Americans pay for their own healthcare needs, usually through employer-provided insurance. But rising medical costs are forcing many businesses, especially small ones, to cut back on this benefit for their workers. This is one reason why the number of Americans without health insurance rose to more than 46,000,000, according to a report last month by the U.S. Census Bureau.
To fill the gap, some community-based medical clinics are using innovative ways to let people know about affordable healthcare and how to get it.
It's early in the day at People's Clinic of Boulder, Colorado, and already the phones are busy, with people calling for appointments and clinic staff calling to remind patients about upcoming checkups.
Meanwhile, the reception area is filling up with mothers holding restless children, working men in overalls and gray-haired retirees. Most come from households where it's hard to make ends meet. According to the clinic's Patient Enrollment Coordinator, Kathryn Werner, there's something else they have in common. "Twenty people right now, waiting to be seen by their doctors -- all of them are uninsured."
With the number of uninsured Americans at an all-time high, low-cost clinics like this are finding their services more in demand. Perla LeGrange, an enrollment specialist at Boulder's People's Clinic, says that many of the patients here live in households where at least one person works. "Mainly it's either at a restaurant as a cook, or they're working at a hotel cleaning," she says. "The people who come in here working with what they can, where they can. Most of them work basically 80 hours (per week) or more, but still, their hourly wage is really low." She adds that often, their employers don't provide an affordable healthcare option.
When someone's living on the edge financially, LeGrange says, they tend to put off their healthcare needs. "There's people that have waited for a couple of years to come. They've waited until the last minute when they can't deal no more with the pain." She recalls one patient who came in with a hernia. "He waited until the last moment to come in, because he didn't have insurance, and he was afraid he was going to get stuck with this big bill. We got him a referral to a specialist, and we got him taken care of."
Many People's Clinics patients qualify for publicly funded programs that pay their medical bills. For those who don't, LeGrange works out a sliding scale payment, and the clinic covers the rest through private donations.
Kay Ramachandran, who heads People's Clinic, believes that communities benefit when all residents have access to regular care. Without it, she observes that they put their health, and finances, at greater risk. "They land up in the emergency room, and that's the one thing we want to prevent. If you identify with the clinic as a medical home, you don't land in the ER, you don't land with those bills and financial trouble."
Ramachandran grows especially concerned when she hears about people who aren't even aware that their community offers a low-cost clinic. "Yesterday I had a patient who called to thank me for the services he and his wife had received here, because we delivered their baby. He said he had never known about this place until he ran from pillar to post [searched exhaustively] and someone said, you should be going to the People's Clinic. So we have taken the initiative to go out and get people in."
People's Clinic has begun conducting more health fairs that offer free or low-cost routine screenings. Ramachandran says the clinic also plans to go to jobsites like restaurants and hotels, where workers tend to be uninsured. She lays out her vision: "Let's say you walk into a small business. The employer is not able to provide healthcare, therefore he's not able to attract employees. The thing is to develop a relationship with that person, to say, 'if you could give your employees half an hour of their workday, to sit down with us and do an intake, on site at your place, we can give them access.' I think we have to think of very creative ways that's appealing to the employer, and at the same time provide access to these people."
This month, clinic workers have been contacting many of these businesses, hoping that if more people sign up for regular care, they'll show up -- instead of waiting until the last minute to come in, as so many are doing these days.