Friday, December 26, 2008
Bush Does Something Right
I applaud "soon to be ex"-president Bush for doing one thing right. During his 8 years as president he opened or expanded over 1200 community health clinics in the United States in under- served cities. These clinics are essential for providing basic medical care and are often the only form of care for people without health insurance.
Even patients who are covered under Medicare and Medicaid ( aka: MediCal in California) cannot find doctors who will see them and the community clinics are their only recourse. Without such clinics our emergency departments would be even more overrun, prenatal services would not happen and basic diseases such as asthma, diabetes and hypertension would skyrocket.
Community clinics will be serving even more people as job layoffs continue and people loose health insurance. What had previously served only immigrants and very poor communities, may soon become the place for mainstream health care, especially as the need for primary care increases with fewer doctors available.
Bush, with his "compassionate conservatism", made good on his early campaign promise to fund these clinics. President-elect Obama sponsored legislation this year that would quadruple federal spending on these clinics from $2.1 billion to $8 billion. (That is a lot of money but it pales when you think of the daily billions that are being spent on the Iraq war, the bailouts for failed business and other legacies of the Bush administration.)
All of this is a step in the right direction. Expanding "universal coverage" without making sure there are clinics and facilities to see patients is a strategy that will not work. Providing health care where people need it the most...in rural areas and urban inner cities...is essential.
Also essential is making sure we have enough primary care physicians and nurses to take care of patients. Even community clinics are finding it hard to find doctors to work there. If Obama wants to continue the (only) positive legacy of Bush, he better tackle the primary care doctor shortage and do it quickly.
Posted by Toni Brayer, MD at 9:56 AM