One of the fundamental building blocks of a healthy community, where the interests of medicine and democracy intersect, is the ability to provide access to quality health care for everyone. We constantly face the deluge of questions on this subject: Who, what, how and how much should we pay for health care? I’m a firm believer that at the individual level, when we are healthier or have access to the help we need to become healthy, we are better off both personally and as a community.
Several issues about community health care are front and center these days and require our attention because, in the end, its effects trickle down to our health or someone we know.
A couple of months ago, I wrote about the lack of funding for the Children’s Health Insurance Program (CHIP), which was a cause for alarm. Both political parties support CHIP, yet it lived in limbo for 114 days until it was included in a short-term spending bill signed by President Donald Trump. CHIP covers children in families who earn too much for Medicaid, but too little to afford private insurance. Additionally, the program affects nearly 9 million youngsters and about 370,000 pregnant women. The problem is that we only have a short-term solution. The CHIP program escaped the gallows, but funding for community health centers remains elusive.
“While we have supported and are very pleased that CHIP relief is included [in the funding], the failure to do the same for health centers leaves them increasingly anxious that many more will face a loss of clinical health professionals who are seeking more stable work options,” said Dan Hawkins, senior vice president, The National Association of Community Centers. Let’s not ignore the impact and urgency here as well.
Community health centers serve one out of every 12 Americans, providing services to our low-income population. The centers will lose $3.6 billion without a funding renewal. This funding renewal for community centers is critical in order to protect all Americans.
It should be also noted that care at our community health centers makes better fiscal sense for all of us as taxpayers. Why? Rather than having those who rely on the centers get their health care needs met in the more costly emergency room setting, they are afforded quality care at a far less expensive price point in the centers. This is important because the ones that are least likely to receive this more cost effective care are the poor, disenfranchised or simply in unfortunate circumstances.
Viewing this problem strategically, I recognize that a viable answer is to connect those who need help with those who are professionally capable of offering it.
That’s why I have worked on an initiative that would establish a New Jersey Community Health Worker Program in the Department of Health that would help to link medically underserved communities with health care resources. As I noted in the proposal, “Community health workers are certified professionals who connect health care consumers with health care providers and resources, with the goal of facilitating access to health care in medically underserved communities and educating health care providers about the unique obstacles faced by members of that community when seeking access to health care.”
A portion of this proposal would standardize both training and certification for health care workers within the State Medicaid reimbursement programs. This program would help improve medical outcomes, lower health care costs (fewer emergency room visits) and reduce the embedded and disturbing inequities in our health care system.
About five percent of patients account for almost one-half of the nation’s health care spending, according to Jacqueline Belliveau, referring to a National Academy of Medicine report. It’s no surprise that researchers directly linked much of that five percent to emergency rooms.
The appeal to this legislation is its effectiveness. Boston’s Brigham and Women’s Hospital implemented a care coordination program with community health workers, resulting in an impressive fifteen percent drop in costs because of fewer emergency visits, according to Belliveau.
“Emergency department-based care coordination also resulted in 8 percent less inpatient direct costs at the large urban academic medical center, reported researchers from the Icahn School of Medicine at Mount Sinai, Brigham and Women’s Hospital and Harvard Medical School,” Belliveau notes.
CHIP and community health centers are at the core of providing decent health care to everyone, which I believe should be a right in the greatest country in the world. We must ensure that these twin pillars receive our support because of the good they provide to our fellow citizens. Congress is currently looking at temporary fixes to both but we should demand that there be some permanency to their funding sources….you know like the corporate tax cuts they just made permanent. Priorities! That’s my take, what’s yours?