News From AmeriCares Free Clinics

Editorial: Free Clinics Left out of Stimulus Package

Karen Gottlieb, executive director of AmeriCares Free Clinics, wrote this Op-Ed for Hearst Newspapers. It was published April 4, 2009 in the Connecticut Post, The Advocate, Greenwich Time and The News-Times.

Health care in the U.S. was in a crisis long before the pink slips started coming. More than 300,000 Connecticut residents were among the country's 47 million uninsured before the economic troubles began – and the numbers continue to grow daily as more workers lose their jobs and health insurance.

Here at AmeriCares Free Clinics, serving the communities of Bridgeport, Danbury and Norwalk, we don't need to see the latest unemployment statistics to know the struggling economy is affecting our neighbors. We see it in the faces of the newly unemployed patients who come to us seeking care or help with prescription drugs they can no longer afford. Our clinics serve low-income, uninsured residents and have never been busier. Our staff and volunteers have been overwhelmed by the influx of new patients since late summer and early fall. Patient visits are up 33 percent in Bridgeport; 25 percent in Norwalk and 13 percent in Danbury. Those numbers would be even higher if we had the resources to accommodate everyone who sought our services.

While the federal stimulus package includes a significant investment in health care – funding for Medicaid; money for hospitals serving a disproportionate share of low-income patients; COBRA subsidies that allow laid off workers to continue their health insurance; funding for federally qualified health centers – free clinics like ours appear to be left out.

The AmeriCares Free Clinics catch the people who fall through the cracks in our imperfect health care system. We serve the people who earn too much to qualify for government assistance programs like HUSKY, yet cannot afford to see a doctor when they are ill. Our patients could go to federally qualified health centers, which charge patients on a sliding scale based on their income, but most cannot afford the fees. Without us, many of our patients would rely on hospital emergency rooms for primary care or choose not to see a doctor at all; risking more severe health problems requiring costlier treatment down the road.

Our cost-efficient model, which relies on a network of over 400 volunteers and donated services, allows AmeriCares Free Clinics to provide nearly $4 million worth of free medical care annually on a budget of less than $2 million. It's an incredible value to both the low-income Fairfield County residents we serve and the taxpayers who don't have to pick up the tab for uninsured patients using the emergency room like a doctor's office. Like many nonprofits dependent on charitable contributions, we are seeing a decrease in donations just when the demand for our services has never been greater. I suspect many of the other free clinics across the state are facing the same dilemma.

Already, our Danbury clinic – the busiest of our three locations – has temporarily stopped taking new patients, unless there's an urgent problem, because we cannot keep pace with the rising demand. Some of our new patients recently lost jobs and their employer-sponsored insurance. Others are self-employed and have paid for health care out-of-pocket in the past, but can no longer afford it because they are working less often. These are some of the state's most vulnerable citizens who have been hardest hit by the economy. The state and its communities have a moral obligation to step in to ensure there is no disruption in the health care services they rely on.

We understand the enormous challenges the state and Congress are facing given the challenging economy, but urge our legislators to support funding for programs that provide free health care for their neighbors who would otherwise go without.

Free clinics shouldn't be a necessity, but until there's national health care reform, it's the only option available for some. Without clinics like ours, many people would go without vital prescription medicines and life-threatening health problems would go undiagnosed. If funding limitations force free clinics to curtail services, the costs will be borne by all state residents one way or another. Those with health insurance will pay higher taxes and premiums to subsidize hospitals treating uninsured patients with exacerbated medical conditions, which are more costly. For uninsured residents who delay critical treatments, such as cancer screenings, the stakes are even higher. They could pay the ultimate price – with their lives.

Karen Gottlieb, R.N., M.BA., is the Executive Director of AmeriCares Free Clinics.