"Some will be happy to pay," said Cheryl Bettigole, clinical director of Health Center No. 10, in the Northeast, "but there's no question that it's going to be hard. It's a working-poor population. People are proud. If they can't pay, they might not come."
The line started forming on Cottman Avenue outside her clinic at 5:30 a.m. yesterday. The waiting list for new patients at this clinic, the city's busiest, is 195 days, which means that more urgent cases - as well as current patients who need to get in quickly - are treated as walk-ins.
Mary Marek, 84, needed a follow-up visit after being hospitalized with a stroke; her treatment would be billed to Medicare. Agnes James, 58, had just lost her prescription drug coverage, five years after she was found to have breast cancer; she estimated that her 10 drugs, all provided free by the clinic, would cost more than $600 a month.
Jean Cadeau, 30, had abdominal pains and no insurance. He said he had gone to Temple University Hospital's emergency room for the pain but left after waiting seven hours. Frankford Hospital's ER did tests and assured him his case was not urgent, he said, but he still is in pain.
A fee would be a hardship, he said, and he might put off problems longer.
The possibility that some health centers might close, however, is scaring people inside and outside the Philadelphia Department of Public Health.
Commissioner Donald Schwarz, like other department heads, has had to present the mayor with scenarios for cuts of 10 percent, 20 percent, and 30 percent to make up for huge shortfalls in revenue for the fiscal year that will begin July 1.
Years of funding decreases, said Schwarz, appointed a year ago, have already left the department so lean "that if you cut one person in vector control, it would affect the rat population."
