Physicians and Latino leaders say the city's rapidly growing immigrant community has benefited significantly from the District's new health care system for the poor, and D.C. Health Department Director James A. Buford pledged to maintain it despite recent upheaval.
Buford said that the success of the ailing $70 million-a-year health care system should be measured in part by how much it can grow beyond its current 28,000 members. A core constituency is low-income immigrants, especially illegal immigrants who are ineligible for other government health aid.
The D.C. Healthcare Alliance "is alive and well and will continue to be alive and well for many, many, many months and years," Buford said at a community forum in Adams Morgan yesterday. "We did a good job of marketing the program. I think what will change a bit is we will move from outreach to helping consumers better use the system."
On Wednesday, Buford announced plans for the department to take over the alliance in the wake of the bankruptcy court filing by Greater Southeast Community Hospital's parent company in November. The District-funded alliance was organized 18 months ago to provide charity health care through six hospitals, 28 clinics and 800 providers.
Anger over medical system reforms by Mayor Anthony A. Williams (D) has been concentrated on the city's east side among poorer and mostly black residents, who were especially opposed to closing D.C. General Hospital. Now the concern is the future of Greater Southeast, the only acute-care hospital east of the Anacostia River.
But in the heart of the city's Latino population, centered in Mount Pleasant, Columbia Heights and Adams Morgan, there was a rising plea yesterday from families, clergy, activists and nonprofit clinic providers for continued, subsidized access to doctors, translators, pharmacies, specialists and hospitals citywide.
The alliance serves about 2,900 Hispanic patients, and 800 more have applied for coverage, said Nieves Zaldivar, alliance medical director for D.C. Chartered Health Plan Inc. Latino patients make up 11 percent of the alliance's 28,000 members, and their numbers are growing. The District's uninsured population is estimated at 65,000.
"One thing we have learned over the last 18 months is the program really needs to grow to accommodate the larger need in the area," Buford said, referring to new Hispanic residents.
Meredith Josephs, medical director of La Clinica del Pueblo, a nonprofit clinic that provides free health care and education services in Mount Pleasant, said the program had marked a "wonderful, tremendous change." Among the clinic's 4,500 patients, mostly the working poor in jobs lacking insurance coverage, such as housecleaning and restaurant work, "close to zero" had access to the traditional health care system before the health care alliance was formed, she said. Now, between 50 percent and 75 percent have access.
That view seemed to be corroborated yesterday by a crowd of about 50 immigrants, mostly from El Salvador, who ranged from infants to an 85-year-old grandmother, Juanita Colindres. "I feel very satisfied, and I ask God that He bless all the people today to keep access open to the poor," said Colindres, a diabetic who receives medicine through the program quarterly.
Similar testimonials were offered by restaurant worker Wilfredo Salinas, 60, who underwent surgery for stomach cancer; Maria Rosales, 40, a maintenance worker who had a tumor removed from a shoulder; Juan Marroquin, 54, a community AIDS educator; and Rina Maldonado, 28, a maid who is seven months pregnant and has a kidney ailment.
Residents asked about the availability of Spanish translators at hospitals and clinics and enrollment officers' training. "It's so important when you are ill. Is the communication easy?" asked Juan Romagoza, executive director of La Clinica del Pueblo.
D.C. Council member Sandy Allen (D-Ward 8), who attended the forum, expressed common cause with the speakers. "Our concerns are the same," Allen said, "east of the [Anacostia] river and west of the [Rock Creek] park."