Alexandria, Va., Clinic for Uninsured Struggles to Find Patients

The Oct. 9 Health section of the Washington Post profiles Queen Street Clinic, a facility in Alexandria, Va., that offers "low-cost" treatment for the area's uninsured and "working poor." Government-run or subsidized clinics usually have waiting lists and "strict residency requirements," making health care options "extremely limited" for those with incomes above the poverty line but unable to afford private insurance. According to a 1998 study, about 17% of Alexandria's population, or 21,000 people, have jobs but lack health insurance. Despite the apparent need for care, the Post reports that the Queen Street Clinic's patient flow has "slowed to a discouraging trickle" since its opening in August. Of those that have used the clinic, one-third are immigrants. While the clinic charges $45 for an office visit and offers Saturday and evening hours, the Post reports that many uninsured patients turn to emergency rooms or private physicians, who charge "considerably more" for treatment. For example, two general medical practices in Alexandria reported that they charge uninsured patients between $100 and $150 for an office visit. Don Burchell, president of Alive!, a group that provides financial assistance to low-income residents, said, "I'm not sure why patients aren't coming, because I can tell you the need for affordable health care here -- and everywhere -- is nothing new. The patients are definitely out there, and I think that $45 is reasonable." However, Judy Southard, director of nursing for the Alexandria Health Department, said, "[I]f I was uninsured and (poor) and I needed to come up with $45, I would probably have a hard time doing it. And I might wait until I was really sick and then go to the ER." But Burchell noted, "I think the problem is a lack of awareness that the clinic is there." Administrators of other low-cost clinics agreed, saying it will take time for the clinic to succeed. Nancy Pallesen, executive director of the Arlington Free Clinic in nearby Arlington, Va., said, "A lot of this is word of mouth among patients. And referrals from the community are key" (Boodman, Washington Post, 10/9).