Editorial: A model for care (Brattleboro Reformer)

There is plenty of talk about Vermont acting as a model for the rest of the nation in showing how health care can be delivered.

We have among the lowest percentages of uninsured people of any state, but there remains a number of Vermonters who fall between the cracks and don’t have health insurance.

But in Vermont, we already have a solution for that.

The Health Center at Plainfield delivers affordable and high-quality primary care, dental care, prescription drug services and mental health assistance. The center is open to everyone, regardless of age or income. It charges on a sliding scale, and people without health insurance pay what they can afford. No one is turned away.

There are eight other centers in Vermont like the one in Plainfield, housing doctors, dentists and other specialists under one roof.

They’re called Federally Qualified Health Centers and there are about 1,200 of them nationwide serving about 20 million patients a year. They’re nonprofit and are funded with a mix of private donations and federal subsidies.

They focus on primary care and preventative medicine. They are essential in a place like Vermont, which has a shortage of primary care doctors.

The Health Center in Plainfield serves nearly 10,000 patients in a part of the state with no primary care physicians and no dentists in private practice who will accept Medicaid. The center also provides transportation for people who don’t have cars, hosts health education classes and offers a range of services beyond patient care. And it still operates at a lower cost than comparable private practices.

Sen. Bernard Sanders says that these centers have "essentially solved the problem of primary care" for medically underserved areas of Vermont.

That’s why Sanders has an amendment in the Senate versions of the health care reform bill (Rep. James Clyburn, D-S.C., has offered a similar amendment in the House version) to boost the funding for the federally qualifying health centers from $2 billion to $8 billion. Sanders said that would mean an increase from 1,200 to 4,800 centers across the country in the next five years.

While the health care debate in Washington has been extremely rancorous, expanding health centers to more parts of the country has significant bipartisan support as an efficient and effective way to deliver health care.

Even if reform fails in Washington, Sanders has managed to steer some federal stimulus money for program and facility expansions at Vermont’s health centers. Sanders says this has resulted in 100 new construction jobs and about 100 more workers hired or retained at the centers.

There are many elements in fixing our health care system, but one of the major ones is providing primary and preventative care to keep small, easily treatable problems from turning into expensive ordeals for the uninsured and underinsured. It’s a lot cheaper to treat a medical condition early on in a doctor’s office, rather than waiting for the unavoidable visit to a hospital emergency room to treat something too late.

We hope more federal funding for facilities such as The Health Center in Plainfield is forthcoming, and that facilities like it will pop up elsewhere around the nation. It is a sensible and cost-effective solution that deserves support.