Shovel ready clinics: a job creation idea so obviously good even Washington couldn't possibly say no ... could it?

• Author: Leonard, Jeffrey

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Barack Obama has spent most of his first term as president wrestling with three enormous tasks: kick-starting I the economy to create jobs again; standing the banking sector back on its feet; and providing health care to the 40 million Americans who lack insurance. He's made progress on all these fronts.

But let's be honest. Despite billions in federal stimulus money, the American jobs machine is barely functioning, and millions of previously hardworking Americans, especially in construction and the "trades," are sitting idle. Despite billions in bailouts, America's banks are barely lending, especially to small businesses. And while Obama did pass health care reform, those very reforms actually threaten to overwhelm an already severely strained primary health care infrastructure with a huge wall of new "customers" demanding health care services.

In 2014, a little more than two short years away, the provisions in the Affordable Care Act (ACA) that are designed to expand coverage will kick in, initiating a deluge of insurance-card-carrying Americans into the health care system. These disproportionately low-income, newly insured people will live in every state and community in the country. Unless we act now, they stand to join the ranks of the "medically disenfranchised"--the more than 50 million already insured Americans who have no regular access to primary health care for lack of physicians and facilities in their local communities. Think our transportation infrastructure is under stress? Our health care infrastructure is like an already dogged highway system that's about to take on 32 million new vehicles overnight.

These three problems--the economy's failure to create jobs, the banking sector's unwillingness to lend, and the health care system's lack of capacity to meet an accelerating rise in demand--might seem intractable, especially in a deadlocked Washington where no new money is likely to be put on the table. But if we could take off our ideological blinders for a moment--if conservatives could stop seeing every federal action as an assault on freedom, and liberals could get beyond their belief that spending more federal money is the way out of every problem--we would find a modest answer to all three of these problems staring us in the face.

Part of the solution is relatively uncontroversial. As Congress and the president have acknowledged, the way to meet the flood of new patients coming down the pike is to expand the nation's existing network of community health centers--nonprofit clinics that offer primary care to the medically underserved, often in rural areas or inner cities. But to get this done, there's no need to appropriate billions more in direct government spending. Rather, there is a way to lure skittish banks into lending private capital to finance a health center construction boom in all fifty states, simply by tweaking the language of an existing federal lending program. Doing so would save money in the long run by providing cost-effective primary care to those who desperately need it. And it would quickly create tens of thousands of jobs, many of them in the hard-hit construction sector. Moreover, unlike the roads, bridges, and other complex infrastructure projects the Obama administration wants to fund, few of which are shovel ready, health center projects could get the hammers swinging in months, not years.

Community health centers may sound like a liberal pet project--they originated under Lyndon Johnson's Great Society, after all, and offer care regardless of patients' ability to pay--but they have long enjoyed the steadfast support of Republicans and Democrats...