The latest estimate attaches a price tag of $1.5 trillion, over 10 years, to the national health-care system overhaul. Questions abound about whether this is the best approach to providing the 43 million uninsured Americans with health insurance. But maybe we’re asking the wrong questions. In searching only for an insurance answer, we may be overlooking an opportunity to utilize a hidden jewel in our state: the community clinic system.
The 7,000 community clinics throughout California specialize in providing low-cost, high-quality health care to 7.6 million low-income, racially and ethnically diverse Californians. This health-care safety net consists of primary-care clinics operated by governmental entities, tribal organizations and nonprofits.
Community clinics often act as certified enrollers for a plethora of government reimbursement programs. It is estimated that one-third of the 43 million uninsured people in the United States qualify for government coverage plans already in place; but they aren’t signed up. Therefore, by using the services of community clinic enrollers, 15 million uninsured people would be covered immediately upon enrollment.
California’s unemployment rate escalating from 7 percent to more than 11 percent in the past year has resulted in a 50 percent increase in uninsured seeking health care at community clinics. At the same time, the clinics’ trademark of cost efficiency and quality of care remain high. Instead of looking for ways to provide insurance for the millions of uninsured patients, perhaps we should be searching instead for ways to remove the barriers to quality health care. Maybe it’s not a question of insurance but rather a question of access. Or at the very least, maybe it’s a combination of both: insurance and access.
In general, there are three groups of people without health insurance: those who can’t afford it, those who don’t want it and those who can’t get it. People who don’t want insurance are often those who feel invincible or who don’t want to be bothered with the hassle. Many can’t get insurance because of pre-existing conditions. However, those who don’t have insurance because they can’t afford it may be best served by the already established, already successful, already proficient community clinic system.
Most community clinics also specialize in prevention education for diabetes, cancer and other diseases. Research shows that prevention is far more cost-effective than treatment of diseases. For example, one in five elderly hospital patients re-enter the hospital within one year of discharge. The cost to Medicare is $17 billion.
Keeping patients healthy by being proactive with prevention education is the most cost-effective strategy to keeping Americans healthy and keeping the health-care price tag low.
— Cynder Sinclair is executive director of Santa Barbara Neighborhood Clinics.