By Alieta Eck, MD
Physicians are waking up to the fact that they have been used by self-serving politicians and insurers. Their licenses have been co-opted by those who have profited greatly. While physicians were busy studying hard, excelling on their exams and putting in endless hours of often thankless care in their residency training, the MBAs were dreaming up ways to siphon off the fruits of their labor.
In 1965, physicians were blitzed when the huge government programs were started in the name of charity. Instead of being an efficient way to care for the poor and lift them out of poverty, "charity care" has become synonymous with big government programs that are heavy on bureaucracy, crushing the taxpayer and downright cruel to the poor. Medicaid cardholders have difficulty finding a physician who can afford to provide care with the low payments, so the government responds by setting up venues that cost the taxpayer dearly.
Federally qualified health centers (FQHCs) have been established-- each one handed a generous start-up grant of $650,000. They are given "enhanced Medicaid dollars," and free medical malpractice coverage, all ways to increase their revenues and decrease their costs. But a look at their Form 990s tell a story of profligate spending, of highly paid executives and well endowed bank accounts used for travel, "recruitment," and consultants. Sure, the poor are seen on a "sliding scale basis," but the return visits are frequent and the billing to the government relentless. One such clinic takes in $14 million in taxpayer funds and spends $160-280 per patient visit-- for charity care.
Patients are treated as commodities and campaign props for politicians "who buy the poor for silver." (Amos 8:6) and who do very well from the donations of those who establish these clinics. The taxpayer is hit from all sides. The practices of nearby physicians find they must work on an uneven playing field competing with institutions that exist because of their own tax dollars.
The perfect storm of an ailing economy, decreased government revenues, angry taxpayers and the clear exploitation of the poor by the corruption inherent in the Medicaid system is making the physicians wake up. They abandoned the Medicaid program a long time ago and instead have cared for the poor for free, giving real charity at their own expense.
So the doctors are asking, "Why should the taxpayers pay into the Medicaid system to the tune of $10 billion per year in NJ?" "Where is the money going, if physicians are not being paid?" While physicians were getting a total of $90 million in the NJ Medicaid system, the administrators of the Medicaid HMO's and FQHCs were reaping $500 million.
Now the physicians are demanding that the system be dismantled piece by piece, and are asking for volunteers and philanthropists to establish non-government free clinics through voluntary charitable donations. One such clinic was started in Red Bank, NJ, with a lovely building erected through the generosity of Jon Bon Jovi. Physicians are willing to donate their time-- as much as four hours a week, to care for the disadvantaged in their communities. No claim forms, no coding, no bills-- just care.
If the Volunteer Physicians Protection Act (VPPA) becomes law, doctors will receive state sponsored medical malpractice coverage for all of their other work, not just the charity. This would be a big "thank-you" that will only cost the taxpayer if an actual lawsuit is brought and prevails. Lawsuits will be rare, as is the case with the Federal Tort Claims Act that already covers work done in free clinics. And since medical school physicians and residents are already covered by the state, this program would just need to be expanded.
A free clinic in central New Jersey operates by the kindness of volunteers and the generosity of those who choose to donate to a worthy cause. Patients find that the kindness is palpable and they feel uplifted when they leave. The total cost per patient visit is $13. No taxpayer funds are used.
"Most of our twentieth-century schemes, based on having someone else take action, are proven failures. It's time to learn from the warm hearts and hard heads of earlier times."
Marvin Olasky, The Tragedy of American Compassion, c1992, p.233.
Every American needs to decide what role he might play in bringing health care to the poor. Volunteering a few hours per month in a non-government free clinic alongside doctors of every specialty would reap a world of benefit to the caregiver as well as the receiver.
Dr. Alieta Eck, MD graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School of Medicine in St. Louis, MO. She studied Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. John Eck, MD in Piscataway, NJ since 1988. She has been involved in health care reform since residency and is convinced that the government is a poor provider of medical care. She testified before the Joint Economic Committee of the US Congress in 2004 about better ways to deliver health care in the United States. In 2003, she and her husband founded the Zarephath Health Center, a free clinic for the poor and uninsured that currently cares for 300-400 patients per month utilizing the donated services of volunteer physicians and nurses. Dr. Eck is a long time member of the Christian Medical Dental Association and in 2009 joined the board of the Association of American Physicians and Surgeons. In addition, she serves on the board of Christian Care Medi-Share, a faith based medical cost sharing Ministry. She is a member of Zarephath Christian Church and she and her husband have five children, one in medical school in NJ.