I spent a little time this weekend in a food line for the needy, and used the opportunity to find out more about the poor's perception of free clinics. For one, these clinics are not open enough. Both free clinics in Athens that I am focusing on are closed on Saturday. Even the Athens Neighborhood Clinic is closed on Saturday.
After interviewing a board member from one of the clinics today, they said that the only thing holding them back from being open ALL the time is volunteer pharmacists and physicians. We'll return to this issue in a later blog entry.
There are hundreds of these type clinics in the United States, and according to a UVA study, they are only open about 30 hours per week, and less than a third have a licensed pharmacy. So, Athens and her free clinics are on par.
Free Clinics are non-profit organizations for the most part. Being a non-profit executive, I can really appreciate the challenge that they face to raise a budget, train volunteers, make a payroll, and comply with the IRS regs. They are, however, an important part of our medical safety net.
Like many other associations, there is a National Association of Free Clinics that can help with resources, lobbying, etc.
Public Health is defined as “what we as a society do collectively to assure the conditions in which people can be healthy,” according to a 1988 Institute of Medicine report entitled The Future of Public Health. We usually think of public health as a clinic though, like the Athens Neighborhood Clinic. These are a part of our public health system and face their own set of challenges.People can use their Medicare for these clinics or pay a small co-pay. The lines are long and they have to balance their patient load between those paying with Medicare and those who can only pay a co-pay. The result is that many people do not get seen.
The problems are immense, and there is no easy answer. Alan Greenspan was on the circuit promoting his book this past week. In it, he says that the Medicare System will go bust by 2019 unless something significant is done. Wealthy Americans can expect a 100% co-pay.
Outspoken ACC Commissioner Elton Dodson told me, "It is absolutely criminal what we have allowed our health system to become in this country. No civilized western country treats their people the way we treat our people when it comes to health care.
So what is the answer? How will it impact our Health Workforce? Can we help our citizens attain quality health care without moving to a system that rations out services? Can we work within our free markets system to maintain the financial incentive doctors want after investing so many years of their life?
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4 comments:
This is certainly a problem I'd say. What, if anything, can I do as a citizen of the general public about issues like this?
When working on this story, be sure not to confuse Medicare (public insurance for people over 64) with Medicaid (public insurance based on income). I'm surprised the free clinics are seeing many elderly people, unless these Medicare beneficiaries are unable to find local physicians who accept Medicare assignment.
Noting your concern about physician compensation, you might want to consider whether being licensed as a physician guarantees one a certain level of income or -- in the case of certain specialties -- an almost unlimited income. (I'm thinking here of Park Avenue dermatologists and the like, who specialize in elective procedures for wealthy folks.)
Staff-model HMOs, such as Kaiser, manage to attract excellent physicians who work on salary. Would something like this help in ACC?
You're right. Our health care system is critically flawed. Free clinics are a crucial part of our medical system, but it's difficult to sustain the volunteer workforce necessary to provide care on a daily basis. What are other solutions?
p.s. Kudos to you for helping out with the food line. I can't imagine with 7 kids and grad school you have a lot of free time to devote to charity. I believe every little bit helps.
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