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For People With No Health Insurance, One Day Of Free Care

ARIELLE LEVIN BECKER

January 25, 2010

They came by the hundreds in New Orleans, Little Rock, Kansas City and Houston, lured by the offer of free health care at a one-day clinic. For many patients, it was the first time they had seen a doctor in years. Nearly all of them had jobs, just no health insurance.

Feb. 3 will be Hartford's turn for a one-day free medical clinic for people with no health insurance. The National Association of Free Clinics, which has been hosting similar events throughout the country since September, and hundreds of volunteers will set up at the Connecticut Convention Center from noon to 7 p.m. Organizers expect to draw about 1,000 patients.

The one-day clinics are intended to give the uninsured a chance to see doctors and get exams or screenings they might have missed while connecting them with the "safety net" health system that includes free clinics, community or federally qualified health centers, and programs at hospitals for those without insurance, said Nicole Lamoureux, executive director of the National Association of Free Clinics, which represents 1,200 clinics, including three in Connecticut.

Lamoureux said free clinics had a 40 percent to 50 percent increase in patient demand in 2009 and a 20 percent drop in donations.

"While Congress is debating health care reform every single day, we wanted to highlight the work of free clinics and the safety net and also put a face on the uninsured," she said. "So when people are talking about the uninsured, they really can see that many times, it is the person next to you in the grocery line or the person you go to church with."

At the one-day clinics held late last year, about 80 percent of the patients had jobs, Lamoureux said. Many of the patients had multiple life-threatening conditions like cardiovascular disease, hypertension, diabetes or pulmonary disease. For many, it was the first time they had seen a doctor in at least five years.

Dr. Bruce Gould, medical director of the Burgdorf Health Center in Hartford, has seen firsthand the effects of limited access to health care. Patients who have no insurance or poor-quality insurance often avoid medical care, delaying tests or treatment that could stop illnesses before they become severe.

"It doesn't take a very high barrier to separate someone from the care they need," said Gould, one of more than 100 doctors who will be volunteering at the clinic.

Gould, the associate dean for primary care at the UConn Health Center and medical director for Hartford's health department, recalled one woman who came into his clinic, clearly septic a potentially deadly condition. He told her that he should admit her to the hospital. "And she said, 'I'm still paying off the last admission. I'm not going to go,'" Gould said.

The woman managed to get better with antibiotics a lucky break, Gould said.

"For every story like her, there's a whole bunch of people just dying at home or coming in so late that there's nothing we can do, or coming in so late that they end up never returning to a functional lifestyle, so the rest of us pay," he said.

Visitors to the clinic in Hartford will receive a physical exam, vision screening and tests that will be appropriate for them; spend time with a doctor to ask questions; and receive information on programs or clinics where they can receive care in the future.

"When they leave this clinic, they are empowered not just with an appointment but also with knowledge and the peace of mind that somebody cared about them and wanted to know what was going on in their life," Lamoureux said.

Organizers have asked that patients make appointments, but they will also treat walk-ins on a first-come, first-served basis. In the other four cities, the clinics managed to see every patient and accommodate walk-ins, although in Kansas City, where 2,600 people turned out, 25 to 35 patients were turned away and given appointments for care elsewhere.

Connecticut has a lower rate of uninsured residents than the nation as a whole. An estimated 310,000 people in the state, or 9 percent of the population, lacked health insurance in 2008, according to census figures released last fall.

But in some pockets in the state, the rate of uninsured is far higher. In both Bridgeport and Stamford, 20 percent of residents, or more than 25,000 people, had no health insurance. In Hartford, just under 15 percent of residents were uninsured at the time they were surveyed.

And like those who have come to the free clinics, the vast majority of the uninsured have jobs, according to state and federal figures. In 2008, more than 80 percent of the uninsured were in working families and about two-thirds were from families with one or more full-time workers, according to the Kaiser Family Foundation.

The free clinic is "a very small blip in trying to deal with the larger problem of 50 million people who have no access to health care," Gould said.

But it could also connect patients with ongoing care. And, he hopes, it could inspire other health care workers to continue treating patients who do not have health insurance or to become active politically to push for changes in the health care system.

"Regionally, there is some benefit in trying to coalesce the health care community and to highlight the unmet need that exists out there," he said. "Unfortunately, we don't want to see it and so we don't see it. But it's always there."

"It doesn't take a very high barrier to separate someone from the care they need."

Reprinted with permission of the Hartford Courant. To view other stories on this topic, search the Hartford Courant Archives at http://www.courant.com/archives.
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