INDIGENT CARE: VA, MI Facilities Struggle to Fill Need

      As the primary provider of indigent care in the Richmond, VA, area, the Medical College of Virginia hospital is floundering struggling "to cut costs and warn[ing] it may have to trim care for the uninsured unless the state helps more." State Del. Franklin Hall (D), head of the MCV Hospital Authority, said, "The hospital historically was the cash cow that provided the money to pick up the slack, but ... it can't do it any longer" (Martz, Richmond Times-Dispatch, 4/11). MCV treated more than 31% of the entire state's indigent medical cases in 1997. Dr. Daniel Jannuzzi, Medical Director of Cross-Over Health Center, a free clinic that sends most of its patients to MCV, said, "A lot of hospitals in the area probably would do more charity care if MCV was not such a resource. They would have to." Currently, MCV is the only "hospital in the [Richmond] metropolitan area devot[ing] more than one of every $50 billed to charity care" (Martz, Richmond Times-Dispatch, 4/11).

Motor City
      In metropolitan Detroit, a growing number of uninsured citizens are fueling a new crop of free health care clinics staffed by volunteer doctors and nurses, with four in place and another on the way. The Detroit Free Press reports that clinic "directors don't accept government money. They don't take insurance payments. Few require proof that the patient is poor. Their focus is on helping the uninsured stay well." Mary Ellen Howard, director of the St. Francis of Cabrini Clinic in Detroit, which like many other clinics in the area is overwhelmed with patients, said, "I don't know what I'm going to do. Should we add more days? ... We cannot take care of the need. We're not the answer. there's a bigger need out there that needs to be addressed" (Wendland, 4/15).