As Catholics, and other Americans, continue the debate over national solutions to help the uninsured, Our Lady of Hope Clinic in Madison, Wisconsin is helping treat the uninsured one person at a time. Long time reader Steve Karlen is the development director for the clinic, which opened in April of this year. OLHC has a unique model, based on Dr. Kloess and Dr. Johnson’s desire to provide outstanding primary care through a structure designed in accordance with Catholic principles of solidarity and subsidiarity.
Like the increasingly popular private practice or closed practice model, OLHC accepts up to a set number of patients, which due to OLHC’s non profit model are called benefactors. The limit is set at 600, which has not yet been met, so the clinic is still accepting memberships. Benefactors receive unlimitted primary care through the clinic with no additional charges or co-pays beyond the annual benefactor fee — which is set at a 1200 dollars with various discounts which can apply for couples, children, or younger patients. (This pricing is comparable to other closed practice/concierge-style doctor’s offices.) Like a closed practice, benefactors can make same day appointments any time and have direct access to their doctors via phone and email. They are expected to carry insurance for specialist, prescription and hospital care — however benefactors can often save money overall on health care by switching to a high deductible plan for care not covered by the clinic.
However, unlike the standard concierge-style medicine practice model, Our Lady of Hope Clinic provides free primary care to those without health insurance as well. OLHC is the region’s first, full time, free clinic serving the uninsured, with the capacity to provide 3,000 free medical appointments per year to those in need — many of whom are working poor who do not quality for current government programs. Treatment for the uninsured is completely free, with the only “cost” being that free appointments are offered on a walk-in, first come, first serve basis.
By providing the uninsured in the community with a venue to get treatment for basic ailments like ear infections and influenza (rather than falling back on the emergency room) and offering preventative and maintenance care for those with long term conditions such as diabetes, blood pressure and heart disease. The clinic can also serve as a gateway for uninsured patients, providing them with referrals to other facilities which offer diagnostic and specialty and hospital care — including other facilities which offer free or discounted care for those without insurance.
Obviously, a model which has doctors spending half their time on non-paying patients isn’t going to be making them rich, but what makes it possible for the practice to be a stable, family-supporting job for the doctors is dropping the overhead expenses doctor’s offices normally spend dealing with insurance companies, Medicare and Medicaid. OLHC is run entirely off the memberships of benefactors and does not accept insurance or government health care programs of any kind. Should new strictures eventually be offered requiring such practices which accept government funds to offer birth control and other services incompatible with a Catholic conscience, this give the clinic independence, but the primary reason for this is to avoid the significant administrative costs that is involved in dealing with both insurance and Medicare/Medicaid. This allows the doctors and staff to focus all their time and energies on patients, and makes the clinic a truly local unit of solidarity.
Though the concierge-style closed practice has become an increasingly popular model in large urban areas, Our Lady of Hope Clinic is only the second Catholic clinic to launch with this type of model, following in the steps of St. Luke’s Family Practice in Modesto, California. Such an approach is necessarily local and personal, and I hope its example will not be automatically dismissed for that reason. In our mass society, statistics sometimes seem to be taken more urgently than direct action. Problems stated broadly such as “there are 47 million uninsured in America” can lead some people to argue that a local effort which helps a few hundred or a few thousand makes “no difference”, turning instead to organizations as large and distant and the statistics themselves in search of solutions. And yet, every problem is a local problem for someone. While the proliferation of clinics such as OLHC would clearly not solve all problems in our national health care system, I think this is clearly a deeply Catholic response to the problems which many of those in our communities suffer, and I hope that more such clinics will follow the example of Our Lady of Hope and St. Luke’s.