Use Of Federal Health Clinics Soars

LEESBURG, Va. -- Federally funded health centers, originally created to serve the poor, are seeing a surge of patients as more Americans struggle financially.
The centers are on track to handle more than 20 million patients this year, up by more than two million from last year and twice the figure of a decade ago, according to surveys by the National Association of Community Health Centers.
"They're seeing lines out the door," said the association's research director, Michelle Proser.

On a recent afternoon at the Loudoun County Community Health Center here, patients came in at a rate of one every two minutes. Operating chief Stephanie Kenyon said the waiting list has jumped to 500 from 20 in a few months. Some of the new patients are college-educated and, until recently, held jobs that put them in the middle class.

Former President George W. Bush doubled financing for the centers, bringing their number to 1,200 nationwide. President Barack Obama included $2 billion for them in his stimulus package, and a House bill would add $38 billion over a decade. That could double again the number of patients treated.

The centers are addressing in a smaller way two issues that also underlie Mr. Obama's health-care proposals: lack of access to care and high costs. The uninsured often need pay only $20 or so for an appointment with a center doctor. The no-frills centers receive block federal grants for much of their funds and pay medical staff a fixed salary, so they have little incentive to jack up costs with unnecessary care.
Still, they're no panacea. Many centers have long waiting lists, and they offer only basic services. Uninsured people who need heart surgery or an MRI still must rely on charity care from a hospital, their own savings or other means. Any attempt to provide more comprehensive care at centers would require significant federal money at a time of concern over spiraling budget deficits.

Loudoun County, in the more distant Washington suburbs, was once the richest county in the nation, but the housing bust hit it hard.

O'Delia Mandrell, 57 years old, said she got "pretty desperate" last year and went to the center for the first time. The former Navy reservist won't receive full health benefits until she turns 60, and said she had to quit working other jobs because of a virus that has weakened her body. Doctors think it may be Lyme disease.
"They haven't charged me a dime and really work with me 100%," she said.

"There is a different group of folks coming in now who might not have come in in the past," said Dan Hawkins, policy director at the national health-center association.
Community health centers charge patients on a sliding scale, usually starting at about $20 a visit and going up to several hundred dollars for the more affluent. Occasionally, those without money can get care for free.

The average cost to the center is about $145 a visit, according to national data from the Health Resources and Services Administration, which oversees community health centers. That's a lot less than it costs hospitals when the uninsured use emergency rooms for treatment of everyday ailments that aren't emergencies.

A new report by researchers at George Washington University estimated that additional funding for centers in the House bill would save the health-care system $212 billion to $251 billion over the next decade, in part by reducing the number of visits to hospitals and more highly paid private doctors.

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