People's Heath Care
It is now approaching time when some heavy decisions about the direction of the Ann Arbor Free People's Clinic must be made. Some clinic workers see the Free Clinic here solely as a provider of health care; with a goal of providing health care services to people who, for whatever reason (financial or otherwise) feel they can not get the kind of health care they need and desire at the established medical institutions and facilities. Other free clinic workers wonder why, in a town such as Ann Arbor that purports to house the "finest health care resources in the world," a free clinic even has to exist. These workers see the goal of the Free Clinic as being not simply to insure the survival and growth of the free clinic; but to assure decent health care for everyone, whether delivered through free clinics or in huge medical complexes. To make the Free Clinic into any kind of powerful force creating change in the health care system, the political behavior of the clinic must become the daily program of the clinic.
Here's a proposal to make free clinics into a force for radical change in the health care system, outlined by Torn Bodenheimer in the March, 1972 issue of Health Rights News:
"Free clinics must not see themselves as just another provider of health care. If they do, the high volume of patients will result in long waits, rushed depersonalized visits and enormous guilt by free clinic workers about the inability of the clinic to meet the demand. Clinics should attempt to provide high quality, unrushed, humanized care to everyone. This changes free clinic workers' and patients' attitudes about the process of health care, and makes the health care experience at free clinics a unique one. Now, care in many free clinics is almost indistinguishable from that given in crowded hospital outpatient departments.
"If clinics are to vote for quality rather than quantity health care, they must do something for the many people whom the clinic has insufficient resources to serve. Free clinics must help the patients they cannot handle to find decent care elsewhere. This means that the clinic must know how to refer patients to other institutions. But if it really cares about the patients it refers, the clinic must assign a patient advocate to that patient. The advocate goes with the patient to the outpatient clinic, or whereever, and demands that the patient receive decent health care. This process of patient advocacy is in itself a political act against the hospital. It should lead to demands on that hospital to reduce waiting times, provide interpreters -- demands to do whatever is needed to give patients decent health care. All clinics should place a high priority on setting up political patient advocacy programs."
It is really important to remember that the money, personnel, and equipment for health care is overwhelmingly owned by the established institutions. Torn ends his article by saying, "We must make all those resources -- not just our own meager free clinic ones -- work for people's health."
What implications does all this have for the Free Clinic in Ann Arbor and for the patients who use the clinic? For one thing, some of the medical professionals who volunteer their services at the Free Clinic are beginning to get very uptight about the possible politicalization of the Free Clinic. They feel they are offering their services to an "alternative institution" that they see exists for delivering service. Many of these people state that they know changes must be made in the hospitals they work in, but that the Free Clinic should not take any role in requesting, demanding, or implementing those changes in any kind of "radical" (?) way. They feel that by offering medical service to those who aren't receiving decent medical care, the clinic is, in fact, part of the solution to the problem. Some other clinic workers believe this to be a faulty analysis. They feel that by not taking a stand on issues; by seeing what is wrong with the hospitals, medical schools, and health care system in Ann Arbor and not saying or doing anything about it -- the Free Clinic IS, in fact, taking a political stand. That stand is: accepting the status quo, going along with a health care system that is not meeting the needs of this community. But, it would take a free clinic every other block to meet the needs of the people who are not receiving adequate, compassionate, and/or free health care (that's probably everyone) in this town and in the county; and a "Free Hospital" to make referrals to, to handle the more extensive health problems. To these people, it is almost a joke for Free Clinic workers to claim that the Free Clinic exists to meet the needs of the people. It never has and it never will. The needs are too great. But it can work on changing systems and creating systems whereby those needs can be met.
Some clinic workers see the Free Clinic as still being able to provide a model of how health care can and should be delivered; accepting fewer patients (for example, 20-25 patients per night instead of the 35-45 the clinic is now seeing) and seeing them much more adequately. It could also get into holding extensive health education classes to teach people how to take care of their bodies so they can stay healthy (you don't need no doctor!) There would also be a great need for an extensive patient advocacy program to be developed so that all people in Ann Arbor and Washtenaw County who need health care can demand and receive that care at the local medical facilities.
Unfortunately, there is a very large bind with all of these things. If the Free Clinic moves in the direction of becoming a force in confronting the established health institutions, it may lose many of its doctors and perhaps other medical-technical volunteers. In addition (subtraction?) to that, the clinic may also jeopardize its funding sources which are all largely establishment sources at this time. Now how does a Free Clinic run -- on any level -- without doctors and without funds? Furthermore, it is one thing to demand that a patient be seen with compassion and have all his or her questions answered fully by the medical professionals at the established medical facilities -- but it's another thing to demand that health care be given free to all. These are just some of the problems involved if the clinic gets into implementing its "changing consciousness." Since health care involves all the sisters and brothers in this town, and since so many sisters and brothers rely on the Free Clinic for their health care, it would be far out if the Free People's Clinic could get some feedback from the community and from its patients on how they feel about the direction and goals of the clinic. If people can get into it, write the clinic at 500 E. Washington St., Ann Arbor, Michigan 48108; or stop by when it's open (Monday - Thursday nights at 7 and Saturday afternoons at 1) and rap with the advocates or anybody working at the clinic. Or: come to Free Clinic meetings (held every Sunday at 8 pm, usually in the Free People's Clinic). Also, if the clinic does get into this patient advocacy trip, it's going to need lots of people to be trained in how to go over to the hospitals and advocate for patients rights -- so, if you can get into that, let the clinic know. Remember, what the clinic does will probably affect all of you who use it; so lets get together and figure out what trip the Ann Arbor Free People's Clinic should go on!
Healthy People are usually more Powerful
All Power to the People!
-- Nancy Lessin, People's Health Committee
There will be a meeting of the Community Advisory Board of St. Josephs' Hospital, Monday, April 17 at 4:00 pm. Concerned members of the community are going with their city council representative to this meeting. The Community Advisory Board has denied our request for an invitation to the meeting, yet this group of defense (air-war) contractors, and university presidents keeps on with their plans to raise millions of dollars to build a new, nonfunctional hospital. The number of bed increases the new hospital will have is only 180, while the fact remains that they don't even have their present medical unit serving the needs of the community -- we were forced into setting up the Free People's Clinic to attempt to take care of the needs of the people, as they are not being provided for by the existing medical complexes -- St. Joe's and the University Hospital. We are going to the meeting to find out why. They have put us off before, threatened to arrest us, and refused to talk with us but we will not be kept from the information that the community rightly needs to know and for that we have to make them understand that we all need to know. COME TO ST. JOE'S APRIL 17!!!