Our colleague Dr. Virginia M. Brennan, an associate professor in the Graduate School at Meharry Medical College has just published a new book entitled: Free Clinics, Local Responses to Health Care Needs. The book brings together 25 papers on free clinics that have been published in the Journal of Health Care for the Poor and Underserved.
Why are free clinics necessary and what role do they play in the provision of health care in the US. The answer is presented in the book’s foreward:In 2011, 46.3 million people were uninsured in the United States, about 15% of the population) This figure was expected to rise by the end of 2012. For minorities, the figures are worse, with nearly 30% of Hispanics and nearly 20% of African Americans being uninsured) Free clinics receive nearly 4 million patient visits a year. Without these clinics, the nation’s emergency departments and public health clinics (including federally qualified community health centers) would have to absorb all these patients and the costs associated with their care.
Simply put, free clinics provide an enormous amount of care. Even after the full implementation of the Affordable Care Act it is estimated that 20 million plus people will be without health insurance in the US. Many millions more will be under-insured meaning that the cost of actually using their insurance will be prohibitive. Thus, “free clinics” stand as a reminder of the failure of our society to guarantee health care as a human right. They also demonstrate the enormous commitment of many health care professionals to caring for people even when not paid.
Since the chapters come from an academic journal there is focus on critical thinking and data-driven evaluation. This is not a coffee table book idealizing the people who provide free care. There is, for instance, discussion of the “stop-gap” and “band-aid” nature of free clinics. Half of the book is devoted to general experiences with free clinics and the other half is devoted to papers on student-run free clinics. The book will be particularly valuable for those involved with (or thinking of setting up) free clinics.
Free clinics should not really be needed. Yet for those of us working in primary care the problems of un-insurance or under-insurance (particularly in working-class immigrant communities) is a daily reality. We work at and we refer to free clinics because we must. But all the while we remember that in the great towers of Wall Street – the banks, the insurance companies, the brokers – there is the money to set this problem right.