January 25, 2006
If Daniel Ward could be granted one wish, every household in Hood River and Wasco counties would contribute a small amount of money to their community health clinic.
“I wish we had thousands of people who would say ‘Here’s $25, use it for someone who needs it,’” said Ward, executive director of La Clinica del Cariño.
He recently shared that wish with Sen. Rick Metsger, D-Welches, during the legislator’s visit to the Hood River facility.
Ward informed Metsger that the Mid-Columbia region has faced tough economic times in the past few years, with 14 percent of the population now living in poverty.
And that, said Ward, has made it more difficult for clients to pay the full cost of the care that they receive. In fact, Ward said that Medicaid, which pays as little as 10 percent of the actual bill, represents about 35 percent of the income at the clinics in Hood River and The Dalles.
He said the rising cost of housing, utilities, fuel and food has made it even harder for poorer families to pay for services at La Clinica and the state’s other 150 community health centers. He said the Gorge facilities are dependent upon private payments for more than half of the $5 million operating budget.
“A lot of people think we are a government clinic but we are more like a co-op that is owned by the patients. Each person who pays us keeps the doors open for the next person,” said Ward.
And, contrary to popular belief, he said more than half of the 125-200 patients seen at the clinics daily are not farm workers. Ward said the majority of clients are “Anglos” but almost all of the staff is bilingual to meet both language needs.
He said 35,000 medical patients and more than 24,000 dental patients have been treated since the Hood River facility was founded in 1986. Two years ago, a sister clinic was opened in The Dalles and has contributed to that total. The La Clinica staff now consists of 11 doctors, four dentists and 86 nurses and medical/dental specialists.
The irony of the funding struggle, said Ward, is that every $1 spent at one of the 2,000 community health clinics across the nation saves $7 for Medicare, Medicaid and private insurers.
“I think this just highlights the national crisis that we are in. What’s amazing is that more than two-thirds of the people that La Clinica sees have jobs but can’t afford health insurance,” Metsger said.
He believes that Oregon officials need to find a way to fill the gap for more than 16 percent of the population that is uninsured. Metsger also contends that a federal remedy needs to be found since four out of five uninsured persons are now from working families.
“These clinics are very special, they are becoming more and more of a resource for people who are working but can’t pay the high cost of insurance,” he said. “Government at both the state and federal levels clearly needs to make a greater investment in these types of programs.”
He said the cost of health insurance is far outpacing wages. So, more and more businesses are finding it unaffordable to provide employees with coverage. Ward concurs that the cost of an independent policy can often be as high as $2,000 per month —which puts it out of reach for most families.
“In this country we have a lot of doctors, but most take very few uninsured people, if any, because that’s not how the system is set up. They have to keep bringing people in to make money,” said Ward.
He said it is ironic that health insurance companies pay people to find ways out of compensating claimants. He said that strategy contributes to a problem which ultimately, costs all taxpayers more money. Since 30 percent of the uninsured are less likely to see a physician for treatment of an injury or the onset of an illness, Ward said the indigent or underinsured are more likely to end up with an expensive hospital stay for a major health crisis.
Ward said the recent constrictions put on bankruptcy filings have just made things more difficult for the uninsured. He said many people who file have been swamped with medical bills for an uninsured hospitalization.
“The number of working poor is growing. For a lot of people, it’s medical problems that drive them under. It’s not racking up credit card bills,” said Ward.
He said within the past 15 years, Medicaid beneficiaries have risen from 20 million to 51 million individuals. And the qualifications to access the government program have tightened — which makes Ward wonder how much higher that number could be.
If the Medicaid figure is combined with the 45 million Americans who are uninsured altogether, Ward said that is 96 million people who currently do not have access to health care — except through centers such as La Clinica, which base payments on a sliding fee scale that is dependent upon income.
The lowest cost paid for a service is $25 — and Ward said it is heartbreaking to watch a struggling family part with even that small amount of cash.
“Fifty-five percent of the people we see have no insurance and we rely on them to pay the bills. So, that gets really tight for us — but we won’t turn anyone away,” said Ward.
La Clinica provides a range of services, from urgent care for emergencies, to minor surgeries and full dental services. More than half of the babies born in Hood River County are delivered by the clinic and pre-natal and pediatric services are in demand at both facilities, which also draw clients from Klickitat and Skamania counties in Washington State.
“We treat everyone from womb to tomb,” said Ward.
In addition, La Clinica holds a warm coat drive every winter to help struggling families. And sponsors a community garden where area residents can, literally, reap what they have sown.
“Our whole purpose is to make life better for people. And that is getting harder with so much less money available,” said Ward. “It seems like the rich are getting richer and the poor are getting poorer and it’s much harder to get what we need.”