/Side Effects Public Media

One Saturday afternoon at a backyard cookout, St. Louis, Missouri, architect Dan Rosenberg enjoyed a cheeseburger – a food he’d enjoyed many times before.

That night, a couple hours after he went to sleep, he woke up with a searing pain in his stomach—pain he describes as “a nine on the ten-scale.”


Bram Sable-Smith/Side Effects

When Darvin Bentlage needed colon surgery in 2007, he had an expensive stay at the hospital.

“The room alone for a week was $25,000,” Bentlage says. Add in the cost of the procedure and, “it added up to about $60,000 or $70,000.”


Bram Sable-Smith / KBIA/Side Effects Public Media

When cattle farmer Greg Fleshman joined the board of Putnam County Memorial Hospital in rural northern Missouri in 2011, the hospital was on the brink of closing.

“Things we just falling apart financially and the morale of the employees. And it just seemed to get worse and worse,” he recalls. “Those were the darkest days.”


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