VIEWPOINT: Health care reform offers security of affordable coverage

Through the eyes of its patients and providers, Washington’s Community Health Centers see all of the complex factors that contribute to our current health care dilemma. These centers are local, nonprofit health care providers that serve the state’s communities and most vulnerable populations.

For patients, health care is too expensive and uncertain. Without reform, premiums are projected to rise to one-quarter of a family’s income in the next decade. If you fall ill, lose your job or just grow older, you could be priced out of coverage or lose it altogether. Put simply, the only thing guaranteed about health care today is that it will cost more tomorrow.

For providers whose patients include the poor, health care funding is too unstable, jeopardizing our mission of seeing all patients who seek care. Our system took one-quarter of the $1 billion in health care cuts made earlier this year by the Legislature. At the same time, thousands of people who lost their job-based insurance flooded through our doors.

More than 130 CHC sites in Washington provide primary care, dental, behavioral health and pharmacy services to over 640,000 people every year; virtually all of them are low-income and one-third are uninsured. It is our mission and our mandate to engage in the health care reform debate.

Our goals: coverage for everyone, easy access to primary care and efficient use of every health care dollar.

The health care reform proposal outlined by the president and Congress contains several important elements that will provide care for Washington residents of all incomes, help CHCs fulfill their mission, and enable employers and our state to develop sustainable budgets.

 • First, these proposals expand the successful Medicaid and Children’s Health Insurance Programs, which currently cover low-income children, mothers and the disabled. This proposal alone would take care of nearly one-third of our state’s uninsured population.

 • Second, reforms would require insurers to accept everyone. If you got sick, you wouldn’t be denied care, lose coverage or pay more for health care. Every proposal would also require that the government, employers and individuals share the financial responsibility for the cost of coverage.

 • Third, reform proposals would allow those without employer coverage (and likely small businesses, too) to purchase health care insurance through a state or national “exchange.” Individuals making less than $43,000 per year would qualify for a sliding scale subsidy.

The much-debated public plan would be one choice among many other private plans offered to consumers. We anticipate that a public option would allow many currently uninsured people to continue receiving care at their community health center at a very competitive price.

 • Fourth, reform would maintain the long-term financial health of Medicare by cutting waste and rewarding doctors for providing the right care, not more care. In Washington, doctors are paid 11 percent below the national average, severely limiting access to many seniors and people with disabilities. Seniors living in states that spend more get more care but are no healthier.

 • Finally, reform proposals would make major investments in community health centers across the nation. CHCs are an unmatched force in the fight to contain costs. By the latest estimates, increasing the number of CHC patients by 20 million would generate $212 billion in additional savings over the next 10 years, because patients seen at CHCs have much lower health costs than those seen in other settings.

Together, the reforms proposed by Congress and the president promise everyone the security of affordable coverage and access to care, even if you lose your job and your income drops. Washington seniors would always be able to find a doctor. Our state could build sustainable budgets. And community health centers would be able to expand their role in delivering cost-effective primary care to more Washingtonians.

Linda McVeigh is director of the nonprofit Country Doctor Community Health Centers in Seattle.