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Albuminuria and Mortality in Hypertension

Steven G. Coca, DO; and Gregory K. Buller, MD
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From St. Mary's Hospital, Waterbury, CT 06706.

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Ann Intern Med. 2004;141(3):244-245. doi:10.7326/0003-4819-141-3-200408030-00024
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Insurance-free medical clinics are not the solution for the uninsured
Posted on August 4, 2004
Steven Wolfson, MD
Yale University School of Medicine
Conflict of Interest: None Declared

Dr. Berry's Letter describing his Insurance-free Medical Clinic was interesting, but on its face showed exactly why this approach is not a solution to the problems faced by absence of insurance coverage.

The IFMC's, as he describes them, select their patients! Those who sign up have discretionary income, are likely to be healthy, and by his description "positively bristle at elitist paternalism..." I presume that this term refers to those who believe that, for many people, the costs of health care exceed their resources, forcing them to do without, or to accept help.

If help is not available early in the course of their diseases, they get sicker earlier and die more frequently than those Americans who have health insurance.

The IFMC, therefore, may be helpful to the physician's office that saves 2/3 of its overhead. But it is not helpful to most uninsured patients.

Steven Wolfson, M.D.

Conflict of Interest:

None declared

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