.
Town
Meeting Highlights 'Cover the Uninsured
Week'
by
Judah Ken Freed
Public
meeting draws strong support for covering
the 41 million without health
insurance.
.
"I
had no one caring for my children but me,"
said Monet Barton, a self-employed mother
of two girl. "but I have not compromised
on their health care."
Barton stood behind
a podium before a crowded downtown hotel
gathering last Monday afternoon, March 10.
She served as the kickoff speaker for
"Colorado Speaks: A Town Hall Forum on the
Uninsured," staged on the opening day in
Denver of national "Cover the Uninsured
Week."
Barton spoke in
clear tones as a local example of the 41
million people in about 100 million
American households who have no health
insurance. Beyond the uninsured, Barton
also stood before the audience of about
500 people in the Colorado Ballroom of the
Downtown Marriott as a living
representative of the millions
under-insured, also called the
"underserved."
The problem is
economic, she explained from spotlit
platform on the long wall of the ballroom.
Roughly half of the American people cannot
afford any health insurance, or else
cannot not enough coverage to matter. Mot
of these people earn too much money above
the poverty line to qualify for public
assistance, so millions are left in limbo
without any health care coverage at
all.
Unlike most working
parents, Barton said, because she works at
home, she's always been there for her
children. But she admitted being like the
rest of the uninsured.
"I could not afford
at least $200 a month on the premium for
medical insurance," she said. "But my
children always received the care they
needed," like five stitches once, but
mostly checkups, inoculations and dental
visits. "I paid for it out of my own
pocket."
Barton received help
for two years from the Colorado Children's
Health Plan (CHP), the indigent health
care program, but she was disqualified
from CHIP and everything else when her
income passed the maximum
allowed.
Like most uninsured
people, Barton put off a medical condition
until it got worse. She landed in the
emergency room at the University of
Colorado Health Sciences Center (the
central-Denver teaching hospital operated
by the University of Colorado that's
relocating to Fitzsimons in Aurora).
"I was scared and in
pain," she said "I was asking myself, was
my life in danger? What would happen to my
girls? To stay alive, would I have to sign
my live away and then work to make the
monthly payments? I felt helplessness and
panic."
As it turned out, a
"wonderful doctor" at University Hospital
greatly reduced his fee for her surgery,
and she received more than adequate care.
"The ordeal got me
thinking about the lack of health
insurance." she said. "I think about the
worse case scenario for others like me,"
Barton said. "What about those with cancer
or other major problems? The hospital has
to swallow their medical bills, and that
drives up their costs, which drives up the
price of medical insurance."
She concluded, "I'm
not sure what the future
holds."
As the applause
faded, moderator Cynthia Hessin from
Denver PBS affiliate KRMA-TV took over as
host, Before she presented the panel of
six speakers already seated by a table,
she introduced a video from the national
Cover the Uninsured Week campaign,
projected on large screens on each side of
the room. A version of the video would
appear on home TV screens all week as a
PSA, public service
announcement.
Hessin said there
were 500 forums like this one happening
nationwide that day.
Beyond the 45
official partner organizations in
Colorado, a total of 75 organizations were
participating in some capacity across the
state during the week of activities. More
than 700 organizations were participating
nationally.
Other events would
include a Tuesday gathering of about 200
students at the University of Colorado
Health Sciences Center in Denver, a
statewide series of health fairs on
Wednesday, and a Mile High United Way
breakfast on Friday. A spokesperson for
the Colorado campaign said two or three
thousand people attended metro Denver
events during the week, and thousands more
attended events statewide.
Attending the Monday
kick-off gathering in downtown Denver were
a cross-section of those concerned
&endash; government leaders, health care
providers, charity executives and staff,
health care activists, and member of the
general public concerned about their own
health care.
Calls to the
campaign office during the week, said a
spokesperson, ranged from movers and
shakers requesting information to business
owners asking what they can do for their
employees. The campaign mostly received
calls from uninsured people wanting a
solution to their dilemma.
For the Denver "Town
Hall," Hessin said she would ask the
panelists to make statements, then there
would be time for a few questions from the
audience. Following this event would be a
working session of the Colorado Coalition
for the Medically Underserved, which had
used this same room for it's statewide
meeting that morning.
First to speak was
Mitch Ackerman, president of Service
Employees International Union, Local 105.
Representing about 750,000 janitorial and
related workers, he said, the union for
the first time has 300 workers in Denver
covered by health plans.
"The people in the
wealthiest nation on earth can do better
than they have now," he said. His union
for now, and one day soon the whole labor
movement, is committed to creating a
national pool of at least one million
declared health care voters. These
citizens would be committed to voting
every election cycle only for local,
state, and national candidates who favor
somehow covering all Americans.
The microphone stand
on the table slid over to Dr. Patricia
Gabow, Chief executive officer and medical
director of Denver Health. "What we've
been doing is not sustainable." she
said.
Slightly more than
45 percent of the operating funds at
Denver Health come from Congressional
appropriations to states for
Disproportional Share Hospitals (DSH) like
Denver Health, which disproportionately
served the uninsured or under-insured.
About 28 percent went for children covered
by CHP, the state health care plan for
indigent children.
About $170 million
was spent delivering health care services
in the year 2000, Gabow said. The annual
price tag for 2003 is about $200 million,
and it soon will pass $250 million at
current service levels.
Along with the 41
million uninsured in America, she said,
perhaps forty percent of those with health
care now are "just one pink slip away form
being uninsured."
Too many are too
ashamed to seek public assistance, she
said, "Needing to use the safety net in
this economy is not a bad thing."
Communities need to find a "nonpartisan
public solutions" for the gap in health
care between the privately insured and
those qualified for public help.
Next up is Bill
Lindsay, chairing the Health Committee for
the Denver Metro Chamber of Commerce. He
said the business community is now doing
downsizing, "and the cost of health care
is a big issue."
Group health
insurance rates are rising 15 percent a
year or more, he said, like the 25 percent
annual increase in California. Health
insurance is offered to staff by only 25
percent of the small businesses with less
than 25 employees. Small business ventures
comprise about 80 percent of all
registered enterprises.
"The business
community is committed to creatively
finding solution for covering the
uninsured," Lindsay said. "We're willing
to ask the tough questions about the cost
and quality of health care. We're willing
to fund innovative way to provide workers
with coverage."
The president and
CEO of Centura Health, Joseph Swedish,
accepts the mic. After Centura's
experience of operating ten (for profit)
hospitals in Colorado, he began, "The
future ain't what it used to
be."
The "cost shifting"
for covering the uninsured, he said,
"means that everyone ends up paying for
their care, directly or indirectly.
Centura has witnessed a 30 to 40 percent
annual increase in "uncompensated care."
The business
community generally pays 15 cents of every
dollar for shifted costs from the
uninsured, he said, "plus another five
cents per dollar" go to taxes that cover
health care.
The complexity of
the current system of cost shifting is
"straining the health care fabric,"
Swedish said.
The challenge is
creating government policy that does not
harm the marketplace. What's ultimately
needed to cover the uninsured, he said, is
a balance of "personal responsibility and
public markets."
Offering a different
perspective is Anne Van Dusen, the senior
program officer for the Rose Community
Foundation, the health care philanthropy
arm of what began as General Rose Memorial
Hospital.
"We all share a lot
of insecurity right now about the state of
the world, like war and a budget crisis,"
she said, "but we can take heart from an
event like this that we will not let our
neighbors live sick and die
young."
The Rose Foundation
is changing priorities in response, she
said. From funding innovative pilot
programs, "we're now mostly funding
advocacy and education projects as well as
general operating funds for nonprofit
clinics."
All concerned people
need to help inform health care policy
markers about problems and solutions, she
said. "We want to spend our money on our
common concerns."
Last up is Dr. Gary
VanderArk, chair of the Colorado Coalition
for the Medically Underserved, which
organizing a the week of programs devoted
to covering the uninsured. Also a board
member of the Colorado Medical Society
Foundation, he was named 2001 Humanitarian
of the year by the American Association of
Neurosurgeons."
"Please appreciate
all the effort of so many organization
over the past six years to make this week
possible," he said. The coalition itself
had met in that ballroom earlier, he
noted, and asked the audience, only
half-joking, "Where were all of you at 8
a.m. this morning?"
"We've spent six
years developing a plan for universal
coverage," he said, "and we're going to
make this happen in Colorado by 2007. The
coalition until now has been an "egghead
think tank," he said, "but now we're
taking on the job of implementing social
change."
"A sixth of the four
million people in Colorado do not have any
health care coverage at all," he said.
"Many of you in this room and all of you
at this table care about the problem," he
added with an inclusive gesture. "If we
all work together, I'm certain we can do
something with our synergy."
Hessin then accepted
a few question from the audience. The
highlight was a question about universal
health insurance.
The rest of the
industrialized world figured out how to
cover all the citizens at half the price
as America, Gabow said, "so maybe we can
learn something."
Ackerman was
applauded for saying, "We're now paying
the same as we'd pay for universal health
care coverage, but we're not getting
it."
"There may be enough
money in the system to pay for universal
access," said Lindsay, "but for us to get
universal access, the system has to
change."
Universal coverage
would have to contend with three market
drivers, Swedish said. "People want
quality. They want open access to the
doctors of their choice. And they want it
low cost with little personal expenditure.
You can't have all three in the current
system, so something has to
give."
What gave out, in
the end, was time. The room began to clear
except a few dozen sticking around for the
later afternoon session for the coalition.
These few heads leaned together and
imagined a better future.
Orginally
written for The Colorado
Statesman.
March 2003
(c) 2002-03 by Judah Ken Freed
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