Access and Coverage Should Remain the Nation’s Health Care Goals

In a time of uncertainty for health care in the United States, let’s take a moment to list the fundamental areas on which we should be able to agree. Let’s use these centerpiece points as a way to move forward in productive dialogue and policymaking. After all, too many people’s lives and livelihoods depend on us to put aside our differences and successfully accomplish this.

Access to Care is Key

What does this mean? The Institute of Medicine defines access to care as “the timely use of personal health services to achieve the best health outcomes.” This translates into being able to find a medical provider who understands your needs and offers appointments for the care you need, when you need it and in a location you can get to.

Community health centers are the very definition of access to care, serving more than 24 million people nationwide, including over 1.2 million Texans. It’s a health care system that’s proven to be successful over five decades.

The more than 450 health in Texas offer high-quality, cost-effective medical, dental, behavioral health and pharmacy services. They provide care regardless of a patient’s insurance status or ability to pay.

Israel Hilton visited a hospital emergency room in Brownsville, Texas when he began having seizures in 2013. He was diagnosed with depression. Months later his symptoms worsened and the same ER diagnosed him with terminal brain cancer. He had no insurance. Brownsville Community Health Center intervened to coordinate Israel’s treatment and help him access care at M.D. Anderson. But it was too late. Israel died in 2015 at age 51.

We’ll never know whether insurance and the ability to access care earlier would have saved Israel, but we’re certain that his story is not unique. Countless uninsured Texans weigh the costs of medical care against other basic needs. It’s a choice that ultimately represents life and death.

Health Insurance is a Good Thing for Everyone

Primary and preventive services are the foundation for access to care, but truly sustainable access to care must include health care coverage, i.e. insurance. Insurance can mean the difference between life and death, financial security and financial ruin.

The benefits of coverage outweigh the costs. Children with health insurance miss fewer days of school and their parents miss fewer days of work taking care of them. For employers, insured employees miss less work — boosting productivity.

Coco Green of Greenville, Texas also knows the important role health centers play for those without insurance.  Two years ago, Coco felt ill. Her boss, a nurse, took her blood pressure and found it was sky high. She was able to get a same-day appointment at Greenville Community Health Center, where she’s been managing her hypertension ever since.

Coco pays for her care based on her income and gets assistance with the prescriptions she needs to manage her blood pressure. “One of my prescriptions would be $300 a month without their assistance program,” Coco said. “I’m able to pay $5 a month, a normal copay. The remaining money in my budget helps me make healthy food choices.” Without access to affordable prescriptions and medical visits at her health center, Coco’s hypertension could have led to heart complications or stroke.

Not all Texans are as lucky as Coco. Some end up in emergency rooms and never find their medical homes. Hospital emergency rooms do not and should not constitute access to primary and preventive health care and will never be a substitute for health insurance coverage.

Whether we call it the Affordable Care Act or A Better Way, let’s all work together to reach these goals for the good of families, for the good of businesses, for the good of communities, and for the good of the economy.

Increasing the number of people who are insured and who have access to care is an insurance policy for both the Texas and American economies.                                     

José E. Camacho, Texas Association of Community Health Centers

José E. Camacho is Executive Director and General Counsel for Texas Association of Community Health Centers