Deitch said her experience with changing fees several years ago had led her to suggest the city start charging.
Like other clinics - but not the city's - hers had always charged uninsured patients for care on a sliding scale, but the staff did not always enforce the policy, she said.
Facing financial problems, her staff got serious about collecting. "We taught them to say, 'Your fee today is $20. Will that be cash or check?' "
Cash collections skyrocketed 300 percent in a year, and virtually no patients left.
Kusema Warrakah, who chairs the community board that oversees the city's Strawberry Mansion Health Center, has his doubts.
"When you are poor, $5 is a real lot of money," he said.
So far, though, he and others are more worried about possible closings of centers than about new fees.
"Why are you looking to cut essential services when there are billions of dollars in revenue that you are not even looking at?" asked Neil Herrmann, head organizer for Philadelphia Acorn, a community organization.
Nutter will present his budget to City Council on March 19. Schwarz, who is a deputy mayor in addition to health commissioner, said he has no clear sense of which budget-cutting option the mayor would demand.
At a series of citizen forums held by the Penn Project for Civic Engagement and summarized for the mayor this week, however, Philadelphians made clear that closing health centers was about the last thing they wanted - less, even, than cuts in police - and adding fees for services was something to be avoided if possible.
Contact staff writer Don Sapatkin at 215-854-2617 or dsapatkin@phillynews.com.
