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Wednesday, December 13, 2006

UPDATE: Aradia cuts and runs from health care system

posted by on December 13 at 14:10 PM

Long-time Seattle women’s health group cuts and runs, overwhelmed by uninsured

Yesterday Josh slogged the news that Seattle’s 30-year-old, beloved Aradia Women’s Health Center is closing its doors this January. This closure takes a lot of people by surprise (us included!) but “it’s been on the table internally for a lot of years,” according to board member Amie Newman. Aradia has had razor thin profit margins for many years and in 2005, came up $84,000 short. No CEOs have been getting million dollar severance packages or anything duplicitous like that (Aradia’s executives actually get paid very little - peruse their tax forms yourself). The shortfall is mainly because their insurance provider tripled their malpractice insurance in the last three years and also because more low-income women are using clinic services.

While Aradia has a cadre of committed donors, it has, since its creation by a group of frustrated women in the 70s, relied primarily on clinic services for funding. Individual donors and grants foot only 10% of its operating costs, while 90% comes from women who pay for abortions, gynecological work or check ups. The money from the clinic not only pays doctors and staff, but Aradia’s education and advocacy programs. But since the early 90s, the number of patients on Medicaid has jumped from 55% of their clientele to 70% in 2004. Yes, nationwide abortion rates are declining — but only among women above the poverty line. Low-income women are still getting abortions at the same rate, but Aradia makes no profit off them. When 70% of their customers aren’t able to pay, it’s easy to see why they’d be in financial trouble.

So, I asked, if the clinic isn’t supporting you anymore, why not shift your funding focus and try to make up the difference with grants and donations? What it boils down to is this: Aradia’s board of directors believes that their health care model (while wonderful! And great for patients!) is not a good business model. There’s no way, providing the kind of care they do for the kind of people they do, that they can ever do more than just tread water financially. “People have been asking me, ‘How much money do you need? How can we save Aradia?’” says Newman, “But even if we received a check for a million dollars, it may keep Aradia open a few more years, but ultimately this model is not sustainable.”

They decided they had three options: close, merge with a major health care provider or remain independent and open, axing either the advocacy program or the clinic, and slip into bankruptcy more gradually. They decided to close in a large part because they feel women in Seattle won’t be underserved if they disappear — a huge Planned Parenthood just opened ten blocks away from Aradia, for example.

But the causes of the closure point to the atrociously failing American health care system, which puts providers in the Catch 22 of either having to serve only those people who can pay or take a hit by giving free service to those who can’t. 14% of Washington is uninsured (that’s 824,990 people) and 12% is on Medicaid. Nationwide, the number of people on Medicaid, as well the the number of uninsured, has grown steadily over the last twenty years (plateuing, sort of, during the late 90s). Nowdays, 13% of people nationwide are on Medicaid and 15.9% are uninsured. So Washington is pretty typical in terms of its health care woes — we’re ranked 23rd and 24th in numbers of people uninsured and on Medicaid, respectively.

Geez, that’s a lot of numbers to wade through. The point is: what Aradia is experiencing is part of a major, ominous, nationwide trend. Even though Aradia had community support, an excellent and committed staff and a high demand, it proved impossible to provide high quality health care for low income people and not sink into the red.

Now take a second to think about this: what other facilities provides health care service for a large slice of the population, many of whom are uninsured or on public assistance? Nursing homes — and they’re seeing a crunch, too, as the baby-boom demographic bump creeps into old age. While Aradia decided to close its doors, nursing homes are dealing with precipitous profits in a more alarming way: providing worse care, according to a report (.pdf) from the Northwest Federation of Community Organizations. Aren’t you glad Aradia dropped out instead of flunking out? Not that we should be counting our lucky stars… fuckin’ health care system…

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1

"but ultimately this model is not sustainable."

My heartfelt regrets to the closing of Aradia, it's unquestionably a loss to our city. But is this any surprise? There is no such thing as "sustainable capitalism". At all. Ever. All corporate entities must be greedy and grow (and exploit) to remain "financially healthy". That is the underlying rule-set of our money.
Privatization is a ruse. And when left to rule, eventually becomes abuse.

"Service oriented" organizations must constantly aquire money from somewhere other than their clientele. Gov't funding, grants, and donations have traditionally been those places. Those are gradually drying up as "social services" funding is redirected to war. The ultimate social disservice. I suppose.

Essentially this might mean that we arrive at an additional model of goods/services exchange, something which allows and encourages "steady-state" (as opposed to 'growth') organizations. "Public benefit" organizations, like Aradia. And mass transit. And health care. And the post office. And etc.

We can't just sell-off the city and the country to capitalists developing condos, gasoline and sports teams, you know. They certainly don't have our collective best interests in mind.

Posted by treacle | December 14, 2006 12:32 PM

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