Grassroots Medicine The Story of America's Free Health Clinics

by Weiss, Gregory L.

• ISBN13: 9780742540699
• ISBN10: 0742540693
• Format: Hardcover
• Copyright: 2006-04-06
• Publisher: Rowman & Littlefield Publishers

Summary

Grass Roots Medicine describes the emergence of free health clinics in the late 1960s and early 1970s and examines the important transformations that have occurred since the mid-1980s. The book is based on more than 100 interviews with key individuals in the free health clinic movement and shares their comments with readers.

Author Biography

Gregory L. Weiss is professor of sociology at Roanoke College in Salem, Virginia.

Table of Contents

Preface	xiii
An Introduction to America's Free Health Clinics	1	(20)
Common Traits of Free Health Clinics	2	(19)
Community-Based	3	(1)
Community-Started	3	(2)
Community-Directed	5	(2)
Community-Funded	7	(1)
Community-Supported	8	(1)
Private and Nonprofit	9	(2)
Volunteer-Driven	11	(2)
Services Offered for Free or Token Payment	13	(2)
Emphasis on Compassionate Care and Patient Dignity	15	(2)
Targeted on At-Risk Groups	17	(4)
The Emergence of Free Health Clinics	21	(26)
The Social and Cultural Background	21	(3)
The Early Free Clinics	24	(4)
Types of Free Clinics	25	(1)
Characteristics of the Early Hippie Drug Clinics	25	(1)
Characteristics of the Early Neighborhood Clinics (Minority)	26	(1)
The Struggles of the Early Free Clinics	27	(1)
Five Early Free Clinics	28	(19)
The Haight-Ashbury Free Clinics (San Francisco, California)	28	(1)
The Founding of the Haight-Ashbury Free Clinic	28	(4)
The Development of the Clinic	32	(1)
The Free Clinics Today	33	(1)
The Los Angeles Free Clinic (Los Angeles, California)	33	(1)
The Founding of the Clinic	33	(1)
The Development of the Clinic	34	(1)
The Free Clinic Today	35	(1)
The Berkeley Free Clinic (Berkeley, California)	36	(1)
The Founding of the Clinic	36	(3)
The Development of the Clinic	39	(1)
The Clinic Today	39	(1)
The Free Clinic of Greater Cleveland (Cleveland, Ohio)	40	(1)
The Founding of the Clinic	40	(1)
The Development of the Clinic	41	(1)
The Clinic Today	42	(1)
The Bradley Free Clinic (Roanoke, Virginia)	43	(1)
The Founding of the Clinic	43	(3)
The Development of the Clinic	46	(1)
The Free Clinic Today	46	(1)
The First Transformation in Free Health Clinics: An Increased Focus on the Uninsured and Working Poor	47	(28)
The Early Years	47	(1)
The Shift in Focus to the Uninsured and Working Poor	48	(2)
Background of the Need	50	(6)
The United States Health Care System in Global Perspective	50	(2)
The United States Health Care System	52	(1)
Public Insurance Programs: Medicare, Medicaid, and the State Children's Health Insurance Program	53	(1)
Medicare	53	(2)
Medicaid	55	(1)
The State Children's Health Insurance Program (SCHIP)	56	(1)
Key Problems in the United States Health Care System	56	(6)
Huge and Rapidly Increasing Health Care Costs	56	(1)
The Large Number of Uninsured Americans	57	(5)
America's Uninsured Population	62	(5)
Who are the Uninsured?	62	(2)
Who are the Working Poor?	64	(1)
The Definition of Poverty	64	(1)
Low-Wage, No-Insurance Jobs	65	(1)
Forecast for the Number of Uninsured	66	(1)
The Consequences of Not Having Health Insurance	67	(1)
Free Clinic Patients	68	(7)
Background Characteristics	68	(1)
Age	68	(1)
Gender	69	(1)
Income	69	(1)
Race and Ethnicity	69	(1)
Occupation	70	(1)
Genuine Need for Services	71	(4)
The Second Transformation in Free Health Clinics: The Shift to the Medical Mainstream	75	(20)
The Early Years	75	(2)
The Shift to the Medical Mainstream	77	(7)
Change in Patient Population	77	(1)
Best Interest of Patients	78	(3)
Increased Stability of Clinics	81	(1)
Greater Contributions to the Health Care System	82	(2)
Community Receptivity to Free Health Clinics	84	(11)
Community-Wide Perception of Problem	84	(1)
Effectiveness of Free Health Clinics in Addressing the Problem	85	(4)
Nonduplication of Services	89	(3)
Efficient Use of Hospital Services	92	(3)
The Third Transformation in Free Health Clinics: The Move Toward Collective Organization	95	(24)
The Early Years	95	(1)
The Rise of the National Free Clinic Council	96	(4)
The Fall of the National Free Clinic Council	100	(2)
Years of Isolation	102	(2)
Organizing at the State and Regional Levels	104	(1)
The Virginia Association of Free Clinics (VAFC)	104	(6)
The North Carolina Association of Free Clinics (NCAFC)	107	(1)
Free Clinics of the Great Lakes Region	108	(1)
Increasing Development of State Associations	109	(1)
Issues in Developing State and Regional Associations	110	(9)
Perceived Benefits of Collective Association	113	(1)
Networking	113	(1)
Fund-Raising	114	(1)
Group Purchasing	115	(1)
Public Awareness	115	(1)
Data Collection	116	(1)
Legislative Impact	116	(1)
New Clinic Start-Up	117	(2)
The Reemergence of a National Association	119	(1)
The Founding of the National Association of Free Clinics (NAFC)	119	(12)
Incorporation of the NAFC	121	(2)
Issues Regarding the NAFC	123	(6)
Development of the NAFC	129	(2)
Free Health Clinic Staff and Volunteers	131	(24)
Background of Nonprofit Agencies	131	(2)
Free Health Clinic Staff	133	(3)
Free Health Clinic Volunteers	136	(19)
Volunteering in a Free Health Clinic	137	(3)
Staff and Volunteer Motivations	140	(1)
The Importance of Providing Health Care to All Persons	140	(3)
Personal Accomplishment and Fulfillment	143	(4)
Personal Growth	147	(2)
Friendship and Sense of Bonding	149	(1)
Faith-Based or Spirit-Based Reasons	150	(3)
Wanting to Give Something Back	153	(2)
Patient Responses and Outcomes	155	(16)
Attitudes of Free Clinic Patients	155	(7)
Frustration, Resignation, Embarrassment	156	(3)
A Sense of Entitlement and Lack of Appreciation	159	(1)
Appreciation	160	(2)
Measuring Outcomes	162	(9)
Labor Force Participation	162	(3)
Patient Empowerment	165	(6)
The Future Path of Free Health Clinics	171	(18)
Health Care Access Policy	171	(6)
Federal Policy	171	(4)
State Policy	175	(1)
State Health Policy Legislation	176	(1)
State Purchase of Pharmaceuticals	176	(1)
Changes in Medicaid	177	(1)
Direct Support for Free Clinics	177	(1)
Demographic Changes in the United States	177	(3)
The Aging of the Population	178	(1)
The Increase in the Immigrant and Refugee Populations	179	(1)
Corporate, Foundation, and Public Support	180	(4)
Development of Free Clinic Assocations and Supporting Organizations	184	(3)
State and Regional Free Clinic Associations	184	(1)
The National Association of Free Clinics	185	(1)
Long-Standing Groups Supporting Free Clinics	185	(1)
Alternative Volunteer-Based Organizational Formats for Serving the Medically Indigent	186	(1)
Conclusion	187	(2)
Bibliography	189	(8)
Index	197	(4)
About the Author	201