Uninsured population varies in area
By Cynthia T. Pegram
Lynchburg News and Advance
Sunday, March 16, 2003Central Virginia has an estimated 21,000 people under age 62 who don’t have health insurance.
That’s about 1,000 more than last year.
The uninsured population is sandwiched between senior citizens who can getMedicare at about age 65, and children who come under the state’s medical insurance.
Bob Barlow, executive director of the Free Clinic of Central Virginia describes the uninsured as a varied group — some who work long hours at jobs that don’t have benefits, or where the cost of benefits is more than the worker can afford to pay. They’re the folks who just got laid off and can’t pay the price tag of continuing health insurance until they find a job. They try to make with their reserves, but reserves don’t last.
The oldest among them are those who have Medicare but no ability to pay for drugs for chronic illness. Or they are desperate for dental care.
Concern about the uninsured is rising after the weeklong national focus for the first “Cover the Uninsured Week.”
“We think Covering the Uninsured is one of the best things that has happened in a long, long time,” said Mark Cruise, director of the Virginia Association of Free Clinics.
“What it’s doing is developing a national dialogue, raising awareness of people cross the nation at how bad the crisis is.”The best result, said Cruise, “would be system reform.”
The Association of Free Clinic data says that up to about one quarter of all Virginians may have been without health coverage in all or part of 2001 and 2002.
“That’s an alarming statistic,” said Cruise last week in an interview.
Virginia’s population is about 7.2 million people.
The Virginia Health Access Survey puts the number at 413,000 uninsured in 2001 — those are people at or below 200 percent of the poverty level.
Often the uninsured are the people who turn to services like the Free Clinic of Central Virginia.
“And we’re seeing about a 10 percent increase over the last six months,” said Barlow, director of the Free Clinic which has served more than 11,000 people since its founding in the late 1980s.
The uninsured also go to the Emergency Department at Lynchburg General which had 72,000 patient visits last year, and where 22.7 percent of the patients were uninsured.
They also go to the Centra Health Johnson Center in downtown Lynchburg, with 12,538 patient visits last year, up 4 percent from the year before.
Cindy Kirkland, assistant director of Lynchburg Social Services, says that the numbers of people who are older, blind or disabled applying for benefits has increased from 586 cases in October, to 730 by March 10.
“Free clinics served about 56,000 people last year,” said Cruise.
People who are uninsured often delay medical care, according to an Institute of Medicine study. The result is when they get care, disease processes are further along before the first attempt to treat. And their financial plight puts them at a disadvantage to paying patients.
Most of the uninsured who go for treatment at Virginia’s 47 free clinics are working full or part time, said Cruise. “They’re not people sitting at home.”
At the Free Clinic of Central Virginia and at the Bedford Christian Free Clinic, both medical and dental care are available. Because dental care and prescription drugs aren’t covered by Medicare, when elderly low-income people need those services they come to the free clinics.
But most are much younger, probably in their 50s.
“They are very definitely people trying to make a living and supporting their families,’’ Cruise said. “They have wrenching choice — pay for doctor’s visits or put food on the table.”
Not many children are treated at the state’s free clinics, said Cruise. “Virginia’s Medicaid and FAMIS programs are set up to serve the majority of children who have household incomes at or below 185 percent of poverty. If children come to the free clinics, they’re quickly referred for enrollment” to those programs.
Not all the nation’s uninsured are in the low income category, said Cruise, they just can’t pay the $300 or $400 a month for an individual policy. “They make that choice and it contributes to the numbers of uninsured.”
The vast majority of health insurance is through employers, said Cruise.
The free clinics are supported mostly by the private sector, he said.
“Money is not easy to come by,” Barlow said. “We are aggressively seeking new grants from agencies and foundations we’ve not gone to before.”
Some, by utilizing resources like the Greater Lynchburg Community Trust, can have the equivalent of a foundation that produces on-going income.
The Virginia Association of Free Clinics estimates that the clinics spent some $11.6 million in 2002. And for every dollar spent, Free Clinics provided $4.57 in health care services.
It’s the volunteers that make that possible.
Some 9,197 people volunteered in free clinics last year — a figure that included 2,439 physicians, 1,233 nurses to 527 dentists, 191 dental hygienists and 312 pharmacists.
Some $28.3 million in medicine was donated by pharmaceutical manufacturers to free clinic patients.Cruise says that even though so much obvious need is out there for people without insurance, “I’m not optimistic. We’re not seeing any system reform in our health care system in the near future. Free clinics will be around for awhile.”
Contact Cynthia Pegram at cpegram@newsadvance.com or (434) 385-5541.