By Dr. Alieta Eck, MD
A 53-year old man, shoulders slumped, sat on the exam table at the Zarephath Health Center, a non-governmental free clinic in central New Jersey. He was asking me, one of several volunteer physicians, to fill out forms to apply for Social Security disability. His story depicted a safety net that is broken and beyond repair.
Afflicted with severe nasal polyps that have left him unable to breathe through his nose, only high dose prednisone gave him a sliver of relief. He told the tortuous tale of going from an industrious builder to an exhausted dejected unemployed man, unable to get relief. He had qualified for Medicaid, the state/federal “insurance” for the poor that so underpays physicians and surgeons it becomes a cruel offering of false hope.
Last year, surgery was cancelled at the last minute when the surgeon realized that he would not only receive very little compensation from Medicaid, but would also incur full liability if anything went wrong. For $1,600 the surgeon would have agreed to operate, but it may as well have been $60,000. The man was penniless, barely able to pay his rent. Someone told him about our free clinic, founded in 2003, and now seeing 300-400 patients per month at a cost of $18 per patient visit.
Taking no government funds, it operates by the donations of time and money from the community. I examined this man and realized that the surgery could be life-transforming. I called an ear, nose and throat specialist friend of mine. The clinic had some extra funds donated by people who understand our mission and we agreed upon a very reasonable fee. After applying for charity care at our local hospital, pre-op tests were completed and the surgery was done. He can now breathe easily for the first time in many years.
The Zarephath Health Center will pay the surgeon and the patient, so grateful that someone gave him a break, has offered to do whatever he can to help the Zarephath Health Center renovate a new facility as it moves out of a flood plain and quadruples its space.
When Judge Henry Hudson ruled that ObamaCare was un-Constitutional, we, at the Zarephath Health Center, breathed a sigh of relief. For this monstrous law would have increased bureaucratic red tape and placed millions more into a Medicaid system that was and is beyond repair. Costing NJ and federal taxpayers $9 billion per year now in a state with a total budget of $33 billion, it would have expanded the rolls without solving any problem of access to affordable health care.
Unable to find a doctor willing to work within the system, Medicaid recipients over-utilize the emergency rooms where they only receive a quick fix and a band-aid on medical issues that often run very deep. A recent proposal has been made to the NJ Senate minority leader, Tom Kean, suggesting that the Medicaid system be scrapped and replaced with a far simpler program to be administered out of one state office. Even forgoing the $4.5 billion in federal aid, the New Jersey taxpayers would come out ahead.
NJ physicians would be asked to donate 4 hours per week in a free clinic like the Zarephath Health Center. Surgeons could agree to do one operation for free or spend the time in a hospital clinic. The only compensation would be a big “Thank You” from the state in the form of medical malpractice coverage applied to his entire practice– the same coverage given to any physician who teaches in the medical school university hospitals.
No medical malpractice premiums would need to be paid– the state would just stand behind and protect the doctors willing to help the poor for no compensation. No billing, no claim forms, no checks, no corruption, no fraud and abuse– only a return to real charity, not entitlement. Doctors would be compensated by the reduction in office overhead, patients would find access to doctors, volunteers would step in and help and taxpayers would finally get relief. A real sense of community would result.
Maybe it is time to think outside the box, admit that Medicaid does not work for the majority of people who need it the most, and replace it with an assertive, basic, challenging, diverse, effective, gradual and sometimes even faith-based program that is simple, ennobling and empowering. After 45 years of a failed social experiment, it is time to replace Medicaid with real charity.
Dr. Alieta Eck, MD graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School of Medicine in St. Louis, MO. She studied Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. John Eck, MD in Piscataway, NJ since 1988. This article originally appeared on the Association of American Physicians and Surgeons website.
Just plain, old common sense. Note to Susan, Dr. Eck’s suggestions might need some refinement. But what a great starting point!
I totally agree. The more things change the more they need to remain the same. I founded a totally free clinic for illegal aliens in Texas in 1983 and have been delivering this type of care for 27 years for 4 hours a week on Saturday mornings. I also volunteer at our med school but never got any malpractice for that…great idea! Our clinic is popular and is now open 4 days a week. Last year we delivered over 2 million in care for a quarter million in expenses, including comprehensive pharmacy services. The patients contribute a good portion of the funds, and that, they can afford. The insurance that will soon be required of them….NOT.
I’d like to know the Medicaid patient couldn’t just sign off on a legal areement not to sue. Something in between might work. This diea is fine in theory but with even 20 volunteer physicians per health center that leaves hundreds in each neighborhood who may need a hip replacment, a compression fracture fusion, cancer treatment, blood transfusions and so on. A charity health center is not equiped to handle most serious cases such as Aplastic Anemia or cancer. More support is needed for inner city hospitals that do accept Medicaid and these patients. When such hospitals run away to the suburbs this leaves a greater burden for community health centers and more patients left abandoned. Serious illness or disability could force any of us to spend down to nothing sooner than you might imagine. This man could be you! Are you sure you want to do away with such a vital “entitlement.” How can we say life is an entitlement and pick and choose who we feel kile treating. Docs should hold the bag but society needs to do more for John Doe.
count me in
I think this is a brilliant idea that is TRULY efficient. No jackpots for EHR that may never produce an ROI, just a common sense solution.
That’s the only problem, this would require political support and it does not feed the system. It will be tough to achieve adequate scale without exclusively private sector, but I say let’s try it! How do I get involved?