Recently, we had the opportunity to read a book written by former Sen. Bill Bradley, called “We Can Do Better.” When he speaks of healthcare, Bradley discusses how America has been debating this issue since the turn of the century. The issue of healthcare reform was always debated as to whether or not America even had issues with healthcare delivery and finance. As the result of the action taken by Pres. Barack Obama and the Democratically controlled Congress, a bill of healthcare reform was passed. No longer are we debating whether reforms are needed for our healthcare system. Now we are debating nationally and in every locale how we are going to pay for any solutions that are created.
There is another problem that is occurring. Many people in our region and throughout the United States are either still arguing about whether there is a healthcare “crisis” or trying to find legal ways to undo what Pres. Obama and the Congress did. They have refused to embrace the problem, and still see it as a divisive issue between Democrats and Republicans.
Advocates for the homeless might remember that Pres. Ronald Reagan made a comment, words to the effect that there were no homeless people in Washington, D.C. That belief was quickly retracted when he saw homeless adults and children sleeping on the subway grates in front of the White House. We contend that the healthcare crisis is not a political issue, but a human service issue — one in which we should all be involved. We invite all Northeast Florida citizens who do not believe there is a crisis to visit their local clinics, mental health centers and hospital emergency rooms to see the range of sects of our society that have limited or no access to healthcare. This exercise has been done in many locations, including New York City, Miami, Los Angeles and Washington, D.C., and the participants who visited these sites have since changed their minds about the existence of a healthcare crisis.
There is a term in healthcare and public health circles that refers to the most fragile people without healthcare. The term is vulnerable populations. A vulnerable population is a group that has healthcare needs and because of funding, insurance, language issues, cultural beliefs and/or a lack of trust in our present systems, does not seek care. The fact that they do not access care until they are in an emergency mode eventually costs the general population large sums of money. It would be much more cost-effective to provide care on an outpatient basis so these individuals would not need hospital crisis care. There is a term in the field of health economics: Medical Cost Offset. The research shows that if you create care systems for people with chronic conditions, the price of those programs is far less costly then emergency crisis care that the general population is forced to finance through a higher tax system.
The populations that are most vulnerable are the medically indigent. The individuals living in the Northeast Florida area who meet these criteria are:
People who are underemployed, or work for themselves or at a small business that does not provide insuranc
Alcoholics and drug addic
People who have little or no insurance, and have chronic
Many communities in America have worked locally with citizens, elected officials, churches, social service organization and healthcare organizations to create local solutions. There is one program here in Florida about which we are quite knowledgeable. We served as strategic planning consultants to this effort. The program, the Hillsborough County Health Plan, has been in existence for 10 years. The plan was created by a grassroots approach similar to what this article is proposing. This is funded by using a half-percent of the real estate taxes in the county. Before this was created, the citizens voted this in place in a referendum.
We do not know if this plan will work in Northeast Florida; however, we are proposing that a group of stakeholders, citizens and interested parties within Folio Weekly’s readership create local groups in each county, and then — when the counties have come together perhaps — meet as a regional group.
We are appealing to citizens, elected officials, the clergy and social service and healthcare providers to come together and begin the dialogue. I encourage anyone interested to please contact me, and I will act as a clearinghouse to put people together in various locations in our region.
When the groups come together and discuss the issues, they may decide not to create any solutions. However, the fact that the groups are meeting will serve to be a continual influence on the political climate so that one day, we may all realize a solution. And we will no longer have a healthcare crisis.
“We can do better!”
Dr. Daniel Berman, Walden University
Dr. Susan Randers, Walden University
Berman is a professor of Nursing Management and Healthcare Administration at Walden University. Randers is a professor of Psychology at Walden. The two are married and live in Fernandina Beach. Contact Berman at [email protected] or 904-261-2258.