"With great power comes great responsibility" Neighborcare: the Spiderman of health care

Governor Gregoire was interviewed about the proposed Washington state budget for the next 2 years, and with a quiver in her voice she says:

I hate my budget. I hate it because in some places I don't even think it's moral. Who'd have ever thought that I would be doing this.

I wanted to write about something positive, something to dispel the negativity of the realities of massive budget cuts, but I've taken off the rose-tinted glasses (read Idealism Waning) and have embraced the nasty truth: This will hurt. It will hurt everyone, I'm not just talking about those poor people, those "welfare" recipients, those people who suck taxes from hard working Americans. It will hurt YOU. K-12 education, slashed. Higher education costs increasing with no end in sight. Are you a disabled Washingtonian? You might think about moving, if they don't take away your wheelchair or crutches first. Public transportation, corrections, state agencies, state parks are feeling the budget blows. And since we, the Washington voters, rejected tax increases from the recent elections, our state legislature really had no other choice. Geez, I guess on the positive end we aren't as f*****d up as California. Awww, we're gonna miss you, Ah-nold.

But cutting the Basic Health Plan of Washington? This program is not a hand-out, as many may erroneously believe, it's a state-sponsored insurance program that people PAY INTO. Again, PAY INTO, unlike Medicare, which typically has no co-pay or fees. But with the rising costs of healthcare and the decreasing budget, BHP of Washington was closed to new enrollees a while back but unfornuately, just didn't make it off the chopping block this time around. Now all those families (66,000 people) will need to find an alternative method to receive affordable medical.

In comes the health care hero Neighborcare Health, with a sliding fee scale for eligible families. Based on your income, you can receive medical, dental, laboratory and prescriptions at a discounted rate, up to 90%. (Unfortunately it doesn't cover hospitalizations) This isn't unique to Neighborcare,all community health centers offer a sliding fee.

Storytime:
Back in the 60's during the Civil Rights movement came an additional, less famous movement called the Free Clinic movement. Then came Medicare, HMOs, and my BFF Reagan and from here spawned the Community Heath Clinic movement. NOTE: the word "free" is nowhere to be found. LOVE YOU REAGAN! Communithy health centers are non-profit clinics that provide health care for low-income families. Mexico has Centros de Salud, a similar model but are 100% government sponsored. CHC's are not government clinics, they use taxpayer money, grants and private funding. While there is a range of classifications of CHC's, all of them have some government funding, target specific communities (ie- migrant, geographically isolated,rural or urban) and, like every non-profit, have a board of directors. Board of directors means TRANSPARENCY, every single dime spent must be accounted for, unlike private HMOs or PPOs who can charge whatever the hell they feel like. Neighborcare has been around since the Free Clinic movement, althought by different names, and is a long standing model of CHCs in the United States.

CHC's rely on government health programs, like BHP of Washington, for reimbursement for services. It's a catch-22, cutting BHP of Washington means more people will be uninsured, so more people will need our clinics, but without funding from BHP of Washington Neighborcare will have to cut hours, staff and services. Yeah it sucks, but we can tough it out. Neighborcare's 50 years of resilience is credited to smart budgeting, aggresive acquistion of grants and funding and high efficiency.


Efficiency in health care? Hm, what a concept. If we treated health care like we would a factory, we would see major changes in cost and better services. But that's another blog for another day.