Bush is working to establish his legacy before leaving office in a few weeks and hopefully paving the way to huge leaps and bounds of change for the diabetes community in 2009. He recently doubled federal financing for community health centers nationwide, providing for the creation or expansion of more than a thousand clinics in medically underserved areas. These clinics, often the only dependable providers of basic services – and often the government’s safety net for diagnosing diabetes, in our opinion - are seen as a cost-effective alternative to emergency room care. Many uninsured and underinsured seek care there instead of these clinics.
The recession of course has only magnified this problem despite the recent growth of the clinics. While the clinics previously tended to serve people of lower socio-economic status, more middle and upper-middle class professionals who have found themselves unemployed and uninsured have sought care from these clinics. Patients are usually charged on an income-based sliding scale, with uninsured expecting to pay approximately $20 for an office visit.
President Bush supposedly began admiring the cost-efficiency effects of Texas community health centers and pledge to support them while campaigning in 2000. In his first year of office, he proposed to open and expand more than a thousand clinics over five years, a goal he saw accomplished. “They’re an integral part of a health care system because they provide care for the low-income, for the newly arrived, and they take the pressure off of our hospital emergency rooms,” Bush said last year.
Democrats are rumored to say these centers will be part of a central deal struck between Congress and President-Elect Obama, however Obama himself has said little in terms of specific plans. Despite these discussions, staffing shortages have highlighted long-term concerns about quality of care, particularly management and care of chronic diseases. In 2008, the government finally began collecting data at the center for performance measures including diabetes control. We can’t wait to find out more what standards of care they are determining as “diabetes control” and how effective they are.