Why are free clinics needed?

"We would love to be put out of business"

The running joke at any free clinics conference

Common misconceptions

Free clinics are only needed to treat the homeless and the destitute.

The ACA (affordable Care Act) has taken care of everyone and there is no longer a need.

The government gives plenty of support to free clinics.

Anyone can walk into an ER and be treated, even if they can not pay the bill.

The truth

Free clinics are only needed to treat the homeless and the destitute.

People are uninsured for many reasons. Our patients are former CEOs, long term homeless, and the guy making your pizza. The majority are simply the working poor. They barely make enough to pay their bills and even the bus ticket or gas to get to their appointment can mean they don't eat tonight. We do treat the destitute and homeless, but we also treat your neighbor who lost their job 6 months ago. They probably didn't tell you about it but they have used all their savings and still has a chronic condition that needs medication. Without access to a free clinic they can quickly end up in a physical state that will not permit them to ever return to work.

The ACA (affordable Care Act) has taken care of everyone and there is no longer a need.

 Many people are surprised to hear that an estimated 31 million people will be uninsured when the ACA is fully implemented in 2024, according to the Congressional Budget Office (CBO)[i].

 Most of these uninsured and underinsured will be made up of:

1. Those excluded from coverage in states that have opted not to expand Medicaid
2. Low income workers who cannot afford to pay the deductible associated with the most modest insurance plan available under the ACA.
3. Workers whose incomes are so low that they are not required to buy coverage under the ACA

A significant piece of the Affordable Care Act is Medicaid expansion, which provides insurance for nonelderly adults with incomes below 133% of the federal poverty level, or about $31,721 for a family of four. 

Here is a link to a great article further discussing the ACA and free clinics.

North American Free Clinics Report about the safety net of free clinics after the Affordable Care Act. Speaking on the changed made by the ACA "Taken together, these changes were a big first step to expanding coverage, but clearly do not provide universal health care."

The government gives plenty of support to free clinics.

The state of Michigan contributes about 2 million dollars each year to the safety net of free clinics across the state. Our share of that is slightly over $4,000. Every penny counts and we appreciate that we can depend on that $4,000 check each year but it makes a very small dent in our annual budget of $350,000. The federal government does not provide any support to our clinic. We depend on the person behind you at the grocery store, grants, and an annual event The Esteemed Women of Michigan, which benefits the clinic.

Anyone can walk into an ER and be treated, even if they can not pay the bill.

Well to be fair this one is true, a hospital is legally obligated to treat you even if you may not be able to pay the bill. There are many people that use an ER as their primary care doctor. There are two big problems with this method of care.

1. An ER is a perfect for emergencies, but poorly suited for controlling diabetes, high blood pressure or even a stuffy nose. Patients with these conditions will receive better care at our free clinic than they will in an ER.

2. The average ER bill is over $1,000 while the average bill from the Gary Burnstein Community Health Clinic is $0. When the uninsured receive free care at the GBCHC it means that your insurance is not paying that $1,000 ER bill.