Friday, September 29, 2017

Congress should fund Community Health Centers

Funding is running out for community health centers and without action by Saturday about 2800 community health centers would close across the country and eliminate access to about 9 million patients. Altogether, community health centers serve about 27 million people and about 70% of the funding comes from Congress. (link) It is anticipated that the funding will pass and it should.  Bitterness over other health care policy and partisanship should not endanger this safety net.

Unless one works in the non-profit sector or has been without insurance themselves, they may not know about community health centers.  For the homeless, the poor ineligible of medicaid (or prior to the Affordable Care Act for those who were denied insurance due to preexisting conditions), the safety net was community health centers. In the debate over health care, emergency rooms were often mentioned as the health care safety net for those without insurance and having worked with low-income people most of my life, I know that that is true. That is often true however because of poor decision making on the part of the poor rather than that being the only choice. Even when Tennessee had the generous Tenncare program that was bankrupting the State, many poor still went to emergency rooms instead of making doctors appointments.

In Nashville there are a variety of these free clinics. Some of them specialize in specific types of services and limited service such as clinics serving people with HIV or clinics serving children in a school setting, but some are like the Vine Hill Clinic that provides a full range of services. The clinic accepts Medicare, Medicaid (TennCare) and most private insurance is accepted but those without insurance are  charged under a sliding scale model based on what they can afford. It is not free for everyone and clients are required to prove financial need in order to receive free services or services at a reduced cost. No one is denied service because they cannot afford it or do not have insurance.  This center covers services such as checkups, treatment, pregnancy care, immunizations, child care, prescription medicine, and mental and substance abuse treatment.

My view of health care is that we should institute reforms that provide a free market solution for most people, a subsidized high-risk pool for those with preexisting conditions but income to otherwise afford insurance, and community health clinics for everyone else.  Unless we have a complete federal government take over of health care and end up with some sort of National Health Service, we will still need clinics like Vine Hill for those in need.

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