Local clinics brace for more patients as healthcare reform takes effect
Theresa Day, 50, had been waiting two hours for her appointment at the To Help Everyone Clinic, a community fixture at 38th Street and Western Avenue for more than 30 years. A bus driver who lost her job and insurance, she tapped her finger on the chair and flipped through a novel. More than once, she walked down the hall to ask how much longer she would have to wait.
"This is awful," said Day, who suffers from rheumatoid arthritis and used to go to Kaiser. She says she never thought "in a million years" that she would need to come to a clinic for medical care.
As it struggles to care for existing patients, nearly 55% of whom are uninsured and 30% covered by Medi-Cal, the clinic is trying to prepare for more.
There are 1,250 federally funded clinics nationwide that provide healthcare and social assistance, surviving on a mix of grants, fundraising and reimbursements from government insurance plans.
The recession brought waves of additional patients who had lost jobs and health insurance, and the federal government provided $2 billion in stimulus money to help with the influx.
Millions more low-income Americans are expected to begin seeking out doctors and routine healthcare in 2014 when they become eligible for insurance coverage. The Obama administration sees the clinics as a proven model for serving disadvantaged neighborhoods and, just as important, a cornerstone of efforts to control costs.
Federal officials are investing $11 billion to increase the clinics' capacity and help address the major shortage of private doctors in poor communities. Health centers serve more than 20 million Americans and by some estimates could add 10 million more as health reform rolls out.
But the challenges are daunting. T.H.E. Clinic, like others across the nation, struggles to recruit and retain doctors because the pay is comparatively low, the pressure is high and the cases are difficult. Motivating patients to change unhealthy behaviors, show up for appointments and take medications is difficult. The clinics' future also depends in part of on the outcome of state and national elections, which could affect healthcare funding and policies.
It's a big bet that assumes the centers can attract new, insured customers and deliver cost-effective care that keeps low-income patients out of high-priced hospital emergency rooms.
The clinics are already feeling the pressure of competition, aware they won't be able to survive solely as providers of last resort for those who remain uninsured after healthcare reform is implemented. California clinics launched a new marketing campaign this month, calling themselves California Health+, a community health service network offering complete care "under one roof."
"This is our future," said Dan Hawkins, senior vice president of the National Assn. of Community Health Centers. "We're going to have a lot more paying customers, and whether they come back or not is going to depend on how we treat them."