Provide Primary Health Care, Save Money

Community health centers are open to patients with Medicare, Medicaid, private insurance, and those who have no insurance at all. No one who walks in is turned away because he or she lacks payment.
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Community health centers provide quality primary care at a significant savings for millions of Americans, but 60 million Americans still lack meaningful access to primary health care, dental care, mental health counseling and low-cost prescription drugs.

Those are the people Tom Daschle was talking about when the next Health and Human Services secretary wrote that "even if we achieve 'universal' coverage, there will be some percentage of people who still fall through the cracks."

So as Congress and the new administration take on both our economic and health care crises, putting significantly more resources into community health centers would be a smart way to save money, create jobs and help millions of Americans stay healthy.

Community health care programs have been around for a long time. People accept them as a part of their everyday lives. More than 40 years ago, Senator Edward Kennedy had the foresight to author legislation creating the community health centers. Today, support for the successful Federally Qualified Health Center program cuts across party lines. The program was significantly expanded under former President George W. Bush, but we can do much better. One person who agrees with us is President Barack Obama, who last year cosponsored a bill in the Senate to significantly expand the program.

Today, community health centers provide primary medical care to 18 million Americans in underserved rural areas and inner cities. Their doors are open to all, including patients with Medicare, Medicaid, private insurance, and those who have no insurance at all. Furthermore, the centers provide their services on a sliding-scale basis, meaning that those with low incomes receive discounts. In fact, those whose incomes fall below the federal poverty level pay only a nominal fee. No patient who walks into a community health center is turned away because he or she lacks payment.

Our current $2 billion-a-year investment in community health centers provides comprehensive primary health care through 1,100 community-run, not-for-profit organizations in every region of the country. The average cost in federal funds comes out to about $125 per patient per year. By increasing funding to less than 0.5 percent of overall U.S. spending on medical care, we could provide primary health care to every American who needs it. In other words, for a total of $8.3 billion by the year 2015, we could have 4,800 health centers caring for 60 million more Americans in every currently-designated medically underserved area of the country.

In addition to meeting compelling needs, this upfront investment would more than pay for itself. Published reports indicate that overall medical expenses for health center patients are 41 percent lower than for patients seen elsewhere. In the case of Medicaid alone, total costs for patients are almost $1,000 less per person per year than for Medicaid patients treated in other settings. This is achieved by treating people when they should be treated instead of relying on expensive emergency rooms and unnecessary hospital admissions. In fact, community health centers are estimated to reduce health care spending in the United States by between $10 and $18 billion annually.

It is not often that we are presented such a clear win-win situation. A program that meets critical needs while reducing expenditures by more than it costs. No wonder that federal auditors consistently rate community health centers as one of the most efficient uses of federal funds.

In the richest country in the world, no American should have to go without basic health care. Community health centers are a critical lifeline for millions of Americans and we must build upon their success by expanding them to all those in need.

Sanders, a Vermont independent, is a member of the Senate health committee. Clyburn, a South Carolina Democrat, is the House Majority Whip.

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