Whether or not President Obama finds his Tuesday victory lap proclaiming 7.1 million enrollees in the Affordable Care Act is his administration's "Mission Accomplished" moment, there are still millions of people in the United States without health insurance.
That's why Volunteers in Medicine, a primary-care medical clinic which provides services at no cost to financially eligible Hamilton County individuals who otherwise have no access to health care, is still needed.
"We're still here," said Nancy Franks, the volunteer president who was the primary driver behind the faith-based clinic's founding in 2005. "We're not going anywhere."
Chattanoogans should be grateful she and others saw a need, stepped in and acted. In a strategy opposite the creation of the Affordable Care Act, she brought together in public a coalition of foundations, churches, businesses and individuals and built upon an already existing model a health care solution that would not overlap what existed but found a way to reach the most vulnerable.
Where the Affordable Care Act (ACA) has left millions of the previously uninsured 47 million Americans still uninsured, Volunteers in Medicine (VIM) stepped in to serve Tennessee's 850,000 who were uninsured and unable to get insurance.
It offers treatment to patients ages 19-64 who are residents of the county for a minimum of 90 days and who are not covered under the ACA, TennCare, Medicare, liability insurance, workers compensation or other medical insurance providers and whose income is not over 150 percent of the federal poverty level.
Franks, using figures from the Kaiser Family Foundation, calculates that about one in five people in Hamilton County didn't have insurance before the ACA. Now one in six don't.
She said many people believe anyone can go out and buy insurance, including through the ACA, but "they can't. It's an education problem."
Sadly, whether people thought clinics such as VIM would not be necessary any longer or whether foundations and other contributors just changed their giving focus, the local clinic's funding from foundations, churches, businesses and individuals - but no federal funds - fell off 10 percent in the last year.
"It's always a challenge to raise half a million dollars a year to operate," Franks said. "We always say it's free care to the patient but not free care for the organization."
Yet, that amount of nearly $500,000 delivers close to $2.5 million of medical care at a doctor's office rate, she said. At an emergency room rate, it delivers between $9 and $10 million worth of care. For 2013, the $430,000 in funds received delivered $2.2 million in care at a doctor's office rate and $9.8 million at an emergency room rate.
If the ACA offered that rate of return, people would be clamboring for it instead of 56 percent of the country opposing it, as a recent Fox News poll indicated.
"The rate of return is huge [for VIM]," Franks said.
The Chattanooga clinic is one of 96 across the country. The first was founded in Hilton Head, S.C., in 1994 under the leadership of Dr. Jack McConnell, a onetime Chattanoogan and retired physician who helped develop Tylenol.
Its average patient, according to Franks, is between 40 and 64.
The primary concerns of its patients are diabetes, hypertension, heart disease and cancers. Monthly, a mammogram van comes from the MaryEllen Locher Breast Center of Excellence, and that organization follows up with patients who need additional treatment.
For advanced cancers and other problems that require a specialist, patients are referred to Project Access, a referral network led by the Medical Foundation of Chattanooga in partnership with the Chattanooga-Hamilton County Medical Society that helps low-income county residents receive medical care.
The local Volunteers in Medicine clinic, through its first eight years, hosted 43,000 patient visits and saw 110,594 volunteer hours expended.
Among those volunteers is Dr. J. Randy Walker, University of Chattanooga Foundation Professor of Physical Therapy at UTC, who has offered his physical therapy services at the clinic every week since it opened. The clinic also provides hands-on training for his physical therapy students.
"I enjoy giving, being involved," he said one day last week after winding up therapy. "It's also service from the university perspective, and that's important for us."
While Walker says it's a personal "joy to be able to give," he also receives satisfaction in "seeing a change" in patients who might not receive services anywhere else.
"There's a need for it," he said.
Similarly, Franks, who'd be happy to get additional donations or volunteers, most importantly wants Chattanoogans to know there is assistance available for those who fall in what she calls "the big, black hole" where no health care is available.
"We'd welcome new patients," she said.