The fate of a stimulus-funded clinic hinges on the nation's health care future.

NASHVILLE, Tenn.—Unwittingly, Mary Bufwack first applied for stimulus money a year and a half ago. George Bush was in office, Barack Obama was campaigning in Iowa, and the economic crisis was still fermenting on the books of AIG (AIG). It was in December 2007 that Bufwack, the CEO of United Neighborhood Health Services, a network of local health clinics here, sent in an application to Bush's Health and Human Services Department.

The uninsured need health clinics like the homeless need homeless shelters. Clinic rates are adjustable, they almost exclusively serve the needy, and they want to help as many people as possible. Bufwack wanted extra grant money to build a health clinic on Dickerson Road, the thoroughfare of a hardscrabble district on the north side of the city. For whatever reason—lack of mobility, inaccessibility to public transport, neighborhood territoriality—the Dickersonians weren't coming to UNHS's pre-existing clinics. Rather than go to a doctor, they would wait until their illnesses got so bad that they'd have to use the emergency room. And as one of UNHS's educational pamphlets says, "The ER is not a doctor's office."

Soon after she sent in the application, the Bush administration approved the project ... but said it wouldn't fund the clinic. There was only so much money to go around, and even though Bufwack's project was a worthy one, it wasn't at the top of the administration's list. The application was filed away.

More than a year later, somebody—without any prodding from Bufwack—dug it out. There was stimulus money afoot, and the administration needed shovel-ready jobs. "Approved but unfunded" was a good place to start. Dickerson was a go.

Except somebody forgot to tell Mary Bufwack.