by Robert Maynard
Vermonters were recently treated to the story of how the Zarephath Health Center in New Jersey was born out of a vision, a book and a disaster. It is the story of charity care without taxpayer funds, or compassion vs. bureaucracy. It is also a story that some are looking at replicating here in Vermont
On Friday September 21 the St. Michael’s College Conservative Club; the Green Mountain Patriots; Christian Medical and Dental Association, UVM Chapter; Vermont 912 Group; Vermonters for Economic Health and the Ethan Allen Institute hosted an event entitled “Charity Care Without Taxpayer Funds: Is It Possible?” featuring Alieta Eck, MD. Dr. Eck described how voluntary associations can provide large-scale medical care at NO taxpayer costs to Vermonters.
The story of Alieta and John Eck, both primary care physicians, is spelled out in a small booklet by Alieta entitled “The History of the Zarephath Center Health“. Their story started because they were frustrated with the state and federal Medicaid program, designed to care for those without means to pay for medical care. They wanted to make sure that they had a way to care for the poor. Despite the fact that the Medicaid program in New Jersey has expanded, costing taxpayers huge sums of money, the low rate of Medicaid reimbursement is causing private practitioners to lose money on these patients. This is causing physicians to avoid the program and treat patients for free.
It occurred to John and Alieta that a facility established in the vicinity of a local Church could utilize volunteers and charitable donations to involve the broader community in implementing a comprehensive strategy to see each poor person as an individual. Most have needs far greater than just medical, and this would cost the taxpayers nothing. That was the vision, the book was Dr. Marvin Olasky’s 1992 work entitled “The Tragedy of American Compassion“, which chronicled America’s anti-poverty programs beginning with the founding of the nation. Olasky discovered that the most successful programs were faith based, gradual, individualized, challenging and local – the exact opposite of the current bureaucratic, top-heavy government systems. The disaster was when Hurricane Floyd roared through in September of 1999 and left a little 900 square foot house under 14 feet of brown murky water. In 2001 the planning and reconfiguring of the house was approved so that it could become a clinic. Volunteers and donors pooled resources so that the Zeprephath Center was debt free when it opened its doors in 2003. Based on Olasky’s “ABCs of Compassion, the center seeks to identify and address the root causes of poverty, while the government simply sees poverty as a lack of funds.
From this humble beginning the center now has grown to a regular staff of 6 physicians, about 30 nurses dozens of support staff. It has moved out of that 900 square foot former house and into 5000 square foot facility. The center is funded completely by donations and the dollars left in a front box by the 300-400 grateful patients people see each month. All visits and medicines are free. The volunteers and patients feel blessed because they are following a Biblical model to care for the poor. In addition to being more effective than the government’s victimhood model, it costs 10% of what it costs the government at a taxpayer funded fully qualified health center. The center receives no government grants or taxpayer funding.
In May of 2011, Alieta was asked by Senator Rand Paul to go to Washington DC to testify at a Senate subcommittee hearing on how to keep non-urgent illnesses out of costly emergency rooms. She took the time to point to the Zarephath Health Center as a model program that would help to deter the unnecessary use of emergency rooms. She then went on to chronicle cases that the center has taken that would have been extremely expensive if the patient had went to an emergency room, as usually happens in such cases. She noted that the Senate Committee’s own material made the case that a visit to the emergency room averages $1000 per incident, which is roughly seven times the cost of a visit to a community health center. In acknowledging that her own research confirms this finding, she pointed out that the average visit to these centers costs between 140 – $280 per patient. In comparison, a non-government free clinic, such as the one she and her husband founded, costs $13 per patient. This is one tenth to one twentieth the cost of a federally qualified clinic. If there were an adequate number of non-government free clinics, the cost to the taxpayer by keeping people out of emergency rooms would be 100%, and the cost to charitable donors would be minimal. A federally qualified health center in the next town over from where the center is located has an annual budget of $14 million, while the center’s annual budget is $58,000 – none of it coming from taxpayers. Dr. Eck estimates that, for the amount it costs to fund one federally qualified health center, 250 clinics like the center could be funded. In addition to the vast cost savings, she believes that such centers would also deliver better and more personalized care.
The biggest obstacle to expanding the scope and number of such centers and thus fully realizing this vision is current tort law. More physicians would volunteer more of their time if they were not afraid of exposing themselves to frivolous lawsuits. The answer to the problem is serious tort reform. Physicians and citizens in New Jersey have come up with a solution that would make it easier to expand the number of non-government free clinics. They have proposed the NJ Volunteer Physicians Protection Act for physicians who volunteer to donate four hours per week in non-government free clinics. Instead of paying for their service, the sate would extend the same medical malpractice coverage it now provides to medical school attendings, residents and students to the entire practice of physicians who volunteer.
Perhaps we here in Vermont may want to take a closer look at this approach.