Saturday, April 28, 2007

School-Based Health Clinics: So Much is Wrong

The OD reported this week that St. Elizabeth's and Upstate Cerebral Palsy's health clinics have finally opened at Kernan Elementary and Donovan Middle Schools.
"We are very, very thrilled," [Kernan] Principal Andrew Rudd said.
No consolidation here . . 'the clinic will not replace the school's nurse's office.'

No wonder why Principal Rudd is "thrilled": The principal has no reduction in his staff, has another distraction to learning (providing another reason to hire more remedial staff) -- and another step toward government (and the politically connected "elite's") control of every aspect of our lives.

If this isn't enough to get you riled, here is something else to consider:

Health Insurance.

Visit St. E's or St. Luke's campuses and you will see vast expansions taking place. The expansions are so obvious and well known that there is even a rumor (and it is only a rumor) that St. Luke's is interested in the property occupied by Our Lady of the Rosary Church on Burrstone Rd., perhaps influencing the R.C. Diocese's decision to require OLR parish (which is growing) to discuss a potential merger with another parish (i.e., the OLR property will be easy to sell). Regardless, school based health clinics are another form of expansion.
It makes it accessible for the parents," said Melanie Padmanabhan, the family nurse practitioner at the clinic. "If there is an emergency, like if they have an asthma attack, we can treat them here. It's just like a regular doctor's office.
Baloney! We no longer have neighborhood schools so school clinics are not more accessible to parents. And emergencies can be handled by the school nurse (as usual) or by 911. While the parent of a child without transportation is cited as an example of the kind of person the clinic would serve, this would seem to be the exception rather than the rule. After all, how many parents who are really concerned about their child's health situation would send their child to the doctor without accompanying the child themselves?

According to "The Statistic," Oneida County's population has dropped by about 85,000 -- over 26% -- since 1970. In the face of such a precipitously declining population how are our health care providers able to continue the expansions? Health Insurance . . . the next best way to suck money out of your (or your employer's) wallet after taxes.
Students' insurance will be charged for services. If the child does not have health insurance, then the social worker at the clinic will help families get health insurance and other services.

Janine Carzo, administrative director for the St. Elizabeth Family Medicine Center, said the clinic is required by the health department to enroll 80 percent of the student population by the end of the year.
This is just another way for St. E's and UCP to "ding" health insurance and ensure a revenue stream to themselves . . . a way to keep revenue coming in while the population declines. Kids have a hangnail or a paper-cut ? . . Why send them to the school nurse when you can send them to a professionally staffed ("like a regular doctor's office") school-based health clinic - - as long as they have insurance. The school nurse gets some time off, and St E's and UCP get to ding the students' insurance policies. This is greed, plain and simple.

In a companion article OD raises potential disruptions in a child's continuity of care as an issue of concern. Unfortunately, the article seems to imply that the independent practitioners are the bad guys.

The school clinics are not about serving students -- they are a marketing tool : a way to grab "market share" from other medical service providers.

Health insurance rates in the Greater Utica-Rome area were at one time among the lowest in New York State. Now they are among the highest. This is no surprise because we are paying for all the expansions. School based health clinics will only drive rates higher.

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