We are not big fans of quarrels about the health care needs of the uninsured.
This population is every politician’s favorite football: a population with neither well-defined leadership or easily specified needs that permits shifting discussion of one difficult topic – what sort of health reform would be best for everyone – to a more-easily-presented, less-easily -accounted-for zone in which politicians can claim they are doing more than their opposition to devise beneficial policies and programs for an underserved group.
When well-meaning observers overlay specific health care service innovations atop the elusive ‘debate’ about the uninsured, the results are predictable: politically-inspired proponents find the innovation addresses the ‘problem’, while their political opponents see movement in the opposite direction. Kristen Gerencher’s recent Wall Street Journal piece on retail clinics and the uninsured (Yes, The Uninsured Can Get Care, February 14, 2010; subscription required) falls in the former category.
The truth, no surprise, is more complex than the article suggests, and seldom if ever gets explicit attention in such narratives.
Here’s how that plays out in the realm of retail clinics: an observer will assert that retail clinics extend affordable access to basic health care to people who are uninsured, lessening their need for governmental intervention, and point to findings from clinical experts like Rand Health policy researcher and University of Pittsburgh assistant professor Dr. Ateev Mehrotra to support their case.
Meanwhile, those who caution that clinics may not be all that for the uninsured look to the same authority for evidence that clinics are not routinely sited in areas that are as accessible to the uninsured as they are to wealthier, more-likely-to-be insured customers.
It’s practically traditional of course for political adversaries to turn almost any cultural phenomenon into a rope for playing policy tug-of-war. We merely want to give voice to the observation that with respect to the emergence of retail clinics “they (retail clinics) are so not about all of that”.