Are free clinics a better option than government health insurance ?

[Modelworks]

Where I live there are a lot of poor and very low income people. People that make less than $12,000 a year. In this county there are clinics in each city that are focused on low income families. The clinics are operated by a company that receives public and private funding.

The service they provide is so good that I go there when I could go to the expensive, supposedly high end care place. I pay with insurance, but they also take people with no insurance. They charge based on a sliding scale. People with no insurance can be seen for $25 a visit. X-ray are done at cost, lab work is also $25 regardless of the test performed. Anyone can walk in when they open in the morning and be seen that day. They have full service at the place, pediatricians, ophthalmologist, therapist, general practice and dentist. If one clinic doesn't have what you need then they refer you to one of the other ones. It basically operates as a non profit clinic.

To me this solves the problem with health care. If you want to pay for 'better' care you can do so, if not you can find your own methods.

Would it be better for the government to set up clinics like this where they can control cost however they want ?


This is the website of the company.
http://www.goshenmedical.org/index.html

 

[Jiggz]

Your example is like the previously mentioned "Coops". They are feasible and probably better option than direct gov't run hospitals. However, as these coops increase in numbers and sizes, corruption starts to set in. So oversight from a non-partisan organization with prosecution capability should also be established.

 

[Phokus]

Originally posted by: Jiggz
Your example is like the previously mentioned "Coops". They are feasible and probably better option than direct gov't run hospitals. However, as these coops increase in numbers and sizes, corruption starts to set in. So oversight from a non-partisan organization with prosecution capability should also be established.

Healthcare co-ops don't work and are just another example of terrible free-market ideas from libertarians and conservatives. Now if they have government funding/regulations to go along with it, they might work.

http://healthcare-economist.com/2006/08/17/pacadvantage-adverse-selection-death-spiral/

PacAdvantage: Adverse Selection Death Spiral

August 17, 2006 in Current Events, Health Insurance

The adverse selection death spiral has reared its ugly head again. PacAdvantage, an insurance pooling company for 6000 small and medium sized businesses in California has closed its doors. The Sacramento Business Journal reports (?Backer pulls plug on PacAdvantage health purchasing pool?) that the three remaining insurers underwriting the plan have pulled out. Michael Holt of The Health Care Blog analyzes has some perceptive analysis of the situation:

?What happens to voluntary purchasing pools? Simple economics?they only get customers who can?t get a better deal in the underwritten insurance market and so they go into a death spiral where the people in them are too sick to be supported by the premiums they charge. Today PacAdvantage announced that it was closing down, throwing 110,000 people into the small group and individual market, where by definition, no insurer wants them (unless they?re like me?very lucky).

PacAdvantage is the type of organization that our friends in the ?voluntary universal insurance? world (Cato, Galen et al) think is going to solve all of our problems, with no need for pesky mandates to buy insurance, or for community rating, or standardized benefits packages.?

In my June 15th post, I mentioned Cutler and Zeckhauser?s 1997 paper which discussed this concept of an adverse selection death spiral in the context of Harvard?s employee health insurance plans.

 

[JD50]

I call shens on these low income families getting medical care. According to the Dems these people are dying in the streets without ever receiving medical care.

 

[Engineer]

Originally posted by: JD50
I call shens on these low income families getting medical care. According to the Dems these people are dying in the streets without ever receiving medical care.

Low income people "can" get some of the best medical care. Either they get Medicaid and get 100% coverage or they go to the ER and don't pay because they can't. You and I pay for it ALL one way or another (taxes or increased costs from the hospital writeoffs).

What low income people who aren't on Medicaid cannot get is a regular doctor and any kind of preventative medicine, other than what the ER gives.

 

[Modelworks]

Originally posted by: Engineer

What low income people who aren't on Medicaid cannot get is a regular doctor and any kind of preventative medicine, other than what the ER gives.

That isn't always true though. Like I said above the people in my area can get preventative medicine and a regular doctor. I think the key is the places have to be non profit.

 

[Engineer]

Reminds me that I saw a couple of congressmen on TV a few days ago pitching for a critically ill children's charity for medical care. Stated that they needed donations to help these kids get the care that they could otherwise not afford and get. I'm glad that the charity is out there but it's sad that it's needed in the first place.

 

[Vette73]

Originally posted by: Modelworks

Originally posted by: Engineer

What low income people who aren't on Medicaid cannot get is a regular doctor and any kind of preventative medicine, other than what the ER gives.

That isn't always true though. Like I said above the people in my area can get preventative medicine and a regular doctor. I think the key is the places have to be non profit.

:thumbsup:


Problem is current health care providers and many other in the health field are spending over a million a day to make sure this does not happen.

Even that SC congressman has got almost a QTR Million dollars from lobbyist in the health field.

 

[MovingTarget]

Originally posted by: Modelworks

Originally posted by: Engineer

What low income people who aren't on Medicaid cannot get is a regular doctor and any kind of preventative medicine, other than what the ER gives.

That isn't always true though. Like I said above the people in my area can get preventative medicine and a regular doctor. I think the key is the places have to be non profit.

Some of those places do exist, and are often run by charities or are funded by local government at 'mercy' hospitals/clinics. If every county/municipality had one of these clinics offering all of thsoe services, we would not be having this debate. As it stands now, when a free clinic opens up anywhere, you get people coming from hours away to attend, often just to be turned away because they couldn't handle the capacity. (NPR had a story about one such clinic recently...) The need is still definitely there...

 

[fskimospy]

Originally posted by: Modelworks
Where I live there are a lot of poor and very low income people. People that make less than $12,000 a year. In this county there are clinics in each city that are focused on low income families. The clinics are operated by a company that receives public and private funding.

The service they provide is so good that I go there when I could go to the expensive, supposedly high end care place. I pay with insurance, but they also take people with no insurance. They charge based on a sliding scale. People with no insurance can be seen for $25 a visit. X-ray are done at cost, lab work is also $25 regardless of the test performed. Anyone can walk in when they open in the morning and be seen that day. They have full service at the place, pediatricians, ophthalmologist, therapist, general practice and dentist. If one clinic doesn't have what you need then they refer you to one of the other ones. It basically operates as a non profit clinic.

To me this solves the problem with health care. If you want to pay for 'better' care you can do so, if not you can find your own methods.

Would it be better for the government to set up clinics like this where they can control cost however they want ?


This is the website of the company.
http://www.goshenmedical.org/index.html

You do realize that socialized medicine in many other countries operates in almost exactly that way, right? Government insurance at a certain minimum level that operates in a non-profit manner, and if you want 'better' health care you can get private insurance on top of it.

Basically that's the European model in a nutshell (with a few exceptions).

 

[Modelworks]

Originally posted by: eskimospy


You do realize that socialized medicine in many other countries operates in almost exactly that way, right? Government insurance at a certain minimum level that operates in a non-profit manner, and if you want 'better' health care you can get private insurance on top of it.

Basically that's the European model in a nutshell (with a few exceptions).

I am not talking about government insurance. I am talking about places operated by non profit organizations funded partially by the government. The ones here where anyone can walk in , even illegals (I know some have issues with that), and show proof of income. Once they have that they tell you what you have to pay.

 

[LunarRay]

There are quite a few 'Teaching' hospitals around. The quality of care is top notch because the Primary Care Physician Attending is generally a Professor of Medicine or Associate Professor and that person does the referring to the 'specialists' The MD Specialist, Also a Professor of Medicine oversees the Residents who are MD's working toward Board Certification in the broader Classification of say Internal Medicine. Often follow up care provided by Fellows who are Board Certified in the General classification say Internal Medicine working for further specialization in say Endocrinology.

The VA hospital in La Jolla, Ca. uses the MD's from UCSD. UCSD also runs University Hospital who treat many Medicare, Medical, and the other Medi something along with other insurance provider patients.

I think anywhere there is a Med School you'll find this kind of situation. It is the Private hospitals that have the best MD's it is said but I tend to find the Scientists/Professors at Medical Schools are on the cutting edge of treatment.

The wait times are really not bad considering a normal wait to see the family MD is at times an hour. I don't think I've ever waited over half hour to be seen at the VA.

EDIT: I would note that my experience with going to the Naval Hospital in San Diego is that they have many empty beds. I'm not sure if that is because they have a shortage of health care providers or patients.

Free Clinics serve a great need. The only question I'd have is the Medical Staff. Are they Pro Bono providers or are they associated with some University or what. Each case is somewhat different. There are other kinds of clinics too... specializing in various health care and they serve a greater need to the folks seeking that. Those folks usually are very poor.

 

[nageov3t]

I went to a free clinic once... never again.

my leg was in pain to the point where I could barely walk. doc looked at me and gave me a prescription for antibiotics.

two days later, pain was still there and getting worse. I went to the ER, where they were immediately like "wtf" and admitted me. I ended up spending a week in the hospital on IV antibiotics, had a visiting home nurse for a month after that to give me daily AB injections, and was on a slew of pills for like 6 months total to fight off the infection.

had I followed the advice from that crap clinic doc, for all I know I'd be an amputee right now. as it is, my leg never fully recovered (the lower half of one of my calves is discolored to the point where I can't wear shorts without being self-conscious)

 

[fskimospy]

Originally posted by: Modelworks

Originally posted by: eskimospy


You do realize that socialized medicine in many other countries operates in almost exactly that way, right? Government insurance at a certain minimum level that operates in a non-profit manner, and if you want 'better' health care you can get private insurance on top of it.

Basically that's the European model in a nutshell (with a few exceptions).

I am not talking about government insurance. I am talking about places operated by non profit organizations funded partially by the government. The ones here where anyone can walk in , even illegals (I know some have issues with that), and show proof of income. Once they have that they tell you what you have to pay.

And what I'm saying is that the systems set up by the government do almost exactly the same thing with just a different payment mechanism.

 

[Modelworks]

Originally posted by: loki8481


had I followed the advice from that crap clinic doc, for all I know I'd be an amputee right now. as it is, my leg never fully recovered (the lower half of one of my calves is discolored to the point where I can't wear shorts without being self-conscious)

Doesn't really say much against supporting clinics. Hospitals kill people all the time in medical mistakes.

 

[Modelworks]

Originally posted by: eskimospy

Originally posted by: Modelworks
[

I am not talking about government insurance. I am talking about places operated by non profit organizations funded partially by the government. The ones here where anyone can walk in , even illegals (I know some have issues with that), and show proof of income. Once they have that they tell you what you have to pay.

And what I'm saying is that the systems set up by the government do almost exactly the same thing with just a different payment mechanism.

There is a big difference. If you hand out insurance people can go to wherever they like, sounds good, free choice. The downside to that is that it feeds the problem, for profit health care. If you run a non profit clinic that has to meet standards to receive money then you have control over the cost as well as the quality of care while still allowing people who wish to obtain insurance and pay more to go elsewhere.

 

[fskimospy]

Originally posted by: Modelworks

Originally posted by: eskimospy

And what I'm saying is that the systems set up by the government do almost exactly the same thing with just a different payment mechanism.

There is a big difference. If you hand out insurance people can go to wherever they like, sounds good, free choice. The downside to that is that it feeds the problem, for profit health care. If you run a non profit clinic that has to meet standards to receive money then you have control over the cost as well as the quality of care while still allowing people who wish to obtain insurance and pay more to go elsewhere.

Single payer systems most certainly have control over cost (far more than the no-profits I'd wager), and again these single payer systems have the exact same private insurance on top thing that allows for greater quality to those who can afford it.

 

[SammyJr]

Originally posted by: Engineer
Reminds me that I saw a couple of congressmen on TV a few days ago pitching for a critically ill children's charity for medical care. Stated that they needed donations to help these kids get the care that they could otherwise not afford and get. I'm glad that the charity is out there but it's sad that it's needed in the first place.

I always cry a little inside when I see those jars that ask for donations to pay for a child's medical care. We're supposedly a first world country, with lots of money for bombs and bankers, but we make people beg for dimes and quarters to treat their sick child.

 

[SammyJr]

Originally posted by: Modelworks

Originally posted by: eskimospy


You do realize that socialized medicine in many other countries operates in almost exactly that way, right? Government insurance at a certain minimum level that operates in a non-profit manner, and if you want 'better' health care you can get private insurance on top of it.

Basically that's the European model in a nutshell (with a few exceptions).

I am not talking about government insurance. I am talking about places operated by non profit organizations funded partially by the government. The ones here where anyone can walk in , even illegals (I know some have issues with that), and show proof of income. Once they have that they tell you what you have to pay.

These clinics attract people with the least amount of money plus people with preexisting conditions that are too expensive for the private market. How long is such a model sustainable without ever increasing Government funding?

 

[SammyJr]

Originally posted by: Modelworks

Originally posted by: eskimospy

Originally posted by: Modelworks
[

I am not talking about government insurance. I am talking about places operated by non profit organizations funded partially by the government. The ones here where anyone can walk in , even illegals (I know some have issues with that), and show proof of income. Once they have that they tell you what you have to pay.

And what I'm saying is that the systems set up by the government do almost exactly the same thing with just a different payment mechanism.

There is a big difference. If you hand out insurance people can go to wherever they like, sounds good, free choice. The downside to that is that it feeds the problem, for profit health care. If you run a non profit clinic that has to meet standards to receive money then you have control over the cost as well as the quality of care while still allowing people who wish to obtain insurance and pay more to go elsewhere.

In other words, just like the NHS... people can go to the NHS or pay more and go private.

 

[piasabird]

There are clinics like this everywhere. Well maybe not exactly like that. Lots of people go to clinics with low rates to get physicals for public school. Often they only are open one day a week or you have to search for them. I have taken my kids to places like this before. It is often better to supplement health care in clinics than to allow disease and pestilence to flourish. Eventually diseases will seek out the rich people in their rich neighborhoods.

What is good for the poor is often good for the protection of the rest of society. This is why people need to be able to seek our different solutions for health care that work in different situations. Insurance can be just as valid as a free or low-cost option. Insurance companies often force the cost of health care down, but dont work well for low-income people. All insurance companies use rationing or demand higher copays for certain procedures. You can not expect the governemnt to work any differently.

 

[Pliablemoose]

Those free clinics are pretty sad in my experience. I've had to interact with their staff many times over the years, some of the staff is paid, many are volunteers who have full time jobs that do it out of the goodness of their hearts.

Nice folks, but give them a complicated case & the threads start to unravel...

 

[MovingTarget]

Originally posted by: SammyJr

Originally posted by: Engineer
Reminds me that I saw a couple of congressmen on TV a few days ago pitching for a critically ill children's charity for medical care. Stated that they needed donations to help these kids get the care that they could otherwise not afford and get. I'm glad that the charity is out there but it's sad that it's needed in the first place.

I always cry a little inside when I see those jars that ask for donations to pay for a child's medical care. We're supposedly a first world country, with lots of money for bombs and bankers, but we make people beg for dimes and quarters to treat their sick child.

It all goes back to the guns vs. butter debate. We usually choose guns. Although, as of late I'm not sure which is more destructive, bombers or bankers....

 

[miketheidiot]

Originally posted by: LunarRay
There are quite a few 'Teaching' hospitals around. The quality of care is top notch because the Primary Care Physician Attending is generally a Professor of Medicine or Associate Professor and that person does the referring to the 'specialists' The MD Specialist, Also a Professor of Medicine oversees the Residents who are MD's working toward Board Certification in the broader Classification of say Internal Medicine. Often follow up care provided by Fellows who are Board Certified in the General classification say Internal Medicine working for further specialization in say Endocrinology.

of newsweeks top 25 hospitals in america, about 20 of them were teaching hospitals associated with a university.

 

[Vette73]

Originally posted by: Pliablemoose
Those free clinics are pretty sad in my experience. I've had to interact with their staff many times over the years, some of the staff is paid, many are volunteers who have full time jobs that do it out of the goodness of their hearts.

Nice folks, but give them a complicated case & the threads start to unravel...

Thats the thing. A clinic should be for the basic broken legs, colds, rashs, etc... if they get soemthing that is not the standard then they should be sent to the ER or higher up Doc.

If this was planned and one well then it would take a lot of load off of ERs and other places and allow them to do their job and not be held up as Ms. Jones wants her antibiotics for her common cold and will sit in the ER/Docs office until she gets them.