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Saturday, December 27, 2008

Compassionate Conservatism at Work: Bush Expands Community Health Centers

Did you know President Bush expanded not-for-profit government health care? As governor of Texas, Bush saw that the free market just doesn't get the job done in health care. When he became President, Bush followed through on a campaign promise and used federal money to create or expand almost 1,300 community health centers. According to Thursday's New York Times, these clinics, funded mostly by Medicare, Medicaid, SCHIP, and federal grants, provide health care to low-income folks and immigrants in underserved areas. Some highlights:
  • These community health centers take pressure off emergency rooms, where the uninsured often go for non-emergency care when they have nowhere else to turn.
  • Bush's expansion of the clinics—now serving 16 million patients, up 60% under Bush's watch—is the alrgest boost to the community health center program since it started under LBJ.
  • A third of the patients served are Hispanic (yup, we're helping immigrants, also known as our fellow man).
  • Far from fitting the Limbaugh stereotype of wasteful government operations, community health centers are a model of efficiency: for an investment of $2.1 billion in current federal funding, these clinics return savings for the health care system of $17.6 billion a year.
More on community health centers' efficiency:

Though United Neighborhood Health Services has more than doubled in size this decade, Ms. Bufwack, its chief executive, manages to run five neighborhood clinics, five school clinics, a homeless clinic, two mobile clinics and a rural clinic, with 24,391 patients, on a budget of $8.1 million. Starting pay for her doctors is $120,000. Patients are charged on an income-based sliding scale, and the uninsured are expected to pay at least $20 for an office visit. One clinic is housed in a double-wide trailer [Kevin Sack, "Bush Has Built Foundation for Improved Health Care," New York Times, 2008.12.25].

The Times notes that these clinics provide great backup for whatever plans President Obama and Secretary Daschle may come up with to help the uninsured. If Obama and Daschle can't win funding for full-tilt health care reform, "a vast expansion of community health centers may again serve as a stopgap while universal coverage waits for flusher times" [Sack]. The community centers are on Obama's radar: this August, Senator Obama sponsored legislation to quadruple funding for these centers. Michelle Obama worked with community health centers in Chicago.

Bob Ellis once echoed some wishful rhetoric from the McCain campaign, saying that the use of community health centers to provide more cost-effective care and take pressure off emergency rooms was just "a liberal's idea of compassionate health care." Who would have thought that liberal was George W. Bush?

I'm man enough to admit President Bush has done some good things during his eight years. Bush's talk of compassionate conservatism was part of why I was willing to cheer his victory in 2000. His expansion of community health centers shows that even Republicans recognize the government can do some things, like health care, right. If Bush had focused more on programs like that, he might have kept a lot more of us cheering for him rather than for his departure.

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