published Sunday, April 6th, 2014

Local uninsured still have option of Volunteers in Medicine

Whether or not President Obama finds his Tuesday victory lap proclaiming 7.1 million enrollees in the Affordable Care Act is his administration’s “Mission Accomplished” moment, there are still millions of people in the United States without health insurance.

That’s why Volunteers in Medicine, a primary-care medical clinic which provides services at no cost to financially eligible Hamilton County individuals who otherwise have no access to health care, is still needed.

“We’re still here,” said Nancy Franks, the volunteer president who was the primary driver behind the faith-based clinic’s founding in 2005. “We’re not going anywhere.”

Chattanoogans should be grateful she and others saw a need, stepped in and acted. In a strategy opposite the creation of the Affordable Care Act, she brought together in public a coalition of foundations, churches, businesses and individuals and built upon an already existing model a health care solution that would not overlap what existed but found a way to reach the most vulnerable.

Where the Affordable Care Act (ACA) has left millions of the previously uninsured 47 million Americans still uninsured, Volunteers in Medicine (VIM) stepped in to serve Tennessee’s 850,000 who were uninsured and unable to get insurance.

It offers treatment to patients ages 19-64 who are residents of the county for a minimum of 90 days and who are not covered under the ACA, TennCare, Medicare, liability insurance, workers compensation or other medical insurance providers and whose income is not over 150 percent of the federal poverty level.

Franks, using figures from the Kaiser Family Foundation, calculates that about one in five people in Hamilton County didn’t have insurance before the ACA. Now one in six don’t.

She said many people believe anyone can go out and buy insurance, including through the ACA, but “they can’t. It’s an education problem.”

Sadly, whether people thought clinics such as VIM would not be necessary any longer or whether foundations and other contributors just changed their giving focus, the local clinic’s funding from foundations, churches, businesses and individuals — but no federal funds — fell off 10 percent in the last year.

“It’s always a challenge to raise half a million dollars a year to operate,” Franks said. “We always say it’s free care to the patient but not free care for the organization.”

Yet, that amount of nearly $500,000 delivers close to $2.5 million of medical care at a doctor’s office rate, she said. At an emergency room rate, it delivers between $9 and $10 million worth of care. For 2013, the $430,000 in funds received delivered $2.2 million in care at a doctor’s office rate and $9.8 million at an emergency room rate.

If the ACA offered that rate of return, people would be clamboring for it instead of 56 percent of the country opposing it, as a recent Fox News poll indicated.

“The rate of return is huge [for VIM],” Franks said.

The Chattanooga clinic is one of 96 across the country. The first was founded in Hilton Head, S.C., in 1994 under the leadership of Dr. Jack McConnell, a onetime Chattanoogan and retired physician who helped develop Tylenol.

Its average patient, according to Franks, is between 40 and 64.

The primary concerns of its patients are diabetes, hypertension, heart disease and cancers. Monthly, a mammogram van comes from the MaryEllen Locher Breast Center of Excellence, and that organization follows up with patients who need additional treatment.

For advanced cancers and other problems that require a specialist, patients are referred to Project Access, a referral network led by the Medical Foundation of Chattanooga in partnership with the Chattanooga-Hamilton County Medical Society that helps low-income county residents receive medical care.

The local Volunteers in Medicine clinic, through its first eight years, hosted 43,000 patient visits and saw 110,594 volunteer hours expended.

Among those volunteers is Dr. J. Randy Walker, University of Chattanooga Foundation Professor of Physical Therapy at UTC, who has offered his physical therapy services at the clinic every week since it opened. The clinic also provides hands-on training for his physical therapy students.

“I enjoy giving, being involved,” he said one day last week after winding up therapy. “It’s also service from the university perspective, and that’s important for us.”

While Walker says it’s a personal “joy to be able to give,” he also receives satisfaction in “seeing a change” in patients who might not receive services anywhere else.

“There’s a need for it,” he said.

Similarly, Franks, who’d be happy to get additional donations or volunteers, most importantly wants Chattanoogans to know there is assistance available for those who fall in what she calls “the big, black hole” where no health care is available.

“We’d welcome new patients,” she said.

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LibDem said...

It's great to conduct a campaign to sabotage ACA and discourage people from signing up, then brag about your success.

April 6, 2014 at 7:12 a.m.
sangaree said...

Volunteers in Medicine is not all the accolades this article is trying to make it out to be. It can take weeks to months to get in and people in need of immediate care and without insurance find themselves having to go to an emergency room anyway. At least that's what I've heard from people who attempted to be seen at their site.

April 6, 2014 at 11:08 a.m.
Rickaroo said...

About a week ago Ron Hart wrote an article in which he said that "Obamacare is an unwieldy morass of a solution to a problem that never existed." I was flabbergasted at how naïve or willfully ignorant one has to be to make such a bodaciously false claim. How is it that 45 million uninsured Americans, unable to afford or have access to quality health insurance while living in the richest country on earth, is NOT a problem? Did Mr. Hart mean that as long as he and his family are lucky enough or rich enough to afford it, then all is well and to hell with everybody else? Does he honestly think that those 45 million+ Americans are simply too lazy or stupid and therefore deserve to suffer and even die without health insurance? Did he think that nobody doesn't have health care in the U.S. because there is always the good ol' Emergency Room to turn to?

This editorialist exhibits every bit as much naivete or willful ignorance in this article. When he quotes from Nancy Franks, volunteer president, that "there is assistance available for those who fall in what she calls 'the big, black hole' where no health care is available," the key word there is "assistance" - which is VERY limited. While Volunteers in Medicine is a great organization and deserves praise for the charitable work that its volunteers provide, it is extremely limited in what it can do. It is able to give only the most basic of medical care and is not equipped to treat more serious conditions and emergencies. And the referral agencies it mentions for the more serious conditions are likewise very selective and limited in scope.

Thanks to Gov. Haslam's stubborn insistence in clinging to his ideological guns and callously refusing to expand Medicaid for those so poor that they fall through the cracks, there are still over 200,000 uninsured Tennesseans in that "big black hole." And VIM is in no way intended to fill that hole. In fact there is no charity with the means, the money, or the staff to be able to provide the full range of medical services needed for those still without health insurance.

It's time for these willfully ignorant and malicious ideologues, liars, and propagandists to stop disseminating false information and time for people to bring them to task for their brazenly false and erroneous claims. Give VIM the credit it deserves. But don't dare imply that it or any other charitable organization is the solution the uninsured are desperately needing.

April 6, 2014 at 12:38 p.m.

Maybe the charitable Tea Party will send out pictures of Benny Hinn, Billy Graham, and Jesus to the uninsured so the sick and dying can be healed at home to save money for bigger churches, church jet aeroplanes, preacher mansions, and Bryan College science teachers.

April 6, 2014 at 12:59 p.m.
Plato said...

" the Affordable Care Act (ACA) has left millions of the previously uninsured 47 million Americans still uninsured"

What an egregious lie that statement is. Millions of people have been left uninsured primarily due to bone-headed Republican governors like Haslam that don't want their name associated with anything that Obama is connected with, regardless of how beneficial it would be to their constituents. Beyond that, anyone that is left without coverage is doing so at their own volition choosing to pay a fine rather than obtain coverage even though the government would subsidize a portion of the premiums.

This whole notion that charities are a substitute for a legalized mechanism for folks to access health care, is about the looniest idea yet from the Wingnuts.

BTW Great post Rick - you flat nailed it! :)

April 6, 2014 at 4:37 p.m.
Rickaroo said...

Plato, like you, I cannot for the life of me understand how anyone can think that charities should be able to fill any and every void in our society. They certainly have their place, but there is something terribly amiss when a country as rich as ours has so many poverty stricken, poorly educated, uninsured people.

"Philanthropy is commendable, but it must not cause the philanthropist to overlook the circumstances of economic injustice which make philanthropy necessary." - MLK Jr.

April 6, 2014 at 11:44 p.m.
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