Making the case for access in health reform (Rep. Danny Davis)

Irene and Michael Hurley were part of the hard-working community of South Chicago. They had steady jobs, a happy home life, and big dreams.  All of that came to a screeching halt when Michael became ill. With physicians unable to make a diagnosis initially, Michael could no longer work and was placed on disability.  And no job meant no health insurance.  Fortunately, the Hurleys found help at Chicago Family Health Center (CFHC).

Michael was finally diagnosed with myotonia, a form of muscular dystrophy.  The doctors on CHFC’s staff worked to get Michael into a treatment program that would accept an uninsured patient.  Irene was able to get care and affordable medication for her diabetes   – as well as dental care – on a sliding-scale fee basis.   Under one roof, the couple found health care services that were not only affordable, but of the highest quality.

Best of all, the Hurleys found a health care home where their names were known and their health care needs were addressed on a regular basis. Michael Hurley ultimately lost his life to the disease last May, but thanks to CHFC, he got the high-quality care that gave him more time with his wife, and all the way through, as a patient, he was treated with the respect that a hard-working man had earned and deserved.  “He loved the health center, and they took care of him,” Irene says.  “Even when he got on Medicare and was told he could go to another doctor, he refused.  He wanted to stay with Chicago Family Health Center.  They helped us so much.”

There are 60 million people like the Hurleys in America.   They come from different economic backgrounds, they live in big cities and small towns, yet what unites them all is that they are part of America’s “medically disenfranchised” – those who have no access to basic health care.  Many of the medically disenfranchised even have insurance but cannot find a place where they can receive care. And the problem is getting worse in these tough economic times.  The number of medically disenfranchised grew three times faster than the total population over the last two years. Were it not for the remarkable growth rate of community health centers like CFHC, the number of medically disenfranchised would have been even higher.

Strengthening our national network of Community Health Centers  — one of the best kept secrets in medicine – can help counter America’s growing access problem.  Medical disenfranchisement is fueled by a host of factors that include worsening shortage of primary care doctors in
needy communities and a troubling scarcity of providers willing to treat the uninsured or publicly insured.  Adding to the trend are fewer medical students choosing primary care over more lucrative and
specialized fields.  Although health centers sprang into existence more than forty years ago as part of President Lyndon Johnson’s War on Poverty, the economic downturn has made their mission more important now than ever.  Low-income families have traditionally struggled with health care barriers, but now there are indications that the struggle has shifted to the doorstep of middleclass America as  job losses mount, and more people lose their employer sponsored health insurance coverage.

Getting the care for a common cold, migraine, or high blood pressure can and should be easy, whether one has an insurance card or not. At a Community Health Center, you don’t need an insurance card to get in the
door.  Care is provided on a continuous basis with a comprehensive approach can include the entirety of a patients’ needs–  low-cost prescription drugs, mental health counseling, pediatrics, diabetes management.  That is why  the more than 18 million people who use a health center as their family doctor have 41 percent lower total health care expenditures than patients who seek care elsewhere.  As a result, health centers save the health care system up to $18 billion annually. The prescription is simple: treat people before they get sick and require care at a hospital.

The results speak for themselves and will continue to do so in communities that are lucky enough to have a health center or, thanks to the American Recovery and Reinvestment Act , that will soon have one. Health centers have a long record of lowering infant mortality rates, reducing chronic disease among low-income families, and easing the burden on hospital emergency rooms.  These are results that deserve close attention as we take the first deliberate steps to overhaul our health care system.

Universal coverage is a critical goal, but even if every man and woman, every parent and every child in America woke up with an insurance card in their hands, they would still need a place to go for health care.  We must not only invest in creating health care homes by expanding the network of health centers, but also keep them strong with continuous investment that includes fair reimbursement from Medicaid, Medicaid and
private insurers.

President Obama is taking important steps in the right direction.  The one-time Recovery Act funding will undoubtedly improve our nation’s health, by making it possible for existing community health centers to offer additional care, and also improve our economy’s health by generating more jobs with every new health center that opens its doors.

But we have come too far to stop there.  For health reform to succeed, we have to ensure that every family in America has both insurance coverage and a health care home.