Science stimulus

After a month investigating, or at least poking around on, the topic of stimulus money coming to the greater Seattle area, I had trouble finding any great stories.

Yes, as I reported on KPLU, there’s money to clean-up diesel pollution around the ports.  And, there’s a decent chunk of funding for Community Health Centers (which serve low-income and uninsured people).  And, as Sandy Doughton reported, faculty at the U.W. will get plenty of additional NIH research funding.

But, I was looking for the big legacy projects, something akin to the fine parks structures built by FDR’s Civilian Conservation Corps in the 1930’s.  As I said in my clinics story, the federal stimulus money is “more of a cushion to soften the crash,” than a spark to create something new.

Maybe the U.W. will build a great new science lab that was only a pipe dream before.

Other beat reporters at KPLU have found similar tales when it comes to stimulus money and public housing, and public schools.  In order to get the money spent quickly, it is paying for projects that were already planned and would have happened anyway, eventually.  The stimulus makes them happen more quickly.  Or else, instead of creating jobs, it’s preserving work that would have been eliminated by budget cuts elsewhere.

I’m not saying it’s bad to preserve jobs from the chopping block, or speed up a construction schedule.  It just makes it hard a decade from now to point to something and say, That’s the legacy of what the federal government did during the Great Recession.

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Stimulus money may rescue researchers, clinics

I’m digging for details on where federal stimulus money may end up, in the realms of health care and science, here in the Seattle area.   So far, still more questions than answers.  But, here are two examples:

– Community medical clinics.  There is money set aside to help these clinics survive the double-whammy of more people in need of free or subsidized coverage, while budgets are being slashed.   Tom Trompeter, the CEO for the HealthPoint clinics in King County says he expects some of the money will be for expanding services, to reach new clients.  He’s also hopeful that funding for Medicaid will increase, which would be the simplest way to support these clinics.

– Bio-medical researchers.  A big boost in funding went to the National Institutes of Health ($10.4 billion total), and the U.W. is one of the leading recipients of NIH grants.  One scientist at the Fred Hutchinson Cancer Research Center said last week she was already re-formulating some proposals that had missed the funding cut last time around.  One chunk of the NIH money will be spent on construction — new labs and equipment.

There are a lot of new deadlines for proposals.  Some research funding cutoffs are as soon as June, while the construction grant proposals are due by September.

If you’ve heard of stimulus money flowing to any local institutes or organizations, please share.

Medical clinics where you shop

Last week, I wrote a story about the mini-clinics inside grocery and drug stores. It included this paragraph:

“Most treatments are priced at 59 dollars. You’d be billed twice or three times as much at a traditional urgent-care clinic. MultiCare accepts insurance and Medicaid, so most people end up with just a co-payment either way. To break even, the mini-clinic needs to see at least 25 patients a day. That covers rent and the salary for the Nurse Practitioner who staffs it. The one-person staff keeps costs down – along with treating only minor ailments. Is this the next big trend? Not yet, despite hype from some chains. It’s been moderately successful in other parts of the country – but not a revolution.”

For Tacoma’s MultiCare health system, the key is integrating the retail clinic with their larger system. Many of the patients (including the two that I interviewed in the drugstore) were referred from MultiCare’s traditional urgent-care clinic, which was overcrowded.

The question I did not address, but hinted at, in the story is this: Are these retail clinics a good indicator of how much you pay for inefficient overhead during your basic medical appointment? We’ve been hearing for years how wasteful the medical system is, and how paperwork eats up a big share of every dollar. But this seems to be a graphic illustration, at least for all those visits that didn’t need fancy MRI machines and surgical suites nearby.

Medicine and shopping

I’ve been watching the trend of drugstores (and supermarkets) adding mini-medical clinics inside their stores. It’s an interesting idea, sort of an end-run around all the hassle of trying to get an appointment with your doctor and be seen in a timely manner. Instead, just walk into the nearest drugstore and have your minor ailment checked out. And, it’s supposed to provide an option for people without insurance.This started on the East Coast, and Bartell Drugs first tested it here in Washington a couple years ago, by contracting with a chain called Minute Clinics. Apparently, that didn’t work out so well.

Now, Rite Aid is trying a new angle, at two of its stores in Tacoma. It’s teaming up with a local health-care provider, in this case MultiCare Health System. MultiCare is huge in Tacoma, the dominant medical provider, with four hospitals, and a network of primary care and Urgent Care clinics. MultiCare is staffing the mini-clinics (with ARNP’s — Nurse Practitioners) as one more branch of its network.

According to a story in the Puget Sound Business Journal, these clinics do better (financially) when there’s a shortage of primary care providers — so, outside major cities. In Houston, they’re converting the mini-clinics to telemedicine clinics, because it was too expensive to pay a nurse to sit there all day.

Will this ever be an important trend in medical care? Is it helpful to have a service like this? Or does it just seem like a new type of marketing?