Heart disease is the second most common killer in Kentucky. Prescription drugs can help ward that off; so can having a stent put into the heart.
And despite the expansion of Medicaid in 2014, there are still people who don’t have health insurance, can’t afford their premiums or can’t find a heart specialist because they have Medicaid. For those people, Have a Heart Clinic could be the place to go.
Most of the clinic's patients come from West and South Louisville, where residents are three times more likely to die from heart disease and stroke than people who live in places like the Highlands or East Louisville. And none of Have a Heart's patients have insurance.
Michael Imburgia, a cardiologist who started the clinic nine years ago out of his practice in the East End, said most everyone who comes to the clinic has a job. But they tend to have lower-paying jobs that don’t offer health insurance.
He said many make too much to qualify for Medicaid, and make too much to qualify for a health insurance subsidy on Healthcare.gov. And the price of insurance on the individual market can be as high as $5,000 a year for premiums alone.
“The only type they can afford will have a $5,000 deductible, and these are people that only make $20,000 a year,” Imburgia said. “People shouldn’t be treated differently based on the type of insurance they have.”
The clinic didn’t start as a clinic, but out of Imburgia’s office in East Louisville. And the majority of people he and other doctors would see there for free had to make the trek mainly via the bus from South and West Louisville.
As of February, Have a Heart has a brick-and-mortor location at 310 E. Broadway. Since opening, there has been an uptick of new patients. The clinic sees around 150 patients a year, but Imburgia said he expects to see even more since they now have a more centralized location.
While there are free primary care clinics, and money that goes toward preventive screenings, patients need a place to go when their health condition gets worse. Forty percent of visits at federally qualified health centers are for cardiovascular problems, and yet, almost half of those patients struggle to find a specialist.
“You have a place where no one gets turned away," Imburgia said. "And right now there is a barrier to people who are underinsured and frankly there’s a big barrier for people who are underinsured.”
Have a Heart provides testing and monitoring with machines that usually cost patients a lot of money when they visit other settings like hospitals. And if patients need more advanced care, including heart surgery, Imburgia looks to the clinic's 70 volunteers for a doctor to provide services for free at a hospital.
The clinic is also gearing up to see patients with insurance so they can use that money to help pay for treatment for people without insurance.
Public health efforts like anti-smoking campaigns have reduced the number of people who die from heart-related health problems, but health costs across the U.S. have gone up — mainly because of advances in treatment and longer life spans, according to a 2013 study in the Journal of the American Medical Association.
Currently, the Have a Heart Clinic is open from 9 a.m. to noon two to three Saturdays a month.
