THE HISTORY OF THE

ZAREPHATH
HEALTH CENTER
2003-2011
THE FIRST CENTURY SOLUTION
TO A TWENTY-FIRST CENTURY NEED'
PICIa C, N
.
ZAREPHAT
HEALTH CENTER
The Vision

AREA
HEATH CENTER
The Zarephath Health Center was born out of a vision,
a book and a disaster.
Two primary care physicians in
private practice wanted to be sure
that they had a way to care for the
poor. They were frustrated with the
state and federal Medicaid program,
designed to care for those without
means to pay for medical care.
Private practice office overhead is
high and Medicaid reimbursement
is low, coming several months after
the visit. Rather than lose money
with each Medicaid encounter,
most physicians choose to avoid
the program and treat the poor for
free. Yet the Medicaid program has
expanded in New Jersey, costing
taxpayers a huge sum of money
It occurred to Drs. John and Alieta
Eck that a facility established in the
vicinity of a local church could
utilize volunteers and charitable
donations to involve the broader
community in implementing a
comprehensive strategy to see each
poor person as an individual. Most
have needs far greater than just
medical. And this would cost the
taxpayers nothing.
In 1992, Dr. Marvin Olasky wrote
a book called the Tragedy of Aerican
Compassion. (c. 1 992 by Marvin
Olasky, published by Crossway
Books). He was a Jewish Marxist
Yale student who read a Russian
Bible and became a Christian
believer. He was interested in how
Americans cared for the poor
and his book chronicled the anti
poverty programs beginning with
the founding of the nation. The
most successful programs were
faith based, gradual, individualized,
4
challenging and local-the
exact opposite of the current
bureaucratic, top-heavy government
systems.
Zarephath, named after the Biblical
"widow of Zarephath," means "a
place of refining." It is a community
in central New Jersey started in the
early 1 900's. Willed to a fledgling
Methodist group called the Pillar of
Fire by a widow who could not pay
her taxes, it originally consisted of
1 000 acres, much of it farmland.
Many different Christian ministries
were launched at Zarephath. It
once had a printing facility that
produced and mailed so much
literature, Zarephath was granted its
own zip code.
A radio station, WAWZ-FM, Star
99. 1 , was begun in the early
1 930's, and a grade school,
a college and a church were
established. Several homes, large
and small, were built on the
campus to house those who chose
to live as a community. Most of
the buildings were built on a flood
plain, located between the Raritan
River and the Canal.
When Hurricane Floyd roared
through in September of 1 999,
a little 900 square foot house at
the far end of the property was
covered under 1 4 feet of brown
murky water. It was emptied out
and remained dormant for two
years. In 200 I, the Pillar of Fire
leadership authorized the planning
and re-configuring of the house so
it could become a clinic. Volunteers
and donors pooled resources and
skills, so that it was debt-free when
it opened its doors in September,
2003.
Volunteers renovating the original building that
was ruined by Hurricane Floyd.
at the Grand Opening
The Mission
We at the Zarephath Health Center
were learning the root causes of
poverty. The government looks on
poverty as a simple lack of funds,
and has a hard time categorizing
the poor. Indeed, the government
is criticized heavily when it
attempts to distinguish between the
"worthy" poor, those who are poor
through no fault of their own, and
the poor who lack funds due to
poor choices and bad behavior. Both
may need help, but the kind of help
needs to be very different.
Olasky teaches the "ABC's of
Compassion," and recommends
that successful people personally
reach out to those who are in
need. A brief summary of his seven
principles of compassion is as
follows:
ASSERTIVE - Actively seeking ways
to meet needs, fight social ills, and
care.
BASIC - Look for people closest
to the individual to meet the
needs-frst the family, then the
community, and finally the local and
state governments. This describes
"subsidiarity," where those nearest
the problem are most responsible,
and are subsidized by the next level
of caring commitment. SubSidiarity
represents the most efficient way to
care and is the least subject to fraud
and wastefulness.
CHALLENGING - Gently pressure
people to make changes, instead
of pampering them. Help develop
character traits that lead to more
self-sufficiency and growth.
DIVERSE -Treat each person as an
individual, without a one-size-fits
all approach. Each is an individual
made in the image of God.
EFFECTIVE -Try to avoid being
bureaucratic and unchallenging.
Utilize volunteers with their unique
gifts and capabilities. The bottom
line is changing lives, not counting
the numbers of people treated.
FAITH-BASED - Well managed Christ
centered charities are more effective
at fghting poverty and changing
lives than their non-religious
counterparts.
GRADUAL - Continually re-evaluate
and check the results of the
program. Gradual sustained results,
tested at each step of the way,
will make helping the poor most
successful and sustained.
5
6
HERE ARE A FEW OF THE PEOPLE OUR PHYSICIANS, NURSES AND SUPPORT
VOLUNTEERS HAVE HELPED;
A 28-year-old woman came to us six
months after her father had died from a long
illness. She had been his primary caretaker
while holding down a job in a drugstore.
When she became depressed, she lost her job
and her apartment. When she applied for
fnancial aid from the state, she was told
by the caseworker that, in order to qualify
for funds, she needed to get pregnant. She
needed medicine that cost $230 per month.
We helped her access a program designed by
the pharmaceutical companies, allowing her
to receive a three month supply for free. The
company refused to give her more unless she
had a letter from the state agency explaining
their denial of aid. They would not write it. So
we priced around several stores and bought her
medicine to carry her over. She is getting back
on her feet, has enrolled in a course to become
a phlebotomist, and will be on her own by the
end of the summer. She will not need our care
any more.
A 20-year -old just graduated from college
and was removed from her parents' insurance.
She stayed at home for several months,
caring for her sickly grandmother who was
bedridden with advanced Azheimer's disease
and eventually died. With no paycheck and no
insurance, we were able to take care of this
young woman's simple illness at no cost to
her. She is now at work and does not need the
services of the Zarephath Health Center any
more.
A 52-year-old woman stays home with her
S4 year old sister, who is dying of metastatic
breast cancer. Her husband's paycheck can
keep the household going, but no one in the
house has health insurance. She herself is at
high risk of getting breast cancer, but had
not had a mammogram in S years. She went
to the local, state subsidized hospital, hoping
to get low cost medical care. The physicians
there did a physical exam and blood work,
charging her $495. Then they handed her a
prescription for a mammogram. When she
came to us, we checked around for the best
price, and the Zarephath Health Center gave
her a check to pay for her mammogram. She
recently told me that her dying sister was told
that she will qualify for Medicaid on July 1,
two and a half months from now. This very
sick sister will likely not live that long .
A 49-year-old is disabled with complicated
diabetes. His disability income is $1000 and
his rent is $72S. Whi1e he is on Medicare
and the state run prescription plan for the
poor, he cannot even afford the $S co-pay.We
set up an account in his name, at the local
pharmacy, to draw down each time he flls a
prescription. The local food stamp offce told
him that he qualifed for only $10 per month
in food stamps, so his church supplies him
wi th gift certifcates to the local grocery store.
Many hands are helping this man maintain
his dignity and get the health care and other
support he needs.
A 28-year-old man was terrifed that he
was dying. He could not hold down a job. He
made severl visits to the emergency room and
tests all came back normal. He had $30,000
credit card debt, and was paralyzed with fear.
We spent a lot of time with him, mostly in
phone calls, three times a week for several
months. Each time we saw him we reassured
him of his good health and placed him on
medicine that seemed to help.We never charged
him, but each time, we encouraged him to fnd
work. He fnally enrolled in a truck driving
school, and called on the Saturday morning he
passed the driving test. He now has a good job,
is convinced that he is healthy, and no longer
needs us. His mother is eternally grateful.
7
8
When people ask why we started
the Zarephath Health Center for
the poor and uninsured, we reply
by telling the story of the Good
Samaritan. It is a story that Jesus
told about a man who was lying
by the side of the road, injured
and bleeding. A minister walked
by quickly, thinking that he had to
hurry to preach his sermon. Then
a Bible teacher came by, and also
felt that he did not have the time
or skills to stop and help. Finally, a
Samaritan, a religious outcast , saw
the man, stopped and gave of his
own time and resources to see that
the man was cared for.
We have determined to live out our
faith by following the example of
the Good Samaritan. When we see
TO
M
E, A1.L WHO ARE
people in need, we are not going
to demand another government
program, but rather, we will donate
our own time and find others
willing to help us do the same.
We believe that there is a God in
heaven, and that He would have
us show compassion by meeting
the physical, emotional, spiritual
and relational needs of people with
whom we come in contact. We do
not impose religion on anyone,
but are ready to give an answer
if anyone asks why we have an
enthusiastic optimism about the
future. We are free to tell them how
a relationship with God provided
the missing link in our lives and
how it can be the same for them.
ANIl
WEARY ANU BURDENED.l WILL GIVE YOU REST.
TAKE MY YOKE UPON YOU
AND LEARN FROM ME,
lAM GENTLE
A
NDHUMBLE IN HE
A
RT
AND YOU WIL
L
FIND REST FOR YOUR SOULS.
M
YYOKE IS EA Y
AND MY BURDEN IS [](|J`
-JESUS MMIII;\V II,l810
The wall of the waiting area in the original Zarephath Health Center.
The Operation
Utilizing a committed group of
kind volunteers, we have grown to
a regular staff of 6 physicians, about
30 nurses and dozens of support
staff We are funded completely by
donations, and dollars left in the
front box by the 300-400 grateful
patients we see each month. All
visits and medicines are free. The
volunteers and patients are blessed.
This is the Biblical way to care for
the poor, and it costs 10% of what it
costs the government at a taxpayer
funded federally qualified health
center.
All services are free and medicines
are often given out free of charge
to those with the greatest needs.
We rely on a donation box at the
front desk and charitable donations
from churches and individuals
who believe in our mission. We get
no government grants or taxpayer
dollars.
We learned as we progressed and
found that physicians and nurses
could get free medical malpractice
coverage supplied by the federal
government via the Federal Tort
Claims Act of 1996. This made
it feasible for retired physicians
to donate their time. Doctors
were now able to volunteer their
time without jeopardizing their
livelihood.
By 2010, it was clear that so much
more could be accomplished with
a move to a larger facility. With
only one intake room and two
exam rooms, it was diffi cult to
spend extra time with a patient
who needed it. The Zarephath
Christian Church had grown from
200 to 2, 000 and word of the free
clinic had reached as far away as
Pennsylvania. We expressed our
concern with the leadership of the
church and the Pillar of Fire, and
,
9
10
they identifed a building which
could be reconfgured into a new
clinic.
Volunteers renovating the new health center
across the street on the Zarephath Campus.
Donations and volunteers worked
hard once again to create a beautiful
5,000 square foot facility that
would provide an environment
to care for the poor and utilize
more counselors and professionals
to meet the needs as they arose.
Medical students rotate through.
A seminary student, thoughtfully
contemplating a new role for
someone with his training now
helps with the intakes where
individual new patients are
listened to and networking options
are considered. The church has
developed support groups for
single moms, people who are
grieving, people with addictions
and people who are lonely A food
pantry and used clothing exchange
was established as a part of My
Neighbors' Ministries, locating in
a mirror image building directly
across from the Zarephath Health
Center.
Doctors Eck have been thinking
about ways to improve on the
model, and have determined that
more physicians would volunteer if
they could lower their own offce
overhead. This is what led a group
of policy people to develop the
concept of the Volunteer Physicians
Protection Act (VPPA) where instead
of billing for charity care services,
the state would simply proVide
medical malpractice protection for
the entire practices of physicians
who donated four hours per week
in a non-government free clinic.
This would improve access to
medical care for the poor, relieve
the physicians of the expense and
burden of having to care for the
poor with full liability, and give a
huge break to the taxpayers. The
state would only incur an expense
if a lawsuit were fled, and these
would become less prevalent.
In May of 20 II, Alieta Eck, MD
was asked by Senator Rand Paul
(R-Ky) to go to Washington, DC
to testify at a Senate subcommittee
hearing. The topic-How to keep
non-urgent illnesses out of costly
emergency rooms. She took the
opportunity to explain what is done
at the Zarephath Health Center. The
folloWing is her testimony:
1 1
TESTIMONY TO THE US SENATE COMMITTEE ON HEALTH. EDUCATION.
LABOR AND PENSIONS
On Reducing Inappropriate
Emergency Room Use by the Poor
May II, 2011
Alieta Eck, MD
Physician in Private Practice in Internal
Medicine, Piscataway NJ
Co-founder, Zarephath Health Center,
Zarephath, NJ
President -elect, Association of Aerican
Physicians and Surgeons
Good morning. I a a physician
specializing in Internal Medicine. I
welcome the opportunity to speak in
front of this committee, and explain
what I have observed in both my
23 years of private medical practice
and the 7 years of volunteering in
a free clinic. I believe that I can give
information that wl be valuable
in helping to develop policies that
would be effective in deterring the
unnecessary use of the emergency
room.
Both in the practice where I earn my
living, and the free clinic where I
see the poorest of the poor, I count
it a privilege to be able to make a
difference in the lives of my patients.
My husband, Dr. Joh Eck, MD,
and I dropped out of the Medicaid
program a few years after enrolling,
realizing that it was causing our
practice to lose money, thus
jeopardizing our livelihood. The cost
of fling the claim was greater than
the sum Medicaid would pay us
several months later.
The Foundng of a
Non-Governent Free Clc
After Hurricane Floyd flooded a
small house on the edge of our
church campus at Zarephath, NJ,
we convinced the church leadership
to allow us to renovate it and turn
it into a clinic. We had read Marvin
Olasky's Tragedy of American
CompaSSion, and we determined
to do things differently-to see the
poor for free, to solicit the help of
caring volunteer nurses and support
staff, and to work to identify the
root causes of the poverty that
brought the patients to us, helping
in any practical way we could. The
clinic began operation in September
of 2003. It has a 501 (c)3 charity
status and operates completely by
private donations-with no taxpayer
dollars. In fact, we would turn down
taxpayer dollars, as we frmly believe
charity should be voluntary
Volunteers listen to the stories of
each person who comes in, offering
kind encouragement. A verse
stenciled to the wall in the waiting
room reads, "Come unto me, all you
who labor and are heavy-laden, and
I will give you rest. (esus) "Then a
nurse and physician see the patient
to handle common complaints
such as a sore throat, bronchitis,
hypertension, diabetes, thyrOid
disease and sometimes illnesses that
are more serious and life threatening.
We bind up the wounds of their
limbs and their hearts. The church
has a food pantry and a clothing
thrift shop where some people pay a
few dollars for clothes and many can
get them for free. It is not one-size
fts all charity situation, but varied
help for very different types of
people.
We have never advertised, but the
13
patients come-from as far away as
Pennsylvania and New York, an hour
and a half away
Patients are referred by their friends,
other patients or church members.
Patients are referred by the
emergency rooms, after they have
been seen there.
Patients are referred by nurses in
the hospitals when poor patients
are being discharged and have no
primary care physician.
Patients are referred by local
pharmacies.
Patients are actually referred to us by
the Medicaid offi ce when patients
have complained that they could
not find a physician who accepts
Medicaid.
Patients are referred by all the social
service agencies in the area.
We see patients who have just been
released from prison, referred by
their parole offcers.
We see patients who have been
released from psychiatric hospitals,
prescriptions in hand and no means
to pay for them. They are scheduled
to see a psychiatrist 6 weeks hence at
a state run psychiatric facility, but are
not given any help in between. We
hand them their medicines if they
are available in our little pharmacy.
We handle them medically until
they can get to the proper specialists.
A local community food bank has
a fund set aside for emergency
prescriptions.
We see unemployed union members
who are dejected, wondering how
to pay their mortgages and unable to
pay for medical care.
We see single mothers who bring
their little ones to play with
volunteers i our play area, while we
take care of mom's medical needs.
We try to have the children leave
with smiles on their face and often a
donated teddy bear.
We see children when a pediatrician
or family practitioner are there.
We see people who are, temporarily
unemployed and feeling frightened
and vulnerable.
We see patients who are referred to
us by the unemployment offce.
We see people who are living in
their cars or under bridges, having
been evicted from their homes,
estranged from their families for
many reasons including their own
poor behavior.
We see patients referred to us by
judges in family court.
No one pays a penny, but some put
a few dollars into a donation box
at the front desk. This covers some
of the $ 1 3 average cost per patient.
TESTIMONY TO THE US SENATE COMMITIEE ON HEALTH. EDUCATION. LABOR AND PENSIONS
Medications are handed out for
free-onated by pharmaceutical
companies, drug representatives,
sample closets of fellow physicians,
and some purchased wholesale.
Often we will write for the $4
prescriptions that the free market has
made available to al. Every patient
leaves with a grateful heart, as they
know that people cared for them
because they wanted to, not because
it was their job. Alare treated with
respect, empathy and kindness.
Some people are poor through no
fault of their own, but many have
made bad choices along the way
They need good advice, role models
and people who wl patiently
encourage them to make changes
that will empower them to be lifed
out of poverty. Zarephath Christian
Church has many programs that fll
their social voids-men's breakfasts,
women's luncheons, Bible studies,
support groups for those who grieve,
support groups for battered women,
marriage ministries and other groups
for all ages.
15
Who gets Care at the Zarephath
Health Center?
Let me give you some examples of
actual patients we have seen:
A 54 year old gentleman, a carpenter with no
work, came in with severe nasal obstruction
from sinus polyps. He was on Medicaid but
could not fnd an ENT surgeon who would
operate for the amount Medicaid would pay
Why should a surgeon take on full liability
for such a low fee? This man was asking me
to fl out disability forms. Instead, I called an
ENT friend and asked what he would charge.
We agreed upon a fair amount and the surgery
was done and we paid out of donations we had
received. The very grteful patient came to a
men's breakfast at the church where volunteer
workers are spending their free time fxing up
our new clinic facility He wants to volunteer
as well.
A 34 year old woman came in with
palpitations and a tender thyroid.With no risk
factors for heart disease, we gave her medicine
to slow her heart and had her come back the
next day where our volunteer retired cardiologist
saw her and confrmed the diagnosis. She was
100% better. The charity system was saved
probably $10,000, as a visit to the ER would
have triggered that much in advanced cardiac
testing.
A 25 year old gentleman walked in with a vial
of an anti-psychotic medication that was to be
administered monthly He had the paperwork,
but no one to administer it.We did.
A 15 year old girl with no insurance came
in with palpitations and shortess of breath.
Our retired cardiologist diagnosed a cardiac
conduction defect that would require a surgical
ablation to cure. He called a colleague who was
happy to take care of her for no charge. Her
grateful mother comes in and volunteers to do
clerical work at the clinic.
A couple is overwhelmed with two severely
autistic children. The church has developed a
program whereby these children are give one
on-one supervision in Sunday classes and the
parents can attend church services together. The
parents are extremely grateful and the father,
an air condi tioning specialist has offered to
maintain our system in our new facility
A 48 year old woman came in shOWing all
the signs of the disfgurement of acromegaly,
a disease of the pituitary gland where growth
hormone continues unchecked after puberty This
was diagnosed ten years ago, but she had no
means to pay for care. She wet to the Medicaid
ofce where she was told that the only way to
get Medicaid was to be on welfare. She argued
that she wanted to work, but just needed help
with medical bills. She was thus tured away
and referred to us by the unemployment offce.
A SO year old woman with extreme weight
loss and a breast mass was being worked up
for cancer. Wen no cancer was found, she was
referred to our clinic. It turns out that her very
bad teeth were seeding her bloodstream and
causing the abscesses. Antibiotics helped her
gain weight and a dentist agreed to take care of
her teeth for no charge.
A 54 year old man who had had a kidney
transplant came in with no way to pay for his
TESTIMONY TO THE US SENATE COMMlnEE ON HEALH. EDUCATION. LABOR AND PENSIONS
transplant rejection medicine. This was a true
emergency. We called the towship and asked
if there was some type of charity fund for this
type of thing. Fortunately we were able to get
him the medicine he needed.
Today we see 300-400 patients per
month and the church has made
new space available for us. We
will go from 900 to 4,000 square
feet, with five exam rooms, three
intake and counseling rooms, and
a large classroom to teach classes
on diabetes and other topics. Our
new clinic will have a dental chair
for dentists to volunteer. It is being
built by builders, plumbers and
electricians who are working at
a reduced rate and many former
patients who are volunteering to
do the sheetrock and spackling. The
township building inspector, so
inspired by the stories, has agreed
to put the frst coat of paint on al
the walls for free. Money is being
donated for the work, and we will
open in a month or so, completely
debt free. The church has gone from
an attendance of 150 to 2,000 in
the 7 years the clinic has been in
existence. A culture of caring attracts
people.
Who goes to the Emergency Rooms
for Non-Urgent Complants?
Many patients bring their emergency
room reports wth descriptions of
their ear aches, sore throats or rashes.
When we ask why they went to the
ER for such minor illnesses, they tell
that they would have come to our
clinic, but we were not open. Because
of lack of physicians who are able to
volunteer, our clinic is only open 1 2
hours a week.
Patients who are poor and without
any assets have absolutely no restraint
when it comes to going to the ER.
They know that there is a physician
there 2417 so do not bother to
call an office or clinic to make an
appointment. When I was a resident
many years ago I remember one
patent shOwing me her rash at 3 A.
When I asked why she was coming
for such a minor complant at that
hour, she said she figured it would
be a good tme because we wouldn't
be busy To her, this was a perfectly
reasonable answer.
Patients on Medicaid are twice as
likely to visit the ER for non-urgent
conditions than patients wth no
insurance at al . Their sense of
entitlement, having that Medicaid
card combined with their poor
management of their own resources
makes a warm, clean ER environment
a pleasant place to spend an
afternoon. Since they are not turned
away, they continue to come. They
have absolutely nothing to lose, as
they wlnever see a bill. Any attempts
to divert them are futle.
17
The Cost of Providing
Care for the Poor
I note that on the description of
today's hearing you claim that
the cost to provide care in the
emergency room is $1,000, which
is 7 times the cost of providing care
in community health centers. This
correlates with the information I
have gathered where the costs in
these centers are between $140-
$280 per patient visit. Compare
that to the cost of providing care
in a non-government free clinic
such as ours-$ 13, one tenth
to one twentieth the cost of a
federally qualifed clinic. If there
were an adequate number of
non-government free clinics, the
savings to the taxpayer by keeping
people out of the emergency rooms
would be 100%, and the cost to the
charitable donors would be minimal.
A federally qualified health center in
the next town has a yearly budget
of $14 million-all from taxpayer
dollars. (from the IRS Form 990).
Ours is $58,000-none from the
taxpayers. For the amount it costs to
fund one FQHC, we could fund 250
clinics like ours, and I submit that
the patients would get better, more
personalized care.
I do not like to disparage the work
of others, but the follOwing is an
eyewitness account of someone who
worked in one of those $14 million
FQHCs-
"The bureaucracy was unbelievable. The
administrators had no clue how the care of
patiets worked. Tons of rules. Lack of proper
supplies. Poor quality of the staff working there,
mostly from the indigent areas. Patients had to
wait hours to go through the registration and
verifcation process which was very frustrating
for them. A normal visit to the clinic took over
two hours for a patient. Patients came there
not by choice but because they had no place
else to go. It was not a caring atmosphere. The
administration made everything very difcult."
This is not really surprising, for when providing
charity is a job instead of a voluntary giving of
one's services for no compensation, the dynamiC
change. This is not a new concept. In 1853, Rev.
William Ruffner noted that :
"Charity is a work requiring great tenderness
and sympathy, and agents who do their work
for a price rather than love should not be trusted
to execute the wishes of donors. The keepers of
poor-houses fall into a business, Unfeeling way
of doing their duties, which is wounding and
often partial and cruel to the objects of their
attention."
The NJVolunteer Physicians
Protection Act
So the question is, "What would
it take to have thousands of non
government free clinics scattered
throughout the country?"
The Zarephath Health Center is
open only 12 hours per week as
TESTIMONY U NA E COMMITI E ON HEALTH. EDUCATION. LABOR AND PENSIONS
we have trouble fnding physicians
to volunteer. Physicians have many
stresses and often struggle to meet
all their obligations, suffering from
ever-decreasing third party payments
and ever-increasing administrative
burden. Volunteering does not
easily ft into their schedules. Even
though the Federal Tort Claims Act
(FTCA) gives us free federal medical
malpractice coverage for the work
we do in the free clinic, it is still hard
to fnd physicians.
So we in New Jersey are working on
a solution. Physicians and citizens
have come together to propose the
NJ Volunteer Physicians Protection
Act, whereby physicians would
volunteer to donate four hours per
week in non-government free clinics.
Instead of billing for our services, we
are asking that the state extend the
same medical malpractice coverage it
now provides to the medical school
attendings, residents and students, to
the entire practices of the physicians
who volunteer. The state could
simply take the same paperwork
used by the FICA to identify those
physicians who qualify for coverage.
Medical malpractice coverage would
be the physicians' only reward-
no claim forms, no CPT codes, no
secretaries at either end, no money
flOwing from the government to care
for the poor. Just liability protection.
The rest of the clinic work would be
done with at least 90% volunteers,
with minimal key paid staff, al
funded by private donors, local
fundraisers and corporate donations.
From our experience, there would be
no shortage of volunteer nurses and
support staff And the baby boomers
are poised to become a huge pool
of volunteers with expertise and
experience. There would be no
avenue for fraud and abuse, as no
money would be coming in from
the government.
An organization founded by a
philanthropic couple in Texas called
Echo Clinics (echoclinics.org)
has the mission of facilitating the
founding of 10,000 free clinics by
the year 2030. We look forward
to working with them here in NJ.
They facilitate in identifying core
directors, choosing a free clinic site,
establishing the SO 1 ( c) 3, and going
through the FTCA application.
Senator Bernie Sanders, you hail
from the left, where you proclaim
a deep concern for the poor and
underprivileged. So I would think
that our idea would appeal to you.
Greater and more satisfactory access
for the poor to see physiCians of
every specialty This is universal
access.
Senator Rand Paul, as a member
of the Tea Party movement, you
19
hail from the right, which believes
in freedom, smaller government
and lower taxes. Our plan ought
to appeal to you as the free clinics
would operate with no tax dollars at
all. This is limited government.
The NJ state Medicaid budget is
$ 1 0 billion in a total state budget
of $28 billion. Half of that is for
indigent elderly and half is for acute
care. Of the $5 billion for acute
care, $ 2 billion goes to Medicaid
managed care and $800 million goes
to federally qualified clinics. (data
from statehealthfacts.org) Assuming
an average 20% administrative
cost, that means a total of $500
million of these two entities is
paying administrators of the
system-people who do not touch
the patients. In the NJ Medicaid
budget, $90 million goes directly
to physicians. There is a bit of a
disconnect in common sense here.
Since the Medicaid ofce is currently
directing frustrated patients to our
free clinic, why do we need the
middle man? And why would we
need Medicaid managed care if we
physicians are willing to manage the
care of the patients for free? Who
can argue with free? Since the state
would not be purchasing medical
malpractice policies, the only cost to
the state taxpayer would be incurred
if an actual lawsuit were brought.
From the experience of the FTCA,
these would be rare. It does not take
too much accounting to realize that
NJ would qUickly save $2 billion if
this program were implemented, and
the 50 states could save $100 billion
per year.
The federal government would be
able to lower its Medicaid spending
as well. An added beneft would
be the reduction of the estimated
20-30% cost of defensive medicine
by the reduction of unnecessary
testing done purely to avert potential
lawsuits. This would reduce Medicare
spending as well, another $200
billion in savings, according to
studies done during the Bush
administration.
I am not suggesting that we
dismantle the Medicaid program
in one fell swoop-but give the
patients in need a choice. If someone
finds himself ill and with no
insurance and no funds, he could go
to a Medicaid office and spend time
filling out forms where he might be
rejected, or he could go to a nearby
free clinic. Once the word got out,
a well-staffed free clinic that is open
for many hours a day would be a
huge deterrent from inappropriate
use of the emergency rooms. Also,
each hospital could have several
rooms set up where non-urgent
cases could be seen by physicians
who would donate their time there.
The free clinics would not have to be
free-standing.
And instead of having an entitlement
for what might be a temporary
tough time, why not have a place
to go for only the time that is
needed? After patients have been
helped and are back on their feet,
we will encourage those who find
work to access and pay for care at
our practices. Poverty should be a
temporary state, not a way of life.
We have a website-N]AAPS.org.
There physicians and citizens can
read alabout the NJ Volunteer
Physicians Protection Act and sign
up to voice their approval. So far we
have 40 physicians who agree with
the concept, and I do not believe that
staffing these clinics will be difficult.
We have a seminar coming up next
month to teach church leaders and
concerned citizens how they can
organize and establish a free clinic in
their area. Sometimes it is good to
revisit ideas from the past. Providing
medical care for the poor and
uninsured is one of them.
Thank you for this opportunity to
address this committee.
Respectfully submitted,
Alieta Eck, MD
2 1
22
JIIDUIC to I88 LIIC8Q,
My name is Dr. Alieta Eck. Six years
ago, my husband, also a physician,
started a free clinic at Zarephath, a
church and college campus in the
next town over. We thought that it
was possible to care for the poor
and uninsured in a way that gave
the patients dignity, and not use any
taxpayer dollars. Volunteers stepped
up to help, and one of our earliest
recollections was Missy Gillespy I
cannot remember how she learned
about the clinic, but one day she was
just there-a skilled and dedicated
nurse, just who we needed. She
rolled up her sleeves and got to work
with a clear vision of what we were
all about and were trying to do. She
was truly a godsend.
Although my husband and I had run
a private practice for many years, we
had never run a free clinic, and so
much was different. But I remember
This is a tribute to Missy Gillespy, RN., our frst nurse, who
helped in the early establishment of the free clinic. She is
an example of the volunteer ism that is the heart of this
ministry. She died in 2009 at the age of 42. This message
was delivered at her funeral.
Missy being there just about every
time that I was, and she took the role
of head nurse. She had a winning
smile, a lot of common sense and a
can-do attitude. She helped organize
the pharmacy and the exam rooms
with us and just did whatever was
necessary to get a new clinic up and
running.
People who core to a free clinic
have often been battered by life and
who have a rough exterior. They all
have a story. Some have just recently
lost a job, but others are chronically
unemployed and need more than
some medicines and a pat on the
back. Missy was the type of nurse
who could be pOSitive with anyone
and put them at ease. Missy loved
the Lord and saw the clinic as the
mission that it was-a place where
people could learn that God loved
them. Our job was to demonstrate
that love and caring.
After her car accident a few years
back, she could no longer work with
us. She would call from time to time
to see how things were going and to
give an update of her own medical
situation. I knew she wanted to core
back and her heart was there with
us. Today we are seeing between 300
and 400 patients per month.
Missy exemplified the verse found in
Matthew 5: 1 6:
"Let your light so shine before men,
that they may see your good works
and glorify your father in heaven. "
We are all saddened by the passing
of Missy Gillespy-but we know
that we will see her again someday
and we wll see people who were
touched by her and met their Savior
through that little clinic.
23
DR. ALiETA ECK. MD graduated from the Rutgers
College of Pharmacy in NJ and the St. Louis School
of Medicine in St. Louis, Mo. She studied Internal
Medicine at Robert Wood Johnson University
Hospital in New Brunswick, NJ and has been in
private practice with her husband, Dr. John Eck, MD,
a family practice physician, in Piscataway, NJ since
1988.
She testified before the Joint Economic Committee of
the US Congress in 2004 about better ways to deliver
health care in the United States.
John & Aeta Eck. MDs.
Founders of the
Zarephath Health Center
In 201 1, she testifed before a US Senate subcommittee on ways to keep
patients with non-urgent conditions out of the emergency room. She
appeared on Judge Andrew Napolitano's Freedom Watch.
Dr. Eck is a long time member of the Christian Medical Dental Association
and in 2009 jOined the board of the Association of American Physicians
and Surgeons, becoming the President in 2011. In addition, she serves on
the board of Christian Care Medi-Share, a faith based medical cost sharing
Ministry
She is a member of Zarephath Christian Church and she and her husband
have five children, one in medical school in N].
FOR MORE INFORMATION:
Zarephath Health Center
Location: 595 Weston Canal Rd., Modular A, Somerset, NJ, 08873
Mailing address: PO Box 9182, Zarephath, NJ 08890
732-537-0737
FAX 732-537-0738
zhcenter@aol.com
ww .zhcenter.org
To follow progress on the
Volunteer Physicians Protection Act,
ww . NJAAPS.org
2011

HEATH CENTER