On the first day of my internship, I sat in on a meeting with a local pastor and the director of Oasis of Hope, a free medical clinic for the uninsured. This pastor had just moved back into the area, has a sincere passion for, and extensive history with the NW Grand Rapids community. So Oasis saw him as an ideal fit as a spiritual care counselor for our newly developed team that is focused on creating "Integrated Health Care Mondays: Free mental, social, physical, and spiritual counseling to meet needs of community members." Now I will speak more on that another day, but what I do want to focus on is the familiar question that was asked by this pastor after requesting his presence on our team: a question that many have asked free clinics since the implementation of the the Affordable Care Act (ACA) in 2014. "Are free clinics going to be needed anymore?"
Valid question, right?
As Grand Valley State University Physician Assistant Students, Applebach, Boldt, Fedewa, and VanNoord, who researched a similar question for their research thesis in 2014 pointed out, the ACA meant that Americans are now required to have health insurance. So if free clinics, like Oasis of Hope, only see patients without insurance, and the ACA requires everyone to have insurance, these clinics must have become obsolete throughout the first year of the ACA.
Wrong.
Luckily, Julie Darnell, PhD, a leading expert on the effects of the Affordable Care Act on free clinics, has published the "10 Reasons Why Free Clinics Will Be Needed Post-ACA" that will help us understand why. I've summarized some of her reasons below:
Valid question, right?
As Grand Valley State University Physician Assistant Students, Applebach, Boldt, Fedewa, and VanNoord, who researched a similar question for their research thesis in 2014 pointed out, the ACA meant that Americans are now required to have health insurance. So if free clinics, like Oasis of Hope, only see patients without insurance, and the ACA requires everyone to have insurance, these clinics must have become obsolete throughout the first year of the ACA.
Wrong.
Luckily, Julie Darnell, PhD, a leading expert on the effects of the Affordable Care Act on free clinics, has published the "10 Reasons Why Free Clinics Will Be Needed Post-ACA" that will help us understand why. I've summarized some of her reasons below:
- Today there are 41 million uninsured Americans
-The ACA will cut that number to 29 million by 2016
- But it plateaus there, leaving 29 million Americans still uninsured in 2022 according to federal government estimates
-Oh, and currently, free clinics across the US only see 2 million patients a year
- and those 2 million Include the visits from some of the 10+ million undocumented persons in our country as well - Not all services are covered under the ACA (Dental, case management, optical, health education, and more) but will still be needed
- There are not enough health care providers employed
- - - - Does "No Longer Accepting New Patients" ring a bell? - - - - - Volunteerism provides incalculable benefits to patients
+ Care + Compassion + Attention + Listening + Credibility + Dignity + More time with providers
~Free clinics are community based and flexible
+ Adapts to the community they serve
+ Are not tied down by corporate demands - Volunteerism has benefits for providers too
+ "Respite from corporate demands"
+ Opportunity for faith based service
+ Effective way to prevent "burn out" - Free clinics and their volunteers are experts on tailoring medicine that meets the needs of America's most vulnerable populations
Applebach, Boldt, Fedewa, and Vanoord (2014) bring further clarity by identifying barriers to health care for patients without insurance: drawing conclusions from data collected on those who are specifically seen at Oasis of Hope. Their study showed that health insurance does not equal health care access, and "underserved health populations may never receive the care they qualify for after the ACA" because of barriers to health care access which include, but are not limited to the following:
- Hours of operation (If you can barely pay for your mandated insurance, how are you supposed to take a day off to see the doctor for preventative care measures?)
- Difficulty navigating the intricacies of health care/Lack of knowledge (If someone stopped you on the street today and asked how to get health care, would you know exactly what to do? Plus, how many of us actually read/understand all of those documents...)
- Transportation
- No Child Care
- Financial issues (So my insurance is cheaper, but may still cost more than I can afford, plus a potential co-pay and then full price medications on top of that? This alone will continue to deter people from accessing health care)
- Lack of Translators
- Negative experiences with health care
HEALTH INSURANCE ≠ HEALTH CARE ACCESS
With this information in mind, I will continue my internship knowing that I not only am receiving an excellent opportunity to learn, but also that I am part of a health center that is providing an essential service to those who fall through gaps of America's heath care system.
Unfortunately, however, there is a lack of education by the general population. That lack of education is leading to a misconception that the ACA led to all Americans having unrestricted access to health care. This is clearly not the case, but unless awareness of the need for free clinics around the US is raised, funding (primarily donations) for these clinics will by cut, leaving more than 29 million without their services.
So...
The answer is YES. Free clinics will still be needed in the post-ACA health care system.
If you would like to learn more about or support Oasis of Hope by volunteering, spreading awareness, or donating, you can visit the clinic at:
Oasis of Hope Center
522 Leonard St. NW
Grand Rapids, Michigan 49504
(616) 451-8868
If you are aware of anyone without insurance who is in need of medical care, Oasis of Hope, and any free clinic across the United States is eager to help. Please let them.
Oasis of Hope Hours of Operation
Monday: 9 a.m. - 7 p.m.
Wednesday: 1 p.m. - 6 p.m.
Saturday: 8 a.m. - 1 p.m.
Unfortunately, however, there is a lack of education by the general population. That lack of education is leading to a misconception that the ACA led to all Americans having unrestricted access to health care. This is clearly not the case, but unless awareness of the need for free clinics around the US is raised, funding (primarily donations) for these clinics will by cut, leaving more than 29 million without their services.
So...
The answer is YES. Free clinics will still be needed in the post-ACA health care system.
If you would like to learn more about or support Oasis of Hope by volunteering, spreading awareness, or donating, you can visit the clinic at:
Oasis of Hope Center
522 Leonard St. NW
Grand Rapids, Michigan 49504
(616) 451-8868
If you are aware of anyone without insurance who is in need of medical care, Oasis of Hope, and any free clinic across the United States is eager to help. Please let them.
Oasis of Hope Hours of Operation
Monday: 9 a.m. - 7 p.m.
Wednesday: 1 p.m. - 6 p.m.
Saturday: 8 a.m. - 1 p.m.
Applebach, B., Boldt, P., Fedewa, E., & VanNoord, T. (2014) The potential effect of the affordable care act on a free clinic and barriers to health care access as perceived by patients receiving health care at a free medical clinic. GVSU. Accessed via paper copy.
Darnell, J. (2011). What is the role of Free Clinics in the Safety Net? Medical Care, 49 (11), 978-984.
Darnell, J. (2011). What is the role of Free Clinics in the Safety Net? Medical Care, 49 (11), 978-984.