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Free Clinic sees gap in area health care that it can't fill

By Katie Demeria

As the fight over Medicaid expansion in Richmond continues, those with the Free Clinic in Woodstock have found that, in reality, the benefits of a possible expansion would be limited.

Only a fraction of residents in the area with the potential to gain coverage after Medicaid expansion in Virginia will actually have increased health care, according to Free Clinic Executive Director Pam Murphy.

The clinic recently had a survey conducted by a third party organization to find out how many physicians in the area could take on additional Medicaid patients. They then compared that figure to the number of individuals who could register for Medicaid with the expansion.

The survey found that local medical providers would only be able to take on about 200 patients, while 1,600 residents could sign up for the program after expansion.

"That's a huge gap," Murphy said.

Many Shenandoah County residents must choose between supporting themselves and their families and paying for health insurance, Murphy said. Some can barely afford the minimum necessities in life, she added, so health insurance is not on their radar.

According to a community health needs assessment conducted in 2013 for Shenandoah Memorial Hospital by a third party consulting firm, Shenandoah County has a higher percentage of uninsured patients than both the Virginia and national averages.

The assessment also cited health care affordability and access to services as a key local concern.

Murphy said the Free Clinic attempted to help a local woman with cancer of the throat in 2013. Because she could not afford treatment, the clinic attempted to treat her as best it could while sometimes sending her to emergency rooms in the hopes that a specialist would feel compelled to do something.

"We could not find a surgeon who would offer this woman the free care she needed, and she died of the cancer," Murphy said.

Solutions to these kinds of problems, she added, probably will not be found in either Medicaid expansion or through the Affordable Care Act.

"There are really a lot of things that need to be addressed in this country in order to really have a viable, sustainable health care system," she said.

One issue that must be dealt with at the national level, she continued, is a declining number of local physicians.

"We have a problem in this country that we really don't have enough health care personnel, they're aging out," she said. "We're seeing the baby boomer generation doctors move on, and a lot of us baby boomers are getting to that age where we need more medical care now."

Insurance plans provided through the Affordable Care Act are also having a limited impact, according to Murphy.

Only two or three out of the 710 patients the clinic sees every year have been able to take advantage of an insurance plan through the new online marketplace, she said.

Many cannot afford the plans even at reduced cost.

"I think we would be deluding ourselves if we believed that somehow offering people discounted insurance is going to solve the problem," Murphy said.

"There may be a few people who know they have really serious issues who might seek out that money, but the majority of us are going to hope and pray that we can get better jobs to get better health insurance," she added.

The ability to apply for Medicaid would still probably be the best option for many of the clinic's patients, Murphy said, but many need a much bigger change.

"As much as I appreciate the thought that people have confidence in free clinics and health centers to help fill the gap, there are some gaps that we just cannot fill," she said.

Contact staff writer Katie Demeria at 540-465-5137 ext. 155, or kdemeria@nvdaily.com

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