AccessHealth SC helping communities

With business closings and layoffs dominating the daily headlines, there’s more than enough pain to go around these days. With each job lost, there’s something else lost, too: health insurance coverage for adults and families.

Today, 16 percent of adult South Carolinians have no health insurance. About 67 percent of businesses with fewer than 50 employees don’t offer health insurance benefits. It’s a problem that touches all of us, because the uninsured are our friends, neighbors and even family members. Try this experiment next time you’re at church, out shopping or dropping off your child at school. Count people in groups of six. Number six is uninsured.

Being uninsured is like being alone in a boat, at the mercy of the tides. With the average cost for family coverage now more than $12,000 a year, most people can’t afford to buy health insurance on their own. Often, if a low-income, uninsured person has a health problem like high blood pressure or diabetes but feels reasonably well, they do nothing, knowing a doctor’s visit and basic lab work will cost several hundred dollars out-of-pocket and medicines will cost even more. So they hope for the best and do without a prescription that might control their blood pressure or a doctor’s visit that might detect a looming problem.

That’s when disaster strikes. The neglected blood pressure leads to a heart attack. The uncontrolled diabetes results in an infected foot ulcer and a week’s stay in the hospital. Medical conditions that could have been managed are now life-threatening and cost tens of thousands of dollars to treat. While it’s a personal disaster for the uninsured, it’s also a disaster for those with health insurance. The cost of caring for those who can’t pay for their health care is shifted to those who can in the form of higher insurance premiums. And as premiums go higher, more small businesses will have difficulty affording them.

Fortunately, there are many people working together to provide a safe harbor for low-income, uninsured South Carolinians currently adrift in this uneasy economic sea through an innovative program called AccessHealth SC. Created by stakeholders from the South Carolina Hospital Association, the South Carolina Primary Health Care Association, the South Carolina Free Clinic Association and other, AccessHealth SC is helping communities form coordinated “networks of care” to improve access to healthcare services and better coordinate how services are delivered to low-income, uninsured adults. The help comes in two forms: technical assistance on the best way to create sustainable networks and financial grants.

There are many advantages to community care networks. Working together, network partners such as hospitals, free clinics, Community Health Centers, Rural Health Clinics, doctors, drug and behavioral health providers, can provide more complete healthcare services to patients and stretch scarce resources further. Ideally, each patient will have a “medical home” — a physician who has agreed to take a certain number of pro bono patients for the network, a Community Health Center like HopeHealth that works on a sliding scale or a free clinic. The medical home will maintain the patient’s health records, help with emergent and chronic health care needs and direct them to the best sources of care. This coordinated approach will help protect a person’s most valuable asset, their health, and also help relieve overburdened hospital emergency rooms.

Although the AccessHealth SC program is in its infancy, it’s already making it easier for low-income, uninsured citizens find needed healthcare services. They have launched a Web site (www.accesshealthsc.net) that includes a state map. By clicking on a county, visitors get a list of local community health resources along with addresses and phone numbers. It may seem like a small thing, but for those who have no idea where to turn for help, it’s an important first step in getting access to care.

No one can solve our state and nation’s economic woes overnight. But it is heartening that South Carolina’s low-income, uninsured citizens are not being ignored. AccessHealth SC will provide a way for communities to marshal their resources to serve their own in a more coherent, sensible and cost-effective way.

— Paul DeMarco, M.D., is director of Community Health at Francis Marion University. Carl Humphries is CEO of HopeHealth in Florence.