Public Health Is In A Bad Way

Julio Bellber doesn't need anyone to tell him that there's a crisis in public health. It's 10:45 a.m. at the William F. Ryan Health Center in upper Manhattan, and Bellber, the executive director, has just closed the doors to the walk-in clinic. The reason: Nineteen patients with complaints ranging from asthma attacks to fevers have jammed into the waiting room to see the one doctor who staffs that facility. It's like this most days, says Bellber, whose federally funded center provides primary care for 35,000 to 40,000 urban poor, including 300 who are HIV-positive. It averages 170,000 visits a year, and 45% of clients have no insurance. "We have a capacity issue here," he says. "We book appointments three months in advance."

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