Grassroots Medicine The Story of America's Free Health Clinics

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ISBN: 9780742540705 | 0742540707
Cover: Paperback
Copyright: 3/30/2006

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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.

Preface

xiii

An Introduction to America's Free Health Clinics

(20)

Common Traits of Free Health Clinics

(19)

Community-Based

(1)

Community-Started

(2)

Community-Directed

(2)

Community-Funded

(1)

Community-Supported

(1)

Private and Nonprofit

(2)

Volunteer-Driven

(2)

Services Offered for Free or Token Payment

(2)

Emphasis on Compassionate Care and Patient Dignity

(2)

Targeted on At-Risk Groups

(4)

The Emergence of Free Health Clinics

(26)

The Social and Cultural Background

(3)

The Early Free Clinics

(4)

Types of Free Clinics

(1)

Characteristics of the Early Hippie Drug Clinics

(1)

Characteristics of the Early Neighborhood Clinics (Minority)

(1)

The Struggles of the Early Free Clinics

(1)

Five Early Free Clinics

(19)

The Haight-Ashbury Free Clinics (San Francisco, California)

(1)

The Founding of the Haight-Ashbury Free Clinic

(4)

The Development of the Clinic

(1)

The Free Clinics Today

(1)

The Los Angeles Free Clinic (Los Angeles, California)

(1)

The Founding of the Clinic

(1)

The Development of the Clinic

(1)

The Free Clinic Today

(1)

The Berkeley Free Clinic (Berkeley, California)

(1)

The Founding of the Clinic

(3)

The Development of the Clinic

(1)

The Clinic Today

(1)

The Free Clinic of Greater Cleveland (Cleveland, Ohio)

(1)

The Founding of the Clinic

(1)

The Development of the Clinic

(1)

The Clinic Today

(1)

The Bradley Free Clinic (Roanoke, Virginia)

(1)

The Founding of the Clinic

(3)

The Development of the Clinic

(1)

The Free Clinic Today

(1)

The First Transformation in Free Health Clinics: An Increased Focus on the Uninsured and Working Poor

(28)

The Early Years

(1)

The Shift in Focus to the Uninsured and Working Poor

(2)

Background of the Need

(6)

The United States Health Care System in Global Perspective

(2)

The United States Health Care System

(1)

Public Insurance Programs: Medicare, Medicaid, and the State Children's Health Insurance Program

(1)

Medicare

(2)

Medicaid

(1)

The State Children's Health Insurance Program (SCHIP)

(1)

Key Problems in the United States Health Care System

(6)

Huge and Rapidly Increasing Health Care Costs

(1)

The Large Number of Uninsured Americans

(5)

America's Uninsured Population

(5)

Who are the Uninsured?

(2)

Who are the Working Poor?

(1)

The Definition of Poverty

(1)

Low-Wage, No-Insurance Jobs

(1)

Forecast for the Number of Uninsured

(1)

The Consequences of Not Having Health Insurance

(1)

Free Clinic Patients

(7)

Background Characteristics

(1)

Age

(1)

Gender

(1)

Income

(1)

Race and Ethnicity

(1)

Occupation

(1)

Genuine Need for Services

(4)

The Second Transformation in Free Health Clinics: The Shift to the Medical Mainstream

(20)

The Early Years

(2)

The Shift to the Medical Mainstream

(7)

Change in Patient Population

(1)

Best Interest of Patients

(3)

Increased Stability of Clinics

(1)

Greater Contributions to the Health Care System

(2)

Community Receptivity to Free Health Clinics

(11)

Community-Wide Perception of Problem

(1)

Effectiveness of Free Health Clinics in Addressing the Problem

(4)

Nonduplication of Services

(3)

Efficient Use of Hospital Services

(3)

The Third Transformation in Free Health Clinics: The Move Toward Collective Organization

(24)

The Early Years

(1)

The Rise of the National Free Clinic Council

(4)

The Fall of the National Free Clinic Council

100

(2)

Years of Isolation

102

(2)

Organizing at the State and Regional Levels

104

(5)

The Virginia Association of Free Clinics (VAFC)

104

(3)

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

(10)

Issues in Developing State and Regional Associations

110

(3)

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

(12)

The Founding of the National Association of Free Clinics (NAFC)

119

(2)

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

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Grassroots Medicine The Story of America's Free Health Clinics

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