Universal Coverage – A Call for Action

NCHC Writer
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Rev. Michael D. Place, STD
President and Chief Executive Officer
Catholic Health Association of the United Sates
“Universal Coverage – A Call for Action”
National Coalition on Health Care Leadership Summit
The Carter Center, Atlanta, Georgia
January 26, 2000

I am pleased to join President Carter, Dr. Simmons, and my fellow colleagues in raising awareness of the need for reform in our healthcare delivery system. Reform is needed so that we can banish from our national vocabulary the term “healthcare uninsured.”

Each and every one of us should be ashamed that the American medical system – the envy of the world – is not equally accessible to all people. Those most likely to be without insurance are women, children, full- and part-time workers.

The Catholic Health Association of the United States, which I represent, is the national leadership organization of the Catholic health ministry. Our ministry’s approach to healthcare is shaped by a number of core values, including the belief that each person has an inherent dignity. As a result, we believe there is a human right to basic healthcare and that society has a special duty to care for the poor and vulnerable – commitments that many Americans, regardless of their denomination or faith, also share.

In the last 18 months I have traveled throughout this country meeting with both caregivers and recipients of care. CHA’s 2,000 member organizations are on the frontlines of healthcare and in many cases are the safety net providers in their communities.

As such, Catholic healthcare providers see cases where routine ailments develop into more severe conditions because the uninsured individual has postponed care.

For instance, here in Atlanta, St. Joseph’s Hospital has established Mercy Care out of concern for the unmet medical needs of economically poor. In 1998, Mercy Care Services was responsible for providing nearly 21,000 primary care visits that may not have occurred otherwise. Mercy’s “clinics on wheels” have become “medical homes” for thousands of person in need. In fact, their mobile mammography screenings means homeless women do not need to be out on the streets with potential breast health problems or even breast cancer.

In Manchester, New Hampshire, Catholic Medical Center told me of a 6-year-old girl who came to their emergency center because of severe dental pain. This pain was so severe, she could not eat. She did not go to a dentist because her family did not have insurance. The emergency room became the place where dental care was provided. Another example they mentioned is children being brought by their parents to the emergency room because of an ear infection – a common occurrence as children grow. Would you think that a child should go to an emergency room for an ear infection? Why, because the parents did not have health insurance.

Mercy-Des Moines is very much aware of assisting the uninsured through their House of Mercy. As a free clinic, nearly 900 people a month come in without insurance but because of the Catholic health ministry’s mission, those people are served. What if we were not there? Is this the right way, the only way, for them to have access to healthcare?

And in the South Bronx, the Dominican Sisters Family Health Services is safety net provider in what has been designated as the nation’s poorest congressional district. I learned on a visit there that hospital admission rates in that community for children suffering from asthma and pneumonia, which can be prevented by adequate primary care, are five to seven times the rates in more affluent areas of New York City. Another example of how for children, especially the poor, fairness and equality in healthcare do not seem to be present.

The American society must ensure that each person has access to affordable healthcare. That is why I believe there needs to be a new national conversation on systemic healthcare reform – a dialogue from Main Street to Pennsylvania Avenue – in which our nation’s political and corporate leaders, providers, and faith-based groups join all Americans in search for a solution to make healthcare accessible and affordable for all.

Many of the amendments to the Constitution – beginning with the Bill of Rights and including marginalization of former slaves or the disenfranchisement of women – have come as a result of a national conversation about how to ensure that fundamental fairness and opportunity were available to all.

I would like to propose that we have created what in effect are essential building blocks that allow the American ethos to flourish. The first such building block, responding to the challenge of illiteracy, is universal education, kindergarten through 12. The second, which addresses the possibility of marginalization, is an ongoing process whose purpose is to preserve fairness and equality of opportunity by seeking to eliminate barriers such as racial and ethnic intolerance. In effect we have entered into a type of national covenant to ensure the possibility of our unique sense of independence, as well as to preserve fairness and equality.

It is in this context of significant compatibility of values and of a national commitment to maintaining building blocks necessary to preserve those values that I suggest that there exists, in addition to illiteracy and intolerance, a third “I,” illness – as significant a challenge to independence, fairness, and equality as illiteracy and intolerance.

Obviously, this is not a new challenge. The creation of sanitary districts, tuberculosis sanitariums, water purification plants, and vaccination requirements reflected a public response to the impact of illness on the common good. We supported access to healthcare for those who worked by encouraging the development of employer-provided health insurance during the Second World War. Similarly, we worked to level the playing field and provide some basic fairness when we said the poor and the aged would not be marginalized from our responses to the threat of illness. In effect over the years, in various ways we have had a national response to illness. There has been a type of informal building block.

Why do I say informal? Because as we acknowledge the effectiveness of these previous efforts to address the third “I” of illness, today many would agree that our healthcare system, as it is presently constituted, is not an adequate building block for a free society. Even those who have insurance are at risk not only for the possibility of independence-threatening ill health, but for the loss of their insurance coverage, which is their principal protection against the worst effects of sickness. Instead of double indemnity, they face double uncertainty. For those outside the system – the 44 million – the situation is worse still. Under such circumstances, it seems that our commitment to the notions of independence, fairness, and equality is compromised.

At the Catholic Health Association of the United States, justice and our faith tradition call us to collaborate with others to be both a voice for the voiceless – the millions of uninsured – and agents for change. CHA has been, is, and will continue to be a strong advocate for accessible and affordable healthcare for all in a reformed healthcare system.

I deeply believe that if most Americans understood the suffering that millions among us endure, their values and their morality would wake them up from the apathy that now shrouds the issue of helping the 44 million uninsured.

To raise public awareness and the awareness of our national leaders, we have initiated an ongoing petition drive – Be Heard for Accessible and Affordable Healthcare. More than 13,000 Americans have joined us and our partner the American College of Physicians – American Society of Internal Medicine in challenging our policymakers – from the local level to the White House – to explain their ideas for reform and expanding coverage to the uninsured.

The sands of change are beginning to shift, and today’s summit is another sign of that.

Yet, in preparing for today, I had this thought: How great it would have been that in this city, where Dr. Martin Luther King, Jr. spoke so eloquently of equality, we would have come together today to announce a reversal in the growing epidemic of the uninsured. That we would be here today to say there would be accessible and affordable healthcare for all.

Unfortunately that announcement has to wait for another day. But in waiting, let’s hope and pray that a change comes sooner than later. Our task, therefore, is to make accessible and affordable healthcare for all not only a national priority, but also a reality.

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