Community Medical Clinics Should Not Be Coerced Into Charging for Their Services

To the editor:

As a physician, free-clinic volunteer, philanthropist, and significant donor, I believe that the biggest challenge to health-care charities is John Donovan’s question “If the government is involved in health care, why should I support it personally?” (“Fundraisers Worry About Losing Donors Under New Health-Care Law,” September 12).

I am saddened that so many free and community clinics across the country are being coerced to charge “sliding scales” to gain access to federal funding.

As much as they may spin it, the boards of these institutions have been pressured to alter their original mission statements and goals.

I also believe that development professionals need to be very concerned when their boards of directors or trustees modify their missions because of economic and revenue pressures. Many donors do believe that government is inefficient in providing access to health care.

As I read the article, I wondered how much it actually costs the Free Medical Clinic of Greater Cleveland to collect the small amount that it receives from their patient population.

I wondered how many patients avoid care and don’t come in, now that they are aware of a sliding scale or co-pay. How many patients feel worse about themselves after being seen, and then asked for the $3 that they cannot really afford? What food items do those patients not buy because they have to pay these nominal payments?

The Cleveland organization is chasing government funds, not what is really best for its patients. Time will only tell how the balance sheets of the clinics and hospitals that have chased government funds that come with numerous bureaucratic strings, rules, and regulations will look when Affordable Care Act is fully operational. And what the reaction will be of those donors who will begin paying the new 3.8-percent Medicare tax as well as a 0.9-percent surtax.

Nonprofit health-care organizations will need to work hard to protect the original intentions of their founders.

Howard C. Mandel

Los Angeles