December 8, 2009
Local clinics could vanish along with state funding
Cuts may unravel health safety net
Our View
Every area of state government is being asked to sacrifice as the administration of Gov. Phil Bredesen tries to find $1.5 billion in cuts from the $29 billion budget approved in June.
But across-the-board cuts do not always take into account how hard-pressed certain recipients of state funding were before the budget trouble began. This is certainly the case for community and faith-based clinics, which provide care to almost 300,000 Tennesseans, including those who are uninsured, underinsured and who are homeless. Nearly 50 percent of the patient population at community and faith-based clinics in this state are uninsured, according to the Tennessee Primary Care Association.
For years, these safety-net facilities have been on the frontlines of the struggle over soaring health-care costs. So it was distressing in November to hear Health Commissioner Susan Cooper advise the governor and others attending state budget hearings that the $4 million that goes annually to these clinics would have to be eliminated if the Health Department is to meet the 9 percent budget cut target.
That funding has been committed to clinics since about 200,000 Tennesseans were removed from TennCare rolls a few years ago.
When Bredesen asked, "Are there not more generalized bureaucratic things that you can go after?" for reductions, Cooper replied, "There are no generalized bureaucratic anythings left.''
The commissioner said that the funding loss could force many clinics to close. That, in turn, would send many in this state to emergency rooms for non-life-threatening treatment.
Uncompensated ER care is a major factor that drives up U.S. health-care costs. Others who would have sought help at community clinics will forgo any treatment, risking severe illness and death.
Some community clinics that also receive federal dollars as part of their funding might be able to keep afloat, with shortened hours. But a number of the faith-based facilities have only the state for a dedicated funding source.
The governor and his advisers are working now on a budget to present to the General Assembly early next year. They should consider what will happen to the patients who rely on these clinics to take care of them and their children. They also should consider that continued high unemployment into next year is only going to increase the number of people who can no longer afford insurance and will need the services of these clinics.
Community clinics fly under the radar in the health-care debate, yet they represent the kind of access to care and high quality of care that should be a model for the industry as a whole. The broadest health threats facing Tennesseans, from diabetes to infant mortality, are the bread and butter of these institutions. Some have even added dental and mental-health services to their repertoire.
Most of all, they provide surety to patients who would be turned away from other health providers because of their inability to pay or because they cannot speak English.
The governor and the health commissioner have supported community clinics in the past for their invaluable service. Finding $4 million in alternative cuts will be difficult, but find them they must, if they are to do right by the people of this state.
