Sunday, April 12, 2009

Community Health Care- your tax dollars working!

As our current economic crisis is evolving, health care is taking a huge hit for many families.
Add up the rising costs of everything, and many individuals and families are forced to gamble on staying healthy while stopping any health insurance they have. Then include in the equation the number of people without insurance due to downsizing and layoffs, you hit a terrifying number of individuals and families who are simply without the means to meet their needs for basic health.

Fortunately there is a network of community health centers in the country, acting as a safety net for those tumbling out of the normal working class system of insurance. These centers are typically funded through grants along with federal and state tax dollars. Tobacco taxes along with the settlements of tobacco companies, while the daily frustration and resentment of smokers, is often a consistent resource of much needed funding.

These centers provide a health care home to recipients of Medicaid and Medicare. Fewer and fewer private practices can continue to make ends meet with the shrinking reimbursement rates and slower payment times, and are simply forced to continue providing services in order to stay open and meet the needs of those with private insurance.

These clinics also provide insurance to those who need a safety net, including the uninsured and those whose resident status makes any sort of other coverage impossible. (this is not a forum for immigration issues, but the reality is that without some available clinic, we would have migrant workers unable to harvest our food, children with no health care, mothers with no prenatal care, and tragically sick members of the family of humanity)

My clinic is part of the Salud Family Clinic system. Salud means health in Spanish, and much of the original focus was providing affordable care to migrant families. (The clinic still runs a mobile unit, making rounds of farms and small communities in Eastern Colorado along with all clinics being along the front range,northern I-25 corridor and Eastern plains) With much of the staff being bilingual, and a cultural awareness focusing on the Spanish speaking community, we now meet the needs of thousands of Colorado families who would have little to no health care otherwise.

Of course our system is overwhelmed. We see more patients than in any way is possible, work in consistently busy and challenging conditions, and do our best to provide the very best care that we can in spite of the day to day mountains we face. The pay is less than average, the day entirely too full, and the clinic more overcrowded and dingy than private practices. But every single day we are appreciated. We know at any given moment we impact lives deeply. Despite at times feeling as if we provide a huge quantity of care instead of a huge quality of care, we know deep down that we do incredible things with every task, every smile, and every breath.

Not only that, but I truly work with some of the best coworkers I have had the privileged to work with in my entire life. We keep each other laughing, keep each other going through the rough times, and hold each other up when we feel as if we might fall into frustration. The only reason we are there is because we choose to be. There for our patients, and there for each other. Our bonds are the sort that can only be forged by challenging situations survived over and over.

Of course, we are being stretched even further every day. A system already bulging at the seams is squeezing in even more pieces.Each provider sees an average of 28-30 patients a day, which when you add it up should be a 24 hour day in and of itself. Each patient encounter includes labs, referrals, vaccines, prescriptions, procedures, counseling, education, so on and so on.

I could keep you here telling you heartbreaking stories of the families in our clinic. The single mother who now struggles with MS. The undocumented woman who is left behind, along with 4 children, by a husband killed in a tragic accident. The young 30-something white male who can no longer work construction due to a painful hernia which he desperately needs surgery for. The father of 2 with one on the way, always struggling to get by and now diagnosed with uncontrolled diabetes. The young person with Aids, the developmentally disabled, the mentally ill. On and on and on and on. Every face is a new story of good people.

We found out Thursday that the clinic has received additional funding that will allow us to be open until 9 at night (currently closing at 5 now) and Saturdays. The number of patients we will be able to care for has just increased dramatically. For the families for whom a missed day of pay in order to go to the doctor means a bill unpaid, groceries un-purchased, this can mean the difference between surviving or not.

The news is so new that we are not entirely clear at the bottom levels where the funding came from, but we suspect it is our share of the increased health care funding our current administration has injected into the struggling system.

If you wonder just what those dollars are being used for, here is your story. In this case it is not about mismanagement by those in power. It is not about overspending, consumerism and dishonesty or thoughtlessness. It is 100% about good people, a struggling country, and the basic right to health.

It is good news in hard times. Isn't it about time?

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