A visit to a clinic in Georgia that provides health care only to the uninsured

A MARTÍNEZ, HOST:

How do you get health care if you don't have insurance? Well, that's a question fewer Americans are having to answer than ever before. Less than 8% are uninsured now that there's record enrollment under the Affordable Care Act. It still means millions of people without coverage, though, something we wanted to explore as part of our "We, The Voters" series focusing on health care. So we traveled to Georgia and visited a clinic that serves only the uninsured.

Hi, Greg?

GREG LANG: I'm Greg.

MARTÍNEZ: Hi. A Martinez, NPR.

We're met at the Good Samaritan Clinic by Greg Lang. He's the chief financial officer here, and he tells us about Gwinnett County where the clinic sits.

LANG: Our public high schools often report 90 different languages spoken among their student body. The most significant thing that we do is that we serve undocumented people without question.

MARTÍNEZ: For some of these patients, this might be the first time they have ever seen a doctor - for that matter, gotten any kind of medical care.

LANG: We see measles in this clinic. We've seen whooping cough. We've had malaria. We've even had leprosy in our clinics.

MARTÍNEZ: Good Samaritan has non-emergency care for adult and children ranging from physical exams, services for cardiology, gynecology, and neurology and even dental treatment.

(SOUNDBITE OF DENTAL EQUIPMENT WHIRRING)

MARTÍNEZ: Yanet Munoz Nava is from Mexico.

UNIDENTIFIED PERSON #1: (Speaking Spanish).

YANET MUNOZ NAVA: (Speaking Spanish).

MARTÍNEZ: We spoke after she had her teeth cleaned. Says she feels more secure about her health because of this clinic. And she really appreciates that they always ask her if she's feeling OK.

So considering that Good Samaritan only serves the uninsured, I asked Lang, how do they pay for it all?

LANG: We are generally selling our services at about 60% of what it costs us to render it, and then we do fundraising to make up the difference.

MARTÍNEZ: That means they can't necessarily spend a lot of money on doctors' or nurses' salaries, which makes providers like Cara Rushing invaluable.

Couldn't you make more money somewhere else?

CARA RUSHING: I could. But I worked in traditional healthcare for a big hospital system for five years before I became a nurse practitioner here. And I've seen the difficulties of the logistics and the paperwork and the insurance world. And while it is difficult for our patients to get the access to care that insurance provides, there is an ability to have more of an impact for me personally in this place because I have more stake in the game almost.

MARTÍNEZ: Now, there are limits to what Good Samaritan can provide. It can't do heart transplants or provide something like dialysis. But Lang says dealing with insurance brings its own headaches.

LANG: I often describe our health care system as being in a sister-wife marriage because there's always three people in bed. You have your health care provider, you have your patient, and you have your insurance company. Patient is looking at us, saying, this hurts. Please relieve the pain. And we have to go to the second wife and say, can I do A or can I do B? And I might hear you can't do either of them.

MARTÍNEZ: Lang wants to see the U.S. move away from insurance-based healthcare, but he doesn't think a single payer system fully funded by the government is the answer, either.

LANG: It needs to become a private transaction between a provider and a recipient. I've actually heard local hospital administrators who have complimented us saying, you're doing it the old-fashioned way. If they can't pay you, they bring you empanadas, and that's the truth.

MARTÍNEZ: Which builds a relationship that allows patients to trust their doctors, and that keeps them coming back for care to possibly avoid serious problems later in life. Transcript provided by NPR, Copyright NPR.