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Affordable Care Act not helping enough, clinic director says

Author: B. J. Drye, editor of The Stanly News & Press

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Although the Affordable Care Act’s objective was to ensure that everyone, regardless of economic status, receive greater access to health care, concerns suggest otherwise.

The working poor appear to be part of the demographics on the losing end of the Affordable Care Act’s original intentions. Statistics suggest the federally-mandated health care system is working. Behind the numbers, however, lies a concern that the working poor are expendable when it comes to improved access to health care.

The John P. Murray Community Care Clinic in Albemarle is set up to medically serve Stanly County’s working poor, or those who have no private health insurance, Medicare or Medicaid. To be eligible for services, the patient or client must be between the ages of 18 and 64, diagnosed with a chronic disease requiring daily medication and with a total income of 200 percent of the federal poverty guidelines or less. Typical clients are those working uninsured for minimum wage or less than full time.

“It’s really for people who have nowhere else to go,” said Chris Vaughn, Community Care Clinic director.

When jobs became scarce and the economy tanked in 2008, the number of visits at the clinic increased because there were fewer options for the working poor.

Patients of the Community Care Clinic are those who had fallen between the cracks before the implementation of the Affordable Care Clinic. After the adoption of the national plan, they are still falling between the cracks, but for seemingly different reasons.

Fewer patients are visiting the clinic. Last year, the clinic served 2,264 patients with a medical value of $335,445. Pharmaceuticals distributed there during the period account for $2.2 million.

This year, however, the number of visits declined 20 percent.

On the surface, fewer visits suggest the Affordable Care Act is working. Instead of relying on the services of places like the clinic, the numbers hint that more people are using their insurance for services elsewhere.

But that’s not the case, Vaughn said. Instead, the working poor are going without treatment because they cannot afford premiums and co-payments along with their other financial obligations, she said.

“Some are trying to pay for the Affordable Care Act because they see it as the right thing to do,” Vaughn said.

Their participation, however, comes at the sacrifice of paying other bills, including trips to the doctor, Vaughn said.

“The Affordable Care Act is good for when you go to the hospital,” Vaughn said.

“But for trips to the doctor to treat chronic diseases, many don’t have the money. We tend to treat what hurts.”

Dennis Joyner, director of the Stanly County Department of Social Services and a member of the clinic’s board of directors, said he has witnessed a decrease in the number of services offered by DSS since the implementation of the Affordable Care Act.

“There are a lot of unknowns for how it’s going to play out for a lot of people,” Joyner said.

He added that it remains uncertain if the drop in visitations is due to a lack of affordability because of premium requirements caused by Obamacare.

“I don’t know if the drop we’ve seen is specifically related to that,” Joyner said.

“There’s just no hard data to support that.”

Hospitals across the nation, including Stanly Regional Medical Center, are having to adjust to the national health plan. Consequently, there has been a ripple effect.

“The healthcare industry across the country is undergoing profound changes, both locally and nationally,” said Caroline Lilly, spokeswoman for Carolinas HealthCare System.

“Healthcare providers are facing some unprecedented expectations regarding access, affordability and quality. Federal, state and local budget shortfalls, as well as legislative, regulatory and policy changes, have resulted in constant payment reductions for the care we provide.”

Because of the premium of the Affordable Care Act, many are doing without. Vaughn recalls visitors that report finding ways to live without electricity, or void of heat and proper nutrition. When Vaughn recommends the Community Table as a source for meals, some complain they lack transportation to get there. One patient said she is homeless, choosing to live in the Uwharrie National Forest.

“Those are the people who bother me the most,” Vaughn said.

For those in extreme poverty, they have Medicaid. Medicare assists needy seniors. But the working poor have fewer options, especially in North Carolina.

When the state, like 24 others, failed to expand its Medicaid provisions to offset what the Affordable Care Act would not cover, the working poor again fell through the cracks of the system, Vaughn said.

Vaughn added that she routinely observes patients who ignore their health because of financial hardship only to fall into further decline.

That decline then begins to affect their ability to present themselves for gainful employment. Many of these people are willing to work, but may lack extra skills to transcend into another occupation, she said.

More people are choosing to abandon participation in the Affordable Care Act. There are 1 million North Carolinians without insurance, despite the mandated health care plan, Vaughn said.

Joyner also questions the fallout of those dropping their new mandated healthcare.

“They may enroll, but have to drop it because they can’t afford the premiums, instead choosing to pay the penalty,” Joyner said.

“We just want folks to get adequate care and that it’s consistent.”

The intent to create a national system to ensure health care for all Americans appears to have overlooked the working poor. Instead, they’re opting to go without treating chronic diseases that will eventually affect their ability to work.

“These are people you want to help,” Vaughn said.

About the John P. Murray Community Care Clinic

The Community Care Clinic was founded in July 1998 thanks to the vision of Dr. John P. Murray, a retired physician in Stanly County. The mission of the clinic remains “to provide quality care for the working poor in Stanly County.”

The John P. Murray Community Care Clinic does not receive any federal, state or local funding. It is a 501c3 organization that relies on donations and grants for funding. Stanly Regional Medical Center, Stanly Regional’s Foundation, United Way of Stanly County, Blue Cross and Blue Shield of North Carolina Foundation and local churches provide the majority of funding. Patients are asked to bring a donation to every clinic visit.

The clinic also relies on donations and support from the greater Stanly County community.

There are fewer than three paid staff at the clinic, with 18 medical providers volunteering their services. As many as five college students also volunteer.

The clinic is at 303 Yadkin St., Suite C, Albemarle. For more information, make a financial donation or volunteer, call (704) 984-4668.

B. J. Drye is editor of The Stanly News & Press. Contact him at (704) 982-2121 ext. 25, bj@stanlnewspress.com or PO Box 488, Albemarle, NC 28002.

DMU Timestamp: November 11, 2014 20:35





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