An article in the Sunday, June 23 edition of The Washington Post entitled “Urgent needs from head to toe: This clinic had two days to fix a lifetime of needs” spoke to all of us at Mercy Health Clinic. The piece profiled a couple who decided to seek care at a pop-up weekend clinic staffed by volunteer medical personnel for their first medical appointment in four years. When Lisa’s appointment reveals that she has an urgent medical condition, she is transported to an emergency room for care, then released with an estimated $3,000 debt that they wouldn’t be able to pay, meaning more uncollected debt for a small rural hospital that struggles to stay in business.
There are many truths to this story that relate to patients at Mercy. Thanks to generous donors, Mercy will serve more than 2,000 patients this year. All are low-income and many have nowhere else to go for medical care other than a hospital emergency room, which is the most expensive level of care and the one that cannot offer continuity of care, which is especially important for those managing chronic conditions like diabetes or high blood pressure.
In The Washington Post a few days before, another article, “As price of insulin soars, Americans caravan to Canada for lifesaving medicine” had focused on families who, outraged by the rising cost of insulin, who were able to buy the insulin they needed in Canada, without a prescription, for a fraction of the price they would pay in the US.
At Mercy, medications, including insulin, are provided free of charge to patients because we know that the cost of medication may be a barrier to treatment. Patients might have to choose between buying medicine or groceries. Additionally, patients have been known to reduce doses or skip days to stretch their medications until they can afford to refill them. At best, these choices reduce the effectiveness of treatment, and at worst, could have a serious or life-threatening consequences.
Approximately one third of Mercy’s patients are managing a chronic condition, such as diabetes or high blood pressure. If not properly managed, these individuals are at significant risk of hospitalization, re-hospitalization, heart attack, stroke and serious infection that could require amputation of limbs.
We are serving the poorest of the poor, including the “working poor” who have jobs but still cannot afford care. More than 70% of our patients live at or below the Federal poverty level, individuals who are caregivers or work in fields that are low-wage and often do not offer health insurance, such as childcare, housekeeping, construction labor and other service positions. Even though they are employed, and work full-time, they still do not have access to health insurance and cannot afford health care. The Affordable Care Act expanded access to care in many states, including Maryland, but there are still some 60,000 adults in Montgomery County who do not qualify for any insurance program. Often, those who do qualify for subsidized “affordable” plans find that they cannot keep up with premiums throughout the year and then return to the ranks of the uninsured. In addition, we are now facing uncertainty regarding local and national healthcare policy and the impact it may have on people struggling with poverty.
Mercy is committed to providing care for our low-income neighbors, and we are continually evaluating how best to meet their evolving needs.