There’s a critical decision ahead. Community health centers could lose 70% of their federal funding if Congress doesn’t act by Sept. 30.

Americans are concerned about health care — for good reason. We spend about $10,000 per capita annually on health care, a cost projected to rise to about $15,000 in 2023. Many more American families are being put at risk of medical bankruptcy.

My colleagues and I see a growing number of people delaying or even avoiding care in our practice at the International Community Health Services, a Federally Qualified Health Center.

A patient recently refused an evaluation for possible colon cancer. A daughter canceled a referral to address her mother’s loss in bone-density. A gentleman with persistent headaches would not follow our recommendation to get an MRI. Each made a grave decision based on an unaffordable insurance deductible.

Care for a heart attack, colon cancer and bone fracture is exponentially more expensive than the cost of a colonoscopy, stress test and bone density measure. A sick patient is also less able to stay productive, employed or financially afloat, adding to the economic toll to individuals, families and society.

As a federally qualified center, we work to mitigate financial impact by providing affordable primary care and linking patients to affordable specialty care with a sliding-fee discount. But relying on providers to meet the rising demand for discounted preventive and diagnostic services is economically unsustainable.


The cost and staff required to help patients navigate resources pose a significant challenge. At International Community Health Services, our cost of delivering care has increased over the last five years, in part because patients come to our doors with needs that require assistance beyond what can be delivered in a 15-minute exam. We deploy personnel to help navigate health-care coverage, address social determinants of health including health literacy, and assist with specialty services. We spend $328 dollars per patient encounter — up from about $200 in 2014. Our revenue has not kept pace. With such tight operating margins, the viability of delivering affordable care becomes a diminishing enterprise.

The irony is that federally qualified centers have been a tried and true solution for more than 50 years. We save the health-care system $24 billion a year by reducing unnecessary emergency room visits and hospitalizations. Our quality exceeds other primary care settings in areas such as immunization rates, management of chronic conditions like diabetes, and ensuring healthy pregnancies and care of moms. Because federal health centers are located in the communities they serve; they are economic engines responsible for $54.6 billion of economic activity annually. The health centers return on investment is much greater than the funding we receive, yet at every turn we must fight for long-term and stable support from Congress.

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Several congressional bills have been introduced to extend health-center funding beyond an annual appropriation. The Community and Public Health Programs Extension Act introduced by Sen. Lamar Alexander, R-Tennessee, and ranking member Sen. Patty Murray, D-Washington, would extend level funding for Community Health Centers at $4 billion annually over a five-year period.

The clock is ticking for lawmakers to pass legislation before a major portion of our funding expires. Investing in preventive and early diagnostic and treatment services will generate savings for the health-care system and the American taxpayer. Let’s be smart and support Federally Qualified Health Centers.

Correction: An earlier version of this Op-Ed stated in the tagline that Dr. Getaneh oversees eight clinics in the Seattle area. She oversees 11.