in the trenches

Last week I visited with a local book club, and one of the members was a nurse practitioner working in the trenches herself. She’s at a nearby community health center, a joint that will take care of anybody who walks in the door, where the charge is $15 for those with the lowest income. It’s a critical piece of the local safety net.

Anyway, she told us that finances are forcing her patients to lapse on their medication on a regular basis, and mental illness has gotten out of control in so many. And then there is the occasional patient who becomes insured and asks whether they’re still allowed to see her for medical care.

The nurse practitioner smiled but shook her head. Somewhere along the way we came to believe that those with health insurance don’t get health care at the same places as those without. Like all community health centers, this one is desperate for even the tiniest bits of income, so she says “yes please,” and all but begs her insured patients to keep coming back.

Community health centers provide a tremendous amount of primary medical care and doing so keep people out of Emergency Rooms. The reward? These unsung folks work incredibly hard and make less money than pretty much any other outfit in town. It’s yet another striking example of how sorely misaligned incentives are under our current system.

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Filed under book clubs, do gooders

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