Roderick Jackson, a 57-year-old laborer who came in for a routine physical, was up to date on his screenings, having had his recommended colonoscopy.
“They always take care of me,” said Jackson, a Louisiana native who has lived in Minnesota for more than three decades.
Older patients at the clinic are five times more likely to get screened for colorectal cancers than are patients at the Baton Rouge clinic.
“I have seen what it’s like elsewhere,” said Open Cities’ medical director, Dr. Fred Lewis, who grew up in a small Texas town near the Louisiana border.
“This is an unusual place,” he said. “We can actually treat our patients here. We can get them the help they need.”
Back in Baton Rouge, doctors and nurses at Capitol City Family struggle to find neurologists, gastroenterologists and other specialists willing to take their patients, even though the community has the same number of specialists per capita as St. Paul. Every day, the clinic faxes out referral requests. Most are never answered.
Clinics in the state charity system offer many specialty services, including eye surgery, cardiac catheterization and chemotherapy. But demand is so high that wait times have stretched as long as a year.
“Basically, patients have to be desperately ill to get access to a lot of care,” said Dr. Luther Stewart, one of the clinic’s physicians. “You have to do what you can, rather than what you might want to do.”
In the coming year, the gap in available care at the two clinics may widen.
Minnesota has opened its Medicaid program to all poor adults under the Affordable Care Act. At a desk next to the billing counter at Open Cities, two new employees help uninsured patients sign up for coverage.
Louisiana has opted not to expand Medicaid and bars publicly subsidized coverage for working-age adults without children.