Health Reform Has Changed Very Little

I talked to a director of one of our clinics this afternoon, who told me that three churches in his city have cut them out of their mission budgets because with the new healthcare legislation, they felt there would no longer any need for that clinic.

They are wrong.

I would love to tell you that is the only story like that I have heard. But I can’t. The day after the bill passed, a clinic in another state got a call from their largest grantor saying the same thing. My phone has rung off the wall for over a month from clinics with similar stories.

There is a lot of misunderstanding about what this health bill will do, and when it will do it. And unless we help folks understand what is REALLY happening, a lot of people are going to be even worse off than before.

The legislation that recently passed is mostly a good thing. Personally, I am happy about it, though I think it starts on the wrong end of the problem. 32 million other people will be happy about it, too – many of them patients who have been using our clinics for years. When the bill kicks into gear there will be some wonderful opportunities for Christian clinics and their patients, and some giant challenges, too.

…when the bill kicks into gear.

So here is the straight scoop…

• The bill doesn’t really kick into gear for the uninsured until 2014. That is a long time from now. We won’t see the full benefits of the bill until 2016.
• By conservative estimates 20,000 people die every year because they cannot get primary care. If safety net clinics like those in CCHF loose capacity between now and 2014, the number of people who suffer and die because they cannot get access to primary care will go up significantly.
• Estimates through the federal CBO say that even after the health reform bill kicks in, there will be 24 million people living in our country who will be uninsured. That is right. Of the 56 million people expected to be uninsured by 2019, only 32 million are going to be covered under this bill. That means that America will still have the largest number of uninsured people of any developed nation. We will still be #1 on the wrong list.
• The bill doesn’t magically create enough doctors to see the surge of 32 million new patients. There are still over 17,000 federally recognized medically underserved areas in the U.S. 95 million people currently live in those medically underserved areas. While this bill provides $11 billion to fund new health centers, there are not currently enough doctors in training to fill them – not even close to enough.

Thinking ahead to 2019…surely, 20 million uninsured is better than 56 million, right? So surely there will be less need. More than half of the patients coming to our clinics will be covered, won’t they?

Right now, reliable estimates are that all community health centers (FQHCs) and all free or “charitable” clinics combine to see less than 10 million uninsured people. Virtually all of these clinics are running at or above capacity. The current capacity of charitable and FQHC clinics is half of what will be needed AFTER health insurance reform kicks in!

• CCHF is affiliated with about 200 clinics nationally. About 20% are FQHC or Look Alike clinics (clinics that take Medicaid and receive federal funds), and just over 75% are “charitable” clinics (funded through private donations). Virtually all of our clinics are reporting increases in patient demand of 20% to 50% in the last 24 months. Every clinic I visit tells me with urgency in their voices about how many patients they are turning away every week. One clinic recently reported that they were turning away 150 patients per day because they are already operating well over capacity.

The other legislation that is impacting our world is the economic stimulus and recovery packages. The problem is that they are giving money to the wrong folks. The goal is to restore the institutions that got us into this mess to begin with. Corporate managers are paying themselves bonuses; but the folks who visit our clinics are still out of work, still under paid, still uninsured, still loosing their homes and still can’t afford their medications.

Here is the punch-line…

The economy is not looking up for the people at our end of the world. The poor are getting poorer. The need for Christian doctors to sacrifice time and salary to work among the poor in our clinics is great than ever and growing. The need for us to help these courageous, selfless providers care for the sick is greater than ever and growing. The most efficient and effective health care is being provided by Christian clinics - both charitable clinics and FQHCs. Empowering them to do more will have a direct impact on lowering the overall cost of healthcare in America. (Christian FQHCs rank in the top 5% of community health centers in terms of efficiency; and for every $1 spent, faith-driven charitable clinics provide $8 in health care.)

So health reform has not changed much. 30+million people have hope that 4 years from now they might be able to get insurance. But millions of those live in areas where they still can’t find a doctor who will see them. Well over 20 million people will still be uninsured.

We could quadruple the number of CCHF clinics and double the capacity of every current ministry - and still need more if we are to rise to meet the need in our nation.

It is going to take a movement. Even when reforms kick in. This is an important time for us to turn up the volume of our message.

The need is growing. The opportunities are great. Christ calls us to heal the sick and care for the poor. There are bothers and sisters who are answering the call. Lord, increase their number!