Free clinics popping up to serve millions of uninsured

SCHENECTADY, N.Y. (AP) -- A year ago, the downtown free clinic was operating out of two tiny rooms in a run-down former school building, where volunteer nurses interviewed patients in the hallways.

"It became obvious really quickly that it was too small," said William Spolyar, director of the Schenectady Free Health Clinic, which has treated hundreds of patients since it first opened.

Now in a spacious new office lined with a small pharmacy and six exam rooms, the rapidly growing clinic is a symptom of the growing ranks of uninsured Americans. The National Association of Free Clinics estimates there are about 2,000 free clinics today generating about $3 billion in health care services annually. And with the number of uninsured Americans now estimated at nearly 46 million, free clinics will only continue sprouting up and expanding, said Bonnie Beavers, director of NAFC.

It's no surprise that free clinics, which are run by volunteers and survive on grants and donations, are seeing growing support in their communities too. According to the Institute of Medicine, the uninsured population costs the country between $65 billion and $130 billion every year.

"Quite frankly, we're keeping patients out of the emergency room," Spolyar said. "Providers donate services and equipment, but we're saving them oodles of money."


http://hosted.ap.org/dynamic/stories/N/NY_FREE_CLINICS_NYOL-?SITE=VARIT&SECTION=US&TEMPLATE=DEFAULT&CTIME=2005-12-23-11-36-16

health care.

the emergency room is a lousy place to get a doctor's care.
but what are you going to do if you have no other place to go?

stupid, but the point is this. If medical doctors were allowed to prescribe items such as coenzyme Q10, Pycnogenol, Branched chain aminos, Proteolytic enzymes, essential fats, plant stanols and sterols, phytonutrients and glyconutrients, the need for expensive medications could/would be cut in half or better.

Instead they throw them in the docks for suggesting coenzyme Q10 and seize their records. Pitiful abuse of both ignorance and power.

Most of us are not doctors.

and more.... that a doc would go to the docks for suggesting them is not only wrong, but perhaps in my mind ILLEGAL.

I'm no doc--nor do I play one on TV--however, I was talking to a guy I know who IS a Doc (cardiac) and I asked him about CoQ10 one time. His comment was that more Docs would probably prescribe stuff like that (or even TELL patients about it) except for the fact that liability is a very real issue.

Docs play it safe by prescribing drugs that are approved for treating whatever the ailment is rather than trying a nutritional or herbal therapy. I can't say I BLAME them for it, but it sure is a bitch to think that people could probably benefit from some of this stuff if only they knew.

I'll grant you, some of it is every bit as expensive as regular prescription stuff, and that would rule it out for many of the people who are already uninsured. That still doesn't mean that Docs should be afraid to even discuss certain treatment options with patients because the FDA has such a stranglehold.

At one point I was asking my Eye Doc about the effects of Pot on inner eye pressure. He got really freaked out and dismissed it completely. When I countered with a question about a study I'd seen, he told me point blank that he didn't want to continue the conversation because he could have his med license yanked if he ever DID suggest pot usage to one of his patients.

He also was able to offer some observations about WHY it would be unsuitable to use herbal cures of ANY kind in certain cases (controlling the duration of the medicinal effects is one example as is consistency of dosage) but he got really creeped out by me even ASKING about it.

Since then, we've established a much more solid relationship (funny how a few YEARS as a patient can help that) and I doubt he'd act that way with me today. He'd still probably not suggest it, but at least he'd understand that I'm not with the FDA, nor am I out to create a lawsuit for med malpractice.



Laura

Spring Valley... they both use Q-Sorb technology I believe..... if you go to the NIH and enter Coenzyme Q10 and oh, I don't know... hypertension, here is what you will get. L-Arginine is also quite beneficial in some types of hypertension. You can enter L-Arginine hypertension and see what they have to say about it.


1: J Assoc Physicians India. 1998 Mar;46(3):299-306. Related Articles, Links


Coenzyme Q in cardiovascular disease.

Singh RB, Niaz MA, Rastogi V, Rastogi SS.

Heart Research Laboratory, Medical Hospital and Research Centre, Moradabad, India.

Coenzyme Q10 or ubiquinone normally present in many plant and animal cells is an antioxidant. Coenzyme Q10 deficiency has been observed in patients with congestive heart failure, angina pectoris, coronary artery disease, cardiomyopathy, hypertension, mitral valve prolapse and after coronary revascularization. Coenzyme Q10 is involved in the synthesis of ATP and hence is useful in preventing cellular damage during ischaemia-reperfusion injury. The clinical benefits are mainly due to its ability to improve energy production, antioxidant activity, and membrane stabilizing properties. Several studies showed that coenzyme Q could be useful in patients with congestive heart failure, angina pectoris, cardiomyopathy, coronary artery disease and in the preservation of myocardium. Coenzyme Q10 is normally present in the low density lipoprotein cholesterol fraction and inhibits its oxidation. It can also regenerate vitamin E. Coenzyme Q10 is known for producing minor gastrointestinal discomfort and elevation in SGOT and LDH when used.

Publication Types:
Review

PMID: 11273351

My father, for instance, has heart disease. He has congestive heart failure as a result, and I was looking at COQ10 specifically for that application. It would seem that they use it with some regularity in Japan for treatment of congestive heart failure. As a result of finding that info I asked my buddy the heart guy about it...

I had not seen the info about its impact on LDL, but it makes sense that it would raise it. Frankly, I take it myself because I feel it has a big impact in warding off gum disease and it benefits the heart. Not a bad combo, IMO!

I also think there is too little attention to nutrition in general, when it comes to heart disease and several other long term or chronic illnesses, including Type 2 Diabetes and high blood pressure. It may sound pretty "faddish," but do read the South Beach Diet if you want to see one small example of how your diet can contribute to health problems.

I have virtually eliminated processed sugars and white flours from my world. I also have converted to whole grains exclusively, and I feel MUCh better for having done so. I've lost weight and I have noticed less of the stuff like gas and acid indigestion as well.

We CAN do better than we have been when it comes to self treatments and prevention of some of this stuff. THAT is where nutrition and supplements can be a huge help, IMO. Maybe the free clinics will have the ability to help educate where the insurance companies and the docs who work for them can't--I dunno.


Laura

serious need either with yourself or a friend/relative.

http://www.amazon.com/gp/product/0345441079/qid=1135448140/sr=8-1/ref=pd_bbs_1/002-3684259-6981614?n=507846&s=books&v=glance

--but there is no legally mandated quality control for it. Your odds of getting a decent dose of whatever is on the label are about 50/50.

a standardized extract, nor are they manufactured in an ISO9001 certified facility. Neither of these is correct.

http://ethnobotany.yage.net/externalarticles/standards.html

--actually contain a useful dose. Depends on the brand. http://www.usrf.org/cr-09-00.html

The same goes for other herbal extracts they test.

some of the brands not doing the right thing, there is a book/database of some sort that has tested all the brands and the actual amounts found in all manufacturer's products are listed in it.

http://www.consumerlab.com/results/nr_cholestoff.asp

There are many factors that play a role in heart health and maintaining a healthy cholesterol level. These include diet, exercise, body weight and age. Adjusting diet and exercise properly will provide your body with the important nutrients needed to promote heart health as well as contribute to a healthy body weight. However, these factors alone don't always reduce high cholesterol levels. Other nutrients may be involved in lowering cholesterol. Plant sterols and stanols, the active ingredient in Cholest-Off, have been shown to reduce LDL ("bad") and total cholesterol by blocking cholesterol absorption. Therefore, in addition to a healthy diet and exercise regimen, supplementing with Cholest-Off can help lower cholesterol levels and promote overall heart health. Cholest-Off is recommended to be part of a daily regimen for Heart Health.

If it is just the natural subtance it will vary from plant to plant in potency. The thing to do is to check to make sure it says "standardized". Then you will know it is the potency it purports. Sometimes you will see them side by side. It may cost a couple more bucks but well worth it, to know what actual potency you are taking.

and I'll bet you'd be the very first to cry bloody murder over anyone posting "unproven claims" about alternative medicine.

He's an internist, and if a patient asks about "natural" cures (they're still manufactured, so they're not all that natural), he tells them what he knows. He recommends a more natural way all the time and tries to get patients to eat better and exercise more every day. He's had very few turn down the pharm option for the more natural options, no matter how hard he tries.

As for pot, he's been asked about it, but it's illegal for him to prescribe it in our state. He thinks that's crazy, though. He's had patients who've admitted that they use it for pain or nausea for chemo or long-term health conditions, and they say that it works. Studies back that up, for the most part. He just can't condone it or recommend it.

Malpractice is a huge concern, but in my opinion, most doctors are too gun-shy. Yes, Pharma has done some evil stuff (well, considering how evil they are . . . ), but they're not going around after docs as much as you'd think. Bad lawsuits also don't happen as often as the perception is, either. The reality is, more lawsuits should happen but don't because the case is murky or because the patient likes the doctor, and people don't sue people they like.

because there aren't any peer reviewed clinical trials to support their safety or efficacy.

But you're right: there aren't as many around as there are for Pharma's offerings. There are also problems in consistency, potency, and interactions.

Those "peer reviewed clinical trials" are definitely necessary.

Up until 2 years ago I took people out for walks at our local state park to introduce them to plant usage for healing and eating.I think we need both of these medical knowledges,as well as other ways of healing.Many nurses are returning for training to become nurse practitioners,that way they can proscribe chemical or herbal medicine.

thing going on.... and do you think I want it cut out?? Hell no. I will explore my options, starting here.


http://www.sensiblehealth.com/gallbladder.html

Most folks just don't want to hear it, no matter how
much pain, disability and expense they
are looking at in the "mainstream" medical
area.

I finally got it that, people WANT to be sick and
feel lousy.
My knowledge of alternatives is a competitive
advantage to me. As my peers age and sicken,
I remain strong and well.
If anyone asks me for advice, I give it, but
I've stopped trying to "help" people who
don't want an answer.

www.lef.org

www.alternativemedicine.com

www.nutritionfocus.com

www.orthomed.org

www.americanutra.com

www.efamol.com

www.martekbio.com

www.dhadepot.com

www.digitalnaturopath.com

www.vitaminshoppe.com

www.glycoexpert.com

IMHO, I don't buy CoQ10 because of its cost..

I've heard Puritans Pride, I think it is, has some very good prices on supplements.

left us with their corporate welfare, tax cuts and unnecessary "warz".

even cuba has free health care but not the greatest country on earth? why not
http://news.independent.co.uk/world/americas/article333837.ece

Are you asking why Cuba is not "greatest country on earth"?

Or are you saying we as the supposedly "greatest country on earth" should live up to that title?

is not going to like this.

Soon there will be a law against practicing medicine for free.

180

Many in our area volunteer at the free clincs. They're all for it, mostly because they're ticked off that they can't help everyone who needs it and keep their doors open.

federal grants, Medicare and Medicaid recipients are welcome and so are insured.

If you're disabled or have a cronic illness, you can borrow money to survive..but don't expect the government that raids your paycheck, to help!

At least someone still cares..in a nation that fires workers for developing a medical problem, and crucifies all who are least able to pay down growing debts.

Free clinics are fine for uncomplicated care and routine health exams, but they're not able to provide care for serious illnesses like cancer care or heart disease.

What are the uninsured supposed to do when they have a serious illness?

Not quite a year ago we lost an old friend. He died in the ER waiting room of his local hospital waiting to see a Doc. He'd been at home for a few days with crippling chest pains and refused to go to the ER because he had no insurance.

He didn't want to give up his "lavish" little apartment and his "huge" wardrobe of jeans and T-shirts (along with his addiction to stuff like food and running water) if he went into debt for medical care. (Please forgive my sarcasm here, but this story guts me like a fish every time I talk about it.)

He had worked retail for years and had supplemented it with work as a sound and light man for bands. He was a forgotten person--a gay man without health insurance or much in the way of material goods. He also was one of the funniest people I've ever known.

He had (we found out later) been told by a Doc a couple of years before that he needed to have some serious testing done. The docs thought he might have leukemia. He never had the testing done because he had no insurance and couldn't afford it. He chose to let it go because he figured that even if he DID have it he couldn't afford treatment for it anyway.

This stuff ALL pisses me off because had we known about it maybe we could have helped him. MAYBE we could have found him treatment someplace or maybe we could have given him information about things like Charity Care programs that are currently in place (and little advertised) by hospitals.

He chose to die rather than owe anybody anything. THAT is what the opponents of Single payer health care WANT.

Right now, in the community I live in, 90% of all the docs are associated with TWO clinics/Doctors' Groups. NEITHER of those two clinics/groups accepts Medicaid patients. If you are uninsured and too poor to pay up front for your care, you can go to the ONE free clinic that we have that accepts "no fee" clients.

We are not the only place this is happening, nor are we in as dire straights as other places. THIS is just our reality here in the US. If you are poor and uninsured you can't get regular treatment or follow up for chronic diseases, nor can you get treatment for the catastrophic stuff unless you end up in the ER and that condition is threatening to kill you.

While free clinics are a huge help to some people, they are NOT the answer to the problem. Single payer health care IS.


Laura

are those who lived somewhat outside the mainstream, like your friend. Who weren't wealthy, who sometimes hadn't a nickel to their names. They all gave as good as they got, and it was never with material things. And the things they gave will outlast every material thing I've ever owned.

We send our condolences to you and his other friends.

Mary

It's so very sad that anyone like your friend would suffer like that. We should all be agitating for a better American, one that takes care of its own and doesn't leave them to die in a waiting room, too late for any help. :cry:

The practice my hubby's in refuses Medicaid, too, and it really makes him mad. He had a few Medicaid patients who wanted to follow him from his residency clinic but who couldn't. Medicaid pays so very little, though, that the partners decided that they just can't afford it. They also figure that they're busy enough as it is. I do know that he looked into how they help uninsured, and they do cut the rates way down and work out payment plans to do what they can. He can handle that but is still furious that anyone would die from treatable diseases in this day and age. Don't get him started on how badly we need a national health care plan unless you have a few hours to kill.

I honestly don't. They have a large investment in education, and a very large overhead--no matter what size practice they are in. I sincerely doubt that most people go into medicine unless they honestly care about people. Hell--the hours most Docs I know keep are brutal--and they really don't get paid all that well for those long hours unless they are in some specific specialties.

The hoops they have to go thru just to get paid are just horrible. I doubt that many of them are in an office without at least a couple of staffers devoted to just billing and collections from the various medical plans (private or governmental.)

I honestly think that many Docs would tell you freely that they'd be willing to work for lower fees if it meant that they could hire fewer staff or be guaranteed payment for service rendered--without filing a mountain of paperwork or fighting to collect it.

My biggest issue is with a system that works so hard to drive expenses up that it prices services out of most people's ability to pay. THAT is where we have GOT to fight, and it is probably the toughest political opponent we can ever face. The insurance companies have a HUGE lobby, and they are quite good at what they do. THEY are the biggest villains, IMO.

FWIW, knitter4democracy, I would probably LOVE to sit down with your hubby someday and discuss this issue. I WANT to hear what other Docs outside my circle think about this subject. I doubt I'll be shocked by anything they'd say, except maybe by how vehement they are that we need reform.

Peace.


Laura

is costing them dearly. Most practices have one or two people just working with insurance companies to comply. It is total Bushit. I do believe they went into practice to hlep and now they barely spend 10 minutes with any patient.

I sincerely doubt that ten minutes is enough time to diagnose, discuss, and educate about a lot of the problems people go in with. That same pressure the Docs get to hustle patients through is costing us ALL in quality--and it isn't something the Docs can really control--especially in a group practice.

I have heard Docs talking about patient compliance with treatments and I know that for a lot of people that ten minutes is just not enough. I can't imagine that there is any more time available in free clinics either--you have to know the patient load is terribly high.

I have no doubt that any one of us has had the experience of walking out of the doctors' office and realizing that we forgot to ask something or can't remember what we were told. If you couple that with advanced age or any kind of mental impairment (even a high fever can do that) you just know that we have a lot of people who are not benefiting fully from seeing a Doc.

It also should concern us all because there is no time to look for other issues. By way of example: You can go in for a cough--that is maybe chronic--and if the doc doesn't get that info straight away, they might mistake that cough for some kind of viral thing rather than the symptom of a much more serious problem. We complain that Docs misdiagnose, but I seriously think that if they were left to work at a human pace--if they could take the time they need--we'd see a lot more accurate diagnosis.



Laura

Rushed medicine is bad medicine.

The practice that Hubby's in has a whole billing dept., 3 NPs, 2 PAs, and I don't know how many full-time and part-time RNs and assistants. All this for four MDs (they're looking to hire a fifth, the load is so heavy).

The ten minute visit, though, is specifically kept only for a follow-up visit to make sure everything's going well. All of the partners agree that they need as much time with the patients as possible and have found a system that works for them (15 min. for something that's fairly usual or simple, 30 min. for anything more complicated, 1 hour for new patients and yearly physicals or anything really complicated that needs more time). Of course, even with that, my hubby's often late, as he doesn't like to cut patients off or make them reschedule for a different appointment if he can avoid it.

I don't know any doc who likes the insurance companies. They hate them. Check out Placebo Journal (www.placebojournal.com) if you want to see what they really think of them (it's the only medical humor journal out there). It's by a family practice doc in Maine who's pretty mad at the whole system in general. My hubby loves that mag.

I have read many opinion essays in the med journals (New England Journal is quite liberal and getting more and more strident in its opposition to Bush) on how they would take less money if it meant a better job overall. The problem is, the insurance companies know that and exploit it. There are doctors going out of business or leaving several states because the costs of practice are too high.

As for the hours, they are insane. My hubby is lucky and works in a humane practice, but I will never forget those 120 hour weeks in residency (before the hours restrictions). It was hard on all of us, especially after I'd had our second child. Most doctors' spouses I know joke that we're single parents with the occasional live-in spouse. Hubby was up this morning and out by 6:30 (he'd overslept, as he'd planned on being gone by 5:30), and he probably won't be home tonight until the kids' bedtime of 8pm. That's an easy day, as when he's on-call and covering all the hospital patients, he often gets home later than that only to be up all night answering phone calls and pages and then in early the next morning to check on the hospital patients before heading to the office. All this for a good salary that helps us cover his med school debt (more than our house is worth) and is helping us pay off our consumer debt from med school and residency.

people need medical care its their right...

It is a right, not a privilege to those who can pay for it.

without the government. We may have to sooner than later, because the people suffering in this country will mark the end of Democracy itself. It just might spark a modern day revolution.

which will soon approach the $500 billion mark, this country could have already instituted a solid national health care system. But it's more important that Halliburton and Bechtel execs get their billions from us taxpapers...