A free clinic is a medical facility offering community healthcare on a free or very low-cost basis in countries with marginal or no universal health care. Care is generally provided in these clinics to persons who have lower or limited income and no health insurance, including persons who are not eligible for US Medicaid or Medicare programs. In the US, almost all free clinics provide care for acute, non-emergent conditions. Many also provide a full range of primary care (including preventive care) and care for chronic conditions. Some free clinics include licensed pharmacies and dental services.
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The modern notion of a free clinic began in the 1960s in San Francisco when Dr. David Smith founded the Haight Ashbury Free Clinics in 1967 [1] during the summer of love in the Haight Ashbury district. Free clinics quickly spread to other Californian cities and the rest of the United States. In 1972 a meeting was held at the Shoreham Hotel in Washington DC where clinic staff from around the country gathered and listened to speakers including Dr. Smith. At this meeting the slogan “Health Care is a Right Not a Privilege” emerged as a theme.
During the 1970s and 80’s free clinics continued to evolve and change to meet the needs of their individual communities, however some were unable to survive. Each free clinic was unique in its development and services, based on the particular needs and resources of the local community. There is a saying among free clinic organizations that if you have been to one free clinic you have been to one free clinic. The common denominator is that care is made possible through the service of volunteers, the donation of goods and community support. Funding is generally donated on the local level and there is little —if any— government funding. Some free clinics were established to provide medical services in the inner cities while others opened in the suburbs and many student-run free clinics have emerged that serve the under-served as well as provide a medical training site for students in the health professions.
While both free and community clinics provide many similar services, free clinics today are defined by the US National Association of Free Clinics [1] as “private, non-profit, community based organizations that provide medical, dental, pharmaceutical and/or mental health services at little or no cost to low-income, uninsured and under insured people. They accomplish this through the use of volunteer health professionals and community volunteers, along with partnerships with other health providers.” Some free clinics rival local government health departments in size and scope of service with multi-million dollar budgets, specialized clinics and numerous locations.
Eventually a schism evolved among clinics where some held fast to the idea that services should be provided free of charge to the patient while others felt that the services should be paid at least in part by the patient. This second group of clinics became known as community clinics and would offer services on some sort of sliding fee schedule based on the patient's ability to pay. In the early 1970s Ramparts Magazine said that in order to survive, free clinics would have to be equally active providing service as they were with the mimeograph machine. In other words, the service provided by the doctors was of equal importance to ensuring that people have a right to health.