Our View: Fighting for funds
On May 31, the city of Longview, Texas, received the good news that it had landed a $541,667 grant through the Department of Health and Human Services to provide health care to the low-income and uninsured. Last week, Spokane People’s Clinic got the bad news that it had lost its $400,000 HHS grant to do similar work.
Welcome to the grim zero-sum game of picking winners and losers from a bundle of worthy applicants. These grants are prized, because the need is achingly obvious.
People’s Clinic got a reprieve Tuesday when Washington State University President Elson Floyd agreed to dig into the university’s reserves to replace the grant money for one year. Floyd noted that the deadline of July 31 for patients to find other care was unrealistic. But he also noted that this is a one-time infusion.
If the clinic closes, about 3,000 patients will have to scramble to find care. That’s too many for remaining community clinics to absorb. The result will be more pressure placed on already stressed emergency rooms and an increase in costs associated with last-resort care.
This isn’t a matter of the clinic not deserving the money. A recent review gave it high marks. It’s not a matter of federal funds being cut. The Washington Post recently reported that 500 new clinics have been opened since 2001 and that funding has been boosted by $645 million since 2002.
The problem is that funding continues to lag behind the demand for services, which should be no surprise in a nation where an estimated 46 million people have no health insurance and where the number of employers who offer coverage steadily declines. Until national leaders face up to the enormity of the problem, an increasing number of people will suffer.
The funding gap extends to the National Health Services Corps program, which repays new doctors’ education costs in exchange for practicing at clinics in underserved areas. The program turned away 1,800 doctors last year. The recruitment of veteran physicians is hampered by the higher wages paid by the private sector and the unwillingness of enough doctors to migrate from specialties to general practice.
Another problem is the nationwide nursing shortage, with private health care providers offering top dollar to snatch coveted nurses. This dynamic also hampers the recruitment of nursing instructors. One of the tragedies associated with the possible closure of the People’s Clinic is that it would rob nursing students of a laboratory to develop skills.
Next year, clinic staff, patients and the entire community will be back to worrying whether the federal grant can be reclaimed. And if our community wins, another will lose.