Free clinics meeting a need

SCHENECTADY, N.Y. — After Rick Sawyer had a heart attack last year, he suddenly found himself in one of life's most frightening predicaments.

The 60-year-old from Scotia, N.Y., was staring down a huge stack of hospital bills and had no health insurance for the first time in his life. He soon became one of the growing cross section of racial and economic demographics turning to free clinics for medical care.

The National Association of Free Clinics estimates there are about 2,000 free clinics today generating about $3 billion in health-care services annually.

With about 46 million uninsured Americans today, those clinics are rapidly growing to accommodate a flood of patients.

The Schenectady Free Clinic, where Sawyer went for help, started in two rooms in a rundown former school building just a year ago. Driven by demand, the clinic is now in a spacious new office lined with a small pharmacy and six exam rooms.

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

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. According to the Institute of Medicine, an advisory arm of the National Academies, a group of science and technology experts, the uninsured population costs the country between $65 billion and $130 billion every year.

"As the national statistics on the uninsured has crossed all professional and racial lines over the years, we've seen a representation of that change," said Linda Feldman, spokeswoman for the Venice Family Clinic in Southern California, one of the largest free clinics in the nation.

At Venice, it's not so unusual anymore to get patients who are recent college graduates or come from suburban backgrounds.

"When people say free clinic, you think of tiny buildings that administer to homeless people and drug addicts," said Eric Moore, who went to the clinic a few years after graduating UCLA. "You don't think it's for people who are working."

Now a 35-year-old substitute teacher, Moore had been working two part-time jobs with no health insurance when he suffered a blood clot in his left leg.

But like Moore at the time, the bulk of free-clinic patients earn too much to qualify for government assistance, yet too little to afford health insurance.

According to the Robert Wood Johnson Foundation, a philanthropy group that advocates health-care access, 80 percent of the nation's uninsured either work or are in working families. Among the uninsured working population, 56 percent work full time year-round, while the remainder work part time — sometimes juggling two or three jobs.

Still, free clinics across the country annually serve only about 3.5 million people, just a fraction of the nation's uninsured.

"They're Band-Aid solutions until we have a more nationalized way of addressing the issue," said Liz Forer, director of the Venice Family Clinic.

The services provided at a clinic can vary depending on its circumstances, its staff and the community it serves.

The Mission East Dallas in Texas, for example, provides root canals and tooth extractions because many of its 130 volunteers are dentists. The clinic, which uses the pews of a former church as a waiting room and the ladies' room as a triage area, plans to break ground on a new facility in the spring of 2007.

The Moore Free Care Clinic in central North Carolina, meanwhile, runs a popular physical-therapy class for the many patients who pour in with back pains. A volunteer there works as a physician assistant with back specialists.

Though it's just over a year old and still operates out of a donated office in the county health department building, the Moore clinic is also expanding its hours to accommodate the growing lines of patients turning up at its doors.

The Venice Family Clinic is an example of how sophisticated a makeshift free clinic can become out of sheer demand for services.

When it was started in 1970, it saw patients in the chairs of a donated dental office after business hours. It rapidly evolved over the years and now sees 22,000 patients a year at seven sites in Southern California.

The Schenectady Free Health Clinic served 1,232 patients this year, up from 303 last year. Demand is so high that the clinic is working with the state Health Department to open 10 more locations throughout the state. There is already strong interest from volunteer physicians in Oneonta and Ithaca.

"And if that goes well, we'll ask for 20 more," Spolyar said.