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Establishment Media Discovers Community Health Centers

President signs the health insurance reform bill, which includes funding for CHCs. (Official White House Photo by Chuck Kennedy)

I first wrote about community health centers in the health care law in December, and have subsequently written at least 20 other articles referring to them. I maintain that it was the best money in the entire bill, adding the capacity for millions of people to access what amounts to a universal care program of free or near-free primary care medicine. They can also be centers for innovation in how we provide and even finance medical care, with the use of bundled payments and “medical homes” concepts.

Months and months later, the New York Times gets around to profiling one of these centers, in Portland, Maine.

First through the door of the Portland Community Health Center on Thursday morning was a stick figure of a man, oblivious to the homemade signs and the White House advance team across the street. He had a bald eagle drawn on his sweatshirt, a street-hard weariness in his eyes, and a throbbing pain in his right hand.

Sarah Andel, a nurse practitioner, knew this man, James Hierl: how he lived in a shelter; how his depression made eating seem futile. As she held his numbed hand, working to remove a painful wart with a blade, she coaxed and coddled him: You have to eat; you have to see your psychiatrist; and please, James, eat.

“You’re going to come back in a week,” Ms. Andel said, as her patient headed for the door, finger bandaged, cheeks concave, looking older than his 53 years. “O.K., James?”

Portland’s community health center is very new, having been established thanks to a stimulus grant last year. They provide care regardless of insurance or income, and patients pay a small fee on a sliding scale based on income ($3 per visit for someone making $10,000/year, for example). The center serves immigrants and low-income Mainers who would otherwise cost the state much more in uncompensated care. And the center appears to be a friendly spot for people to get both mental and physical health needs met.

With $11.5 billion in additional funding over the next five years, community health centers can play a major role in improving people’s daily lives, allowing them to be productive, even saving them from death. It’s an incredibly good, compassionate program and its importance should not be overlooked.

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David Dayen

David Dayen