Larry Sigmon knows what it's like to live on the streets without access to regular health care.
Homeless, suffering from depression and addicted to drugs and alcohol for more than 20 years, Sigmon built up a medical bill of $185,000 in emergency room costs. He also delayed treatment of a liver problem diagnosed in 1999 until this year, when he had a job, a home and health insurance.
Now working as a receptionist at Beans and Bread, an outreach center for the hungry and homeless operated by the St. Vincent de Paul Society in Baltimore, Sigmon could be considered one of the lucky ones.
"A lot of people I know have died because of lack of medical care," he told a press conference at the Franciscan Center in Baltimore Aug. 5 announcing the release of a new study on the rapidly unraveling urban safety net providing health care and social services for the poor.
The study by the Open Society Institute-Baltimore and Baltimore REACH, a network of eight community clinics and resource centers for the poor, including the Franciscan Center and Beans and Bread, found that many low-income Baltimoreans were struggling to get basic medical care for themselves and their families.
This was despite a decrease in the percentage of those surveyed who did not have Medicaid or other publicly funded health insurance. Although more than 59 percent said they were without such insurance in 2001, only 47.1 percent in 2003 and 44.1 percent this year said they were uninsured.
But a high percentage of the respondents --- including those with chronic medical problems --- said they had stopped taking prescription medicines or put off a needed visit to the doctor because of their lack of insurance.
"The data verifies our anecdotal evidence that it is increasingly difficult for low-income people to survive in Baltimore without relying on already burdened social services, the health care safety net of low-cost clinics and charity programs," said Barbra Levin, executive director of Baltimore REACH, which stands for Research Education Advocacy and Community Health.
"Helping families access assistance is not enough," she added. "We need to ensure that all Baltimoreans have basic medical care, and in a timely manner. To date that is not happening."
Taking up that challenge on a national scale was the National Coalition on Health Care, which includes nearly 100 U.S. businesses, unions, provider groups, insurers, pension funds, and consumer and religious organizations, including Catholic Charities USA and the U.S. Conference of Catholic Bishops.
After a year of study and debate, the coalition recently released a plan to overhaul the nation's health care system with reforms that would insure all Americans, control health care costs and improve quality and patient safety.
Paul G. Rogers, coalition co-chairman and a former member of Congress, said the report was "politically significant because it shows that there is broad support across most sectors of the economy and society, and across party lines, for tough, systemwide reform."
The coalition's 23-page booklet outlining its plan seeks to put to rest the idea that the nation's health care crisis can be resolved in incremental steps.
"We should not be resigned to settling for small steps forward --- not when the problems of the health care system are growing by leaps and bounds," it says.
Specifically, the coalition outlines a plan for systemic reform based on five principles:
---Health care coverage for all, with a defined core benefit package.
---Cost management that would bring increases in the costs and premiums associated with the core benefit package in line with increases in per capita gross domestic product.
---Improvement of health care quality and safety through better use of technology and establishment of national practice guidelines.
---Equitable financing.
---Simplified administration.
The escalation of health care costs is not just a health care issue but "a major national economic problem" which reduces economic growth and job creation, corporate profits, the global competitiveness of U.S. firms and the viability of pensions, the coalition said.
But paying the greatest price in the health care crisis are people like those surveyed in the Baltimore study, which was conducted through face-to-face interviews done by six medical students with 260 people who obtained services this summer at eight community outreach centers.
For the students, who had just completed their first year of medical school, the experience was a real eye-opener.
"The lessons we learned went far beyond the statistics," said Ariel Green. "We began to see (the people they interviewed) as our neighbors."
Marc Callender said he met many who were living in "the vicious cycle of inadequate medical care and increasing medical debt," leading him to realize "how important advocacy is in medicine."
Deepti Agarwal said the summer experience confirmed her interest in both a family practice and some kind of public health or community service medicine.
And they all came to see the truth of what Larry Sigmon told those at the press conference: "Everybody should get health care, because we're all human and we all deserve it."
---CNS |