Making sure care at Suffolk County's health clinics is affordable for low-income, uninsured patients is important. So is doing everything possible to limit the share of clinic costs borne by county taxpayers.
The current policy that requires the uninsured to show a Medicaid denial letter or automatically pay the highest fee of $75 for a single clinic visit is a pragmatic attempt to achieve both results while county officials pursue plans to privatize the clinics.
But some in the county legislature want a return to the way it was before 2011, when the uninsured were required only to verify their income to prove they qualified for reduced rates. Legis. Robert Calarco (D-Patchogue), sponsor of the repeal, said some patients are not getting needed treatment because they can't afford the $75 and don't have the documentation needed to complete a Medicaid application.
Obamacare will require almost everyone to have some public or private medical coverage beginning in January. Returning to the old Suffolk policy for those who don't have coverage would complicate attempts to privatize the system. And if fewer patients who could qualify for Medicaid apply, Suffolk would be deprived of the federal and state dollars that would otherwise reimburse about 84 percent of the cost of their care.
Privatizing all 10 clinics is the best long-term strategy. It would cut the county's $24-million annual tab for the clinics. And a nonprofit operator designated to run federally qualified health centers would expand clinic offerings to include dental and mental health services and low-cost drugs, while continuing to serve the medically underserved. The $15 per visit most uninsured patients pay at the one clinic privatized so far, the Elsie Owens Health Center in Coram, is well below the county's sliding scale of $35 to $75 per visit based on income.
Instead of going backward, Suffolk should keep its eye on achieving long-term wins for both patients and county taxpayers.