The debate on universal health care has brought attention to the thousands of low-income, uninsured Americans.
The Affordable Care Act, designed to make preventive care more accessible and affordable for Americans, will go into effect in less than two weeks. Marilyn Mesh, executive director of Suwannee River Area Health Education Center, said the new law isn’t perfect, but it’s there to encourage uninsured people to sign up for health care.
“We’re the only industrialized nation in the world that does not provide some basic level of health coverage to all its citizens,” she said.
North Central Florida has a particularly high rate of uninsured families. According to the U.S. Census Bureau, counties such as Union and Bradford have a per capita income below $18,000 per year, and employers are hiring fewer full-time workers and finding other ways to avoid providing health benefits, Mesh said.
Despite efforts by programs like the AHEC to see the needs of the rural poor met, other concerns have to come before health care for some people.
“I think that it is low on some people’s priority list,” Mesh said. “Some for financial reasons, some because they need food and gas in their car and clothes on their body, and at that moment, a health care need isn’t pressing.”
Because people can’t afford preventative care, they’re forced to wait for a medical crisis and go to the emergency room for treatment, which can lead to more serious problems and higher costs for patients and taxpayers. In the long run, she said, universal access to preventative care would save money by cutting down on emergency room costs.
Until the Affordable Care Act goes into effect, few low-cost plans are accessible to people who need them.
The Alachua County Organization for Rural Needs seeks to help low-income residents of North Central Florida by providing low-cost medical and dental care.
“ACORN is one of the few places that people can go and pay out of pocket,” said Mesh, who was the organization’s executive director for more than 18 years. “If you’re desperate for care, ACORN will see you.”
Nichole Vivas-Garcia, a recent graduate from the University of Florida College of Medicine, volunteered at Gainesville free care clinics like ACORN for years. Vivas-Garcia said she knows free clinics mean a lot to the families that use them. In some cases, the people she treats are not eligible for health care because of their citizenship status.
“Basically, these people don’t actually have to pay for their medical care in the Spanish clinic because they do it through grants and everything,” she said. “And a lot of them aren’t always legal immigrants, so they don’t have paperwork and things like that, so most clinics won’t take them.”
Mesh noted Gainesville is unique because it has multiple free clinics offering care to families in need. These clinics are maintained by a variety of groups, including churches, students and shelters.
“Gainesville and Alachua County is a wonderful area because there are so many health care providers who do choose to give up their time and expertise,” she said. “There is no lack of people who need care, unfortunately.”
People living in more rural parts of North Florida frequently can’t find the care they need close to home, forcing them to drive to larger cities, like Gainesville, for treatment.
Florida has a growing need for primary care physicians. Because specialists earn more money, Mesh said, the structure of the payment system leads young doctors looking to pay off student debt to specialize.
The health care law could change that system, placing an equal amount of value on primary and preventative care, evening out the disparity in payment and attracting more young doctors.
Republican lawmakers are still proposing ways to decrease funding for the program, but Mesh said there has to be a change — through a nationwide health plan or local clinic improvement.
“There’s some level of health care that we just can’t continue to provide, because few get a lot, and a whole bunch of people get nothing,” she said.
For more information on where free clinics are located in North Central Florida, as well as programs that AHEC has for rural health care services, contact a local AHEC branch: