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(HealthNewsDigest.com) – Often, the first step in fixing a problem is to find out exactly what isn’t working. With the current proposal before Congress to add a “public option” plan, whether freestanding or part of an exchange, to the already-existing government health plans, this approach of understanding exactly what isn’t working in order to fix a problem becomes especially important.
If a “public option” is implemented, one should ask: will the people who are currently uninsured sign up? This seems frivolous, but it’s valid. Currently one-third of the 46 million uninsured Americans – that’s over 15 million people – are actually eligible for government health coverage plans already in place, but are not signed up.
I know, because six years ago I launched the U.S. Uninsured Help Line (800-234-1317) and the CoverageForAll.org website with the nonprofit organization, the Foundation for Health Coverage Education. The Foundation’s mission is to help the uninsured find government-sponsored health coverage that they didn’t know existed. Today, this resource receives 75,000 queries per month from people in need of health coverage.
Through the Foundation’s services, uninsured individuals gain access to every publicly funded program in the country. After completing a simple 5-Question Eligibility Quiz, each person receives individualized health coverage information specific to their state and situation, along with the ability to apply for these programs with ‘live’ counselors and former Medicaid experts helping them in 140 different languages. In a recent review of our data from eligibility respondents, we found that out of the 34,145 participants who anonymously took the quiz, 78% (26,713) were eligible for free or low-cost government coverage. With the current government health plans, that’s over three-fourths of these uninsured individuals who are eligible for what is being offered right now and still not signed up.
People come to FHCE because they don’t know where else to turn. Yet these subsidized health programs have been ‘on the books’ for years. Clearly, the word is not getting out, and current government funds are not being used effectively.
Perhaps a first step in fixing the health care system would be to create legislation that mandates an effective communication system for any new program, as well as for the programs that are currently in place. In the process of running our U.S. Uninsured Help Line, we have observed many things. The following observations might be helpful to policy makers.
1. Reduce hurdles to access. FHCE sent a team of recent high school graduates to several San Francisco Bay Area agencies to apply for Medi-Cal, California’s version of Medicaid. They ran up against a lack of consistent agency hours, a dearth of options (the agency only knew about the Medi-Cal program despite 10 other state options), and a lengthy complicated application process for eligibility with agency websites that were out of date. It took two days and visits to three different agencies to gather the correct information. Imagine if they had to take several days off from work to collect this information, only to find out some of it was inaccurate. While there are a variety of reasons why 15 million people are already eligible for government health programs they don’t use, here is just one example of the obstacles public agencies unintentionally throw up to hamper efforts to get enrolled. Rather than the usual government hours, why not consider the marketplace concept of extended user-friendly hours? Consider keeping program offices open when people are more likely to be available to use them, like lunchtime and Saturdays, and take the time to educate the employees about the other government-sponsored programs available in the state and where to access more information.
2. Continue to communicate services after initial health program launch is over. No one expects the government to market its programs as intensely as private industry, but Congress needs to be fully committed to creating and broadcasting via all available media on a regular basis. There needs to be a communication effort involving who qualifies for services and how to access them. That means the word continues to go out long after the Administration, Congress and the pundits have moved on.
Unfortunately, the common experience is that much ado is made from the 30,000 foot level when a program is announced, followed by little educational outreach effort made by local agencies to those in need. To this end, public airwaves should be utilized proactively to promote the newly launched options. From its inception, FHCE has relied on free radio and television public service announcements, news stories and health organizations to get the message out about its services, without a single dollar paid for advertising in the mainstream media. Surely if a nonprofit can mount a campaign that has generated nearly two billion media impressions to date, public programs can create equally effective and continuous communiqués.
3. Don’t overpromise. If current government programs aren’t being fully funded due to lack of tax revenue to support them – witness California’s children’s health insurance program, Healthy Families, placed on the chopping block just 3 months after President Obama signed federal legislation in February “ensuring” its viability – then every precautionary measure should be taken to make sure there is money available for any newly promoted program. Before assuring Americans that any new layer of health care service will be provided for those who are eligible, we need to make sure that there is appropriate funding available because being eligible for a program with a waiting list, due to lack of funds, is faux coverage.
4. Put the money where it’s needed – hospitals. The hospital industry spends millions in uncompensated care. This hemorrhaging of cash is contributing to situations where thousands of institutions must cut services, eliminate staff and in some instances, shut down completely. If these hospitals were better funded, the government could make full use of this critical communications partner with trained staff helping patients complete and submit applications online. Efforts like this could bring some relief to all parties.
At FHCE, we have partnered with four hospital groups to assist in outreach efforts and disseminate applications through our CoverageForAll.org website. These joint efforts and employing the online application system for government-sponsored programs are having an impact. When more people are enrolled, hospitals can reduce the risk of providing uncompensated care and receive reimbursement for the care they do provide.
5. Spread the word where it’s needed – chronic disease advocacy groups. According to the Center for Disease Control and Prevention’s findings, nearly 75% of U.S. medical costs are expended on chronic diseases like heart, cancer, stroke, respiratory disease and diabetes. FHCE is building collaborations with national nonprofit specialty disease organizations to help those uninsured who suffer from these maladies find health coverage. These associations, who receive thousands of requests daily from chronic disease sufferers, are referring all callers to us. The government should consider some type of program to work with these entities.
6. Realize what they are replacing. The current health insurance system operates with a network of brokers who save small businesses and individuals money by acting as outsourced human resources departments, working through all of the issues related to health insurance. The broker maintains a relationship with the members of the group to understand the personal needs of each individual before a plan is recommended. Besides health insurance, the broker will also recommend the best options for the group in dental, vision, life insurance, disability and more. All of these types of insurance integrate with the budget and coverage of the health insurance. Brokers help employers and their employees with their election to purchase the plan in the most tax effective manner, so they’re required to possess expertise in tax rules as they relate to Health Savings Accounts, Flexible Premium Accounts, Premium Only Plans, Health Retirement Accounts and much more. All of the above is done before the broker ever receives one penny in compensation and not every group the broker sees signs up. Can a bureaucrat ever care enough without having some “skin in the game”? A government entity needs to maintain a staff under a clear-cut system of merit pay or bonuses for going the extra length to research and explain the best options.
Few will question that change is needed in the current health care coverage system in order to reduce the ranks of the uninsured. Knowing what currently is not working is the first step into helping more people access coverage. The use of multiple forms of media including the internet, radio, television and print to communicate information and determine eligibility as well as to complete and submit applications can be an integral part of the solution. It’s important that the courageous steps that legislators are taking to reform the system are accompanied by due diligence in making certain there is an ongoing appropriate level of communication to reach the public so a healthy outcome is achieved. It’s a prognosis we would all like to see come to pass.
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