Free Clinics Serve Nearly 2 Million without Health Insurance

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More than 1,000 free clinics offer medical and dental care to about 1.8 million people in the United States who do not have health insurance. These facts and more are reported in the first comprehensive survey of free clinics done in about 50 years and now published in the Archives of Internal Medicine.

Every state except Alaska operates free clinics, which the survey found number 1,007. According to Julie Darnell, a researcher at University of Illinois at Chicago who conducted the study, free clinics hosted an estimated 3.1 million medical visits and nearly 300,000 dental visits during the study period, which was October 2005 through December 2006.

The study results were based on data concerning patients, services offered, staff and volunteers, and operating practices from more than 75 percent of the free clinics that were operating during the study period. The definition of a free clinic, according to the study, was one that targets care to people who do not have health insurance, provides direct health care services, care is delivered by volunteers, and the care is never contingent on any type of payment.

Darnell believes there will still be a strong need for free clinics after the health care reform legislation takes hold, “because it is estimated that 23 million people may still be uninsured. We can anticipate that people will have problems accessing primary care, especially given the workforce shortages that we are likely to encounter in primary care.”

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The problems with access to primary care Darnell refers to relates to the decline in the number of primary care physicians. According to the American Academy of Family Physicians, the number of medical school students entering primary care has dropped 51.8 percent since 1997. The organization is predicting a shortage of 40,000 family physicians by 2020, when the demand is likely to peak, as noted in USA Today.

Based on Darnell’s findings, free clinics vary in their profiles. On average they are open 18 hours per week, and they allow very flexible patient scheduling, including walk-ins. Operating budgets for most clinics are less than $125,000, noted Darnell, and they primarily utilize volunteer medical professionals. Mental health volunteers, such as social workers and psychologists, are in short supply.

Funding of free clinics usually comes from non-governmental sources, such as civic groups, churches, foundations, private contributions, and corporations. Services are generally limited to providing medications (mainly samples and through pharmaceutical assistant programs), physical examinations, urgent and acute care, eye and dental care, and health education. Free clinics often assist patients who need laboratory testing and X-rays by finding them free or low-cost services in other locations.

A look at the patients generally served in free clinics reveals that most are females between the ages of 18 and 64, they are at or below 200 percent of the poverty line, and half of all patients are white. Clinic patients generally do not qualify for Medicaid or Medicare.

Darnell believes that it is important to integrate “free clinics more formally into the health care safety net” to accommodate people who do not have health insurance. She also explains that “policy makers and other safety net providers need to acknowledge the valuable role that free clinics currently play.” To find a free clinic in your area, visit the National Association of Free Clinics website and click under “Find a Free Clinic.”

SOURCES:
University of Illinois Chicago news release, June 14, 2010
USA Today, Aug. 17, 2009

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