Michele Bachmann told a crowd over the weekend that Americans can rely on charitable organizations if they cannot afford health care. I actually saw evidence of this over the weekend in Los Angeles. But even this charitable foundation understands that there is no substitute for getting Americans enrolled in some mechanism that can get them the continuing care everyone in this country needs.
At the LA Sports Arena last week, the non-profit CareNow USA ran a free medical, dental and vision care health clinic, which brought in thousands of uninsured Los Angeles residents. There are a staggering two million uninsured residents in Los Angeles County, as many people as the entire population of the state of Nevada. The floor of the arena was full of medical professionals dispensing a variety of care, including dental and vision services, mammograms and other women’s health, immunizations and vaccinations, meditation, acupuncture, HIV and STD testing (a sign announced “results in about 20 minutes”), pharmaceutical services, and more. Most of the patients treated at the clinic were uninsured, but a substantial amount were also underinsured; one of the reasons that dental care dominated the floor space at the clinic is because of major cutbacks to dental care through Medi-Cal, the Medicaid system in California. “I’m waiting for my number to be called,” said one lady in line for dental care. She was number 484, and by midday Saturday they were at 450.
I came to the free clinic expecting to be a little despairing. In the richest country in the world, we still have 50 million uninsured people, many of whom have to rely on clinics like you would see in the Third World for their primary care. And there’s a serious capacity problem. A four-day clinic cannot possibly accommodate the needs of 2 million uninsured residents. Indeed, patients had to choose between dental or vision services, unable to receive both at the clinic. There just isn’t enough help that you can give from a charitable perspective.
But this is where the CareNow clinic got smart. Because a substantial amount of effort was put toward ensuring that all eligible LA residents were able to sign up for some continuing or follow-up care to ensure that they got the help they needed on a rolling basis. In addition to the medical services, a variety of booths offered other services to those assembled. There were signups for preventive measures like anti-smoking programs and preventive dentistry (lots of floss and toothbrushes on hand) and even financial literacy, emergency preparedness and fair housing (housing is the source of quite a bit of illness in low-income communities). Subway sandwiches were given out to attendees, and a lot of free information and gifts were available at the booths. “You can visit all of these places and fill your bags up,” one volunteer told an attendee.
But other booths promoted existing programs to ensure coverage for the uninsured. Healthy Way LA, a program out of the city’s Department of Health Services which provides no-cost care through a state-federal Medicaid grant, was well represented at the event. The program, which has been around for six years, just expanded on July 1, with a goal of reaching 177,000 uninsured residents in the city. And the free clinic was an excellent site for recruitment. “It’s a popular program here today, we have signed up hundreds of people to get more information,” said Frank Martinez, the Marketing Representative for Healthy Way LA who manned the booth on Saturday. They were taking names to follow up for future contact at the clinic, so they can check eligibility and sign them up. “The word of mouth has been tremendous through the media. A lot of people come here already knowing about us,” said Martinez.
Other providers, like LA Care, which offers Medi-Cal, Healthy Kids, Healthy Families and Medicare Advantage plans, were handing out information at the event. “We like events like this where we can educate people on what’s available,” said the representative of LA Care. Additional booths set people up with a low-cost health insurance connector.
Healthy Way LA sets residents up at a “medical home,” typically one of the many community health centers in the city, and allows them to use it for all their medical needs on a rolling basis. In fact, one of the central focuses of the clinic was to match people up with their medical homes at the city’s community health centers. Before leaving, each patient was routed to a follow-up checkout, where city residents would be looked up by zip code and medical needs and referred to representatives of the community health centers in attendance. Aftercare providers were also notified. “I got an appointment for a followup,” said one patient. “I have potential glaucoma because of a family history, and so they gave me a referral.”
It was great to see the focus on getting continuing care at this event. Contra Ms. Bachmann, charity cannot possibly fill the needs of the uninsured. But lowering the rate of uninsured will, and a lot of the barriers here are just public education about their options and alternatives. With community health centers, locally-based programs for low or no-cost care and the expansion of Medicaid, we can truly make a dent in the uninsured without putting hardships or burdens on the individual. And a lot of dedicated people are trying to make that happen.