Passage of the health care reform bill has elicited a number of reactions from local medical professionals who perceive the measure as either a groundbreaking first step to universal care or a catastrophe that will lead to more governmental control. Others, like Donna Young, find themselves somewhere in the middle.

According to Young, executive director of the Scotland Community Health Clinic in Laurinburg, there will be little change in procedure at the county free clinic until health care reform measures are begun in 2014.

"For at least the next four years the free clinic will remain a valued asset in the community," Young said. "The bill in its present form will not impact for another four years, when services will be put in place, so we don't anticipate any changes in our services while things get hammered out."

Young will soon attend a conference of the National Association of Free Clinics, where she will learn more about how other clinics are responding to the coming changes.

"The early talk is that there will still be a long term need for free clinics," she said. "Even with vouchers, not everyone will be able to purchase medicines, and some will not qualify for Medicaid. I don't see the need for free clinics going away just yet."

In response to the four year delay before reform measures begin to take place, the National Association of Free Clinics has held large health care events in Houston, Texas, New Orleans, La., Little Rock, Ark., Kansas City, Kan. and Hartford, Conn., with another held in Atlanta, Ga. today. The purpose of the one day clinics are to assist the uninsured who are in need of immediate medical care.

"Even though Congress just passed a health care reform bill, it may take years before many of its provisions take effect," NAFC Executive Director Nicole Lamoureax said. "There are approximately 42 million uninsured people throughout the U.S. ... who are in need of access to health care now."

An average of 7,000 persons attended the clinics in Houston and in the other metropolitan areas, with some 90 percent of those examined found to have three or more life threatening conditions. Cardiovascular disease, hypertension, diabetes and pulmonary disease were among the leading causes.

Young estimates there are from 5,000 to 6,000 adults in Scotland County who are without health insurance.

"We at the Scotland Community Health Clinic will continue to work hard to take care of our patients here while we watch the results of this historic legislation," she said. "Scotland County people have been hard hit, and we haven't seen the worst of it yet."

The NAFC website defines free clinics as " ... volunteer-based, safety net health care organizations that provide a range of medical, dental, pharmacy, and/or behavioral health services to economically disadvantaged individuals who are predominately uninsured."