The Need for Affordable, Quality Healthcare

More than 300 people listened to a panel of healthcare experts discuss the medical, financial, and social and cultural impacts of high-cost or inaccessible healthcare.

by Moe White –

Health Care CPR is a new nonprofit community-based organization focused on the need for affordable, quality healthcare. Not just “access to insurance,” but access to medical care and treatment.

Founded by community activist Beth Jezek, South Asheville resident and City Council candidate Vijay Kapoor, and former Asheville City Councilman Chris Pelly, the group held its initial meeting Feb. 20 at Highland Brewing in East Asheville. More than 300 people attended.

The group invited both WNC Congressmen to attend and participate, but Rep. Patrick McHenry (R-NC 10) declined, and Rep. Mark Meadows (R-NC 11) did not respond to the invitation.

A panel of healthcare experts discussed the medical, financial, and social and cultural impacts of high-cost or inaccessible healthcare. Dr. Olsen Huff, a local legend for his decades of care for families and children and his advocacy for universal access to medical care, pointed out the importance of coverage of preventative care, especially for children. He noted that the cost of treatment after illness strikes is far higher and more complicated than preventative care, and that such care must be comprehensive—covering dental and vision care as well as general coverage—to be effective. In addition, he said, the change from “fee for service” coverage to “fee for performance” has made a huge difference in the quality of care and the outcomes since the Affordable Care Act went into effect.

Leslie Boyd lost her son to colon cancer because he was ineligible for health insurance.

Several panelists discussed the potential pitfalls of repealing the ACA (Obamacare). A repeal, according to John Wingerter of the Buncombe County Council on Aging, would allow insurers to “underwrite policies but not really insure people; eliminate the 20% cap,” which requires that at least 80% of an insurance company’s revenue be spent on actually providing healthcare; and “end the lifetime and annual caps on coverage,” which used to allow insurers to cut off payments to their customers. That was especially egregious for people with cancer or serious chronic conditions, which can easily cost up to a million dollars to treat over a lifetime. Other problems could include: rate variations among age groups; loss of required coverage (reproductive and maternity care); lower funding for CHIP (for children); return of the “donut hole” in drug coverage; return to “job-lock” whereby people cannot afford to leave a job out of fear of losing coverage.

Perhaps the most moving speaker was Mary Scott Hayes, a physician at the Minnie Jones Center (WNC Community Health Services), who pointed out that many of their patients work full-time but still can’t afford insurance. “They work as roofers, cooks, artists, maintenance men, hotel staff, and other jobs, but they still have to choose between paying for daily needs and paying for healthcare.”

She described the process of dealing with low-income patients. “We meet, then talk about what’s troubling them, diagnose the condition, make a treatment plan … and THEN ask, ‘Can you afford this plan?’” Far too often, she explained, they can’t afford the prescription, or a visit to a specialist, or the cost of lab tests, or can’t afford bus fare or time off from work for follow-up.

And, Hayes said, the ACA has made a huge difference. She described a 55-year-old painter whose osteoarthritis of the knee was getting so bad he was going to have to give up working, and either try to get disability coverage or hope find a lower-paying job. But, with the help of a navigator, he got Obamacare coverage, had his knee replaced, and is now working again—earning his way as a productive member of society.

This man, and other patients Hayes described, explain both the need for and value of the Affordable Care Act, and why Republican plans to “repeal and replace” it will cause havoc to millions. “Someone working at minimum wage ($7.25) for forty hours a week for fifty-two weeks earns just enough to qualify for an ACA subsidy. But if they can only work thirty hours a week, their income’s too low for a subsidy.” Worse, she said, they also get no Medicaid—because North Carolina refused the opportunity to expand Medicaid, which Hayes called “mind-boggling.”

In addition to Pisgah Legal Services attorney Jaclyn Kiger and healthcare advocate Jake Quinn, who moderated the discussion, several people from the audience discussed their own experiences with the healthcare system, both before and since the ACA began to be implemented in 2010.

Leslie Boyd, a professional journalist, lost her son nine years ago to colon cancer. The young man, still in his thirties, was unable to get coverage at any price because of a birth defect that made him vulnerable to colon cancer; he required a colonoscopy every year but could not afford it. His cancer was Stage 3 before it was diagnosed, too late to treat or save him.

Christopher Fielden, 45, is a farmer who also does freelance work as a CAD designer, and serves on several boards promoting local and natural agriculture. On Jan. 2 his appendix burst, and he ended up in the hospital for eight days, with two surgeries. Because he had Obamacare coverage, he was fully insured—though he might not have been—and because of that, “I’m alive.”

“I’ve had insurance from the ACA since its inception,” he said, “but this year I couldn’t get a subsidy for my coverage. I couldn’t understand why, so finally I called Pisgah legal. They figured out what was wrong, and I got coverage. And as I lay in the hospital in so much pain I was thinking, ‘Everyone deserves healthcare like I’ve got.’”

For more information or to participate in Health Care CPR, contact the organizers at HealthCareCprAvl@gmail.com.

 

 

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