Community Clinics Expanded Providing Essential Care

The NY Times article on President Bush’s health care legacy that has expanded the number of community health care access clinics providing much needed primary care to undeserved areas:

In Mr. Bush’s first year in office, he proposed to open or expand 1,200 clinics over five years (mission accomplished) and to double the number of patients served (the increase has ended up closer to 60 percent). With the health centers now serving more than 16 million patients at 7,354 sites, the expansion has been the largest since the program’s origins in President Lyndon B. Johnson’s war on poverty, federal officials said.

The effort is a great start and while this alone will not solve health care problems it is an imperative to reducing costs and providing ready access to health care everyone. The cost reduction comes in at least two forms, the reduction in costs associated with treating the sequelae of chronic diseases as they manifest from neglect and poor primary care but also the reduction in the unnecessary use of urgent care or Emergency Department visits which have ballooned in the last several years as seen in the McKinsey Report on US Health care Spending featured here

The centers serve 1 in 3 people living below the poverty line and 1 in 8 of those without insurance. It is a relative bargain ($8 billion) against other spending initiatives and the high cost associated with coverage plans and subsidizing insurance coverage. Better yet – if the trade associations are to be believed they save money by reducing unnecessary care and spending in the urgent care system (hospitals, ED’s and other access points)

Unfortunately this needs to be tied to a wider program that links the great care delivered by the front line of medicine – community or general practice to the inpatient, urgent and specialized care that has plenty of facilities but for the most part out of the reach of those unlucky enough to warrant the follow up or additional care for conditions that are outside of the capabilities of the community care health system.

This program should be expanded and be a core component of any future plans to help solve the problems of health care. Primary care is the bed rock of good health care and providing ready cost effective access for everyone will help improve the population’s health as well as controlling and decreasing costs.