Better access to health care advocated - Panelists at forum say healthy workers make for healthy system

Kevin Taylor
Spokesman-Review Staff writer


Spokane, WA - People who have been taking the pulse of health care in Spokane -- and the nation -- find it in poor shape.

More and more people without insurance. Workers in low-paying jobs who find premiums and co-pays too expensive and opt out. Owners of small businesses who cannot afford to pay for employee health coverage. Physicians turning away Medicaid patients because the reimbursement rate is too low.

One way to improve things is to make sure low-income and uninsured people have greater access to a full range of health care, panelists said at a forum Thursday night.

Healthy people make for a healthy system was the message offered to about 100 people, who gathered at Gonzaga University's Jepson Auditorium.

One of the concrete examples offered was Project Access, an effort to encourage doctors, hospitals and clinics to provide free care for the poor to prevent more expensive health-care bills down the road. The project has been successful in other cities and just beginning to be organized in Spokane.

"This is not just a problem for people who don't have health coverage -- the loop comes back to us," said Dan Baumgarten, executive director of Spokane's Health Improvement Project, which has fostered a number of community-based health initiatives over the last several years.

Baumgarten was one of three speakers at the symposium on access to health care that was sponsored by RENEW, the Regional Ethics Network of Eastern Washington and North Idaho.

The loop, as Baumgarten was saying, doesn't stop with the uninsured.

"We don't have a society that lets people die in the street," he said, "so we are going to pay for (the uninsured). And we pay an inordinate amount."

People on the bottom of the various sliding scales don't get preventive health care. So when they do get sick, they tend to wait until they are in dire straits before seeking help in emergency rooms.

All this is more expensive.

Baumgarten and Thursday's other speakers -- Dr. Samuel Selinger, a Spokane surgeon, and Michael Garland, former vice chairman of the Oregon Department of Public Health -- each stressed that creating a system that offered more health care to more people would create not only health benefits but also economic ones. Healthier workers need less health care, which translates into savings.

Selinger is spearheading an effort by the Spokane County Medical Society called Project Access. It is based on similar efforts in North Carolina and Kansas that have dramatically improved the health of people in poverty and people without insurance. He said 22 cities will have operational Project Access programs by year's end and a growing list of others, including Spokane, are in the organizing stages.

In Asheville, N.C., which began its Project Access six years ago, out of 15,000 uninsured residents, only 7,500 had access to primary care services in 1996. That had risen to 13,500 by 2000. And as access to care increased, the health of the uninsured residents improved to nearly match that of people with insurance, Selinger said.

The project here is just getting off the ground but both local hospital systems, Selinger said, have said they will treat for free whomever the Medical Society treats for free. And the project has so far signed up 100 of the area's roughly 1,000 physicians, he said.

Participating doctors must agree to take on 10 uninsured patients per year, specialists 20 cases per year.

Selinger expects Project Access to get rolling within a year.


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