Close Up: Church grapples with U.S. health care crisis
3/3/2003 News media contact: Tim Tanton · (615) 742-5470 · Nashville, Tenn. NOTE:
"Close Up" is a regular UMNS feature that takes an in-depth look at
issues and trends. Photographs, a chart and two sidebars, UMNS stories
#114 and #115, are available with this report. A UMNS Report By Jane DuBose*
By Jane DuBose*
Every Monday and Wednesday afternoon, dozens of unemployed,
homeless or down-on-their luck people crowd into the small Volunteers in
Medicine clinic at St. Charles, Mo. They have a litany of medical
problems, but one thing in common: no health insurance.
The St.
Charles clinic, some 30 minutes from downtown St. Louis, is one of 20
Volunteers in Medicine clinics across the United States staffed almost
completely with retired medical professionals. Anita Hockett, a
registered nurse and member of First United Methodist Church of St.
Charles, is one of them.
"We see a lot of people who are
homeless, some people who are sleeping in cars and a lot of people just
out of prison. We have a certain group of people we know very well,"
Hockett says.
The St. Charles clinic is at the epicenter of the
nation's health care crisis. A worsening economy has pushed thousands of
people off payrolls and eliminated health care coverage. Many employed
people can no longer afford medical insurance, and the system shows
signs of ripping apart with Medicaid programs across the nation poised
to slash benefits for the poor.
Just in the past six months,
unprecedented fissures in the nation's health care system have prompted
United Methodists to voice concerns and raise awareness in these ways: ·
Calling on Congress and church members to support universal health care
coverage. "I am trying to get church members thinking about the
contradiction between the way things are moving in this country, and our
basic faith stance and the position taken by this church," says the
Rev. Jackson Day, program director for health and wholeness for the
United Methodist Board of Church and Society, the church's social action
agency in Washington. Day says many people are squeamish about the idea
of the government offering universal health coverage, even though
Medicare and Medicaid are already huge government programs doing just
that for a large portion of the United States. · Organizing local
congregations to raise awareness about the uninsured. Retired United
Methodist Bishop Melvin Talbert is an adviser to Cover the Uninsured
Week in March. The event has been designed to publicize the fact that
41.5 million Americans are without health insurance. · Developing
hands-on solutions, such as the medical clinic in St. Charles. The
Council of Bishops' Initiative on Children and Poverty is considering
support for the clinic concept pioneered by Dr. Jack McConnell, a
retired physician who started the first such clinic in Hilton Head,
S.C., in 1994. · Helping educate the uninsured about the options
they have available. In Salem, Ore., a health care advocacy group
recently received $1.5 million from a grant to help enroll children in
the state insurance program. The Oregon-Idaho Annual Conference is
involved in the effort.
For two decades, United Methodists have
supported the concept of health care services for everyone, but only
recently has the issue been kicked to the forefront, Day says. "We have a
convergence of a number of issues, all of which are bad news for health
care consumers."
Those include the rising unemployment rate and
accompanying uninsured rate. The U.S. Census Bureau says 1.4 million
Americans lost their health insurance last year, the largest single-year
jump in more than a decade. Uninsured people are more likely to forgo
visiting a doctor or filling a prescription than are insured people,
according to the Commonwealth Fund, a New York-based foundation that
supports research on health care and social issues.
Meanwhile,
health care spending is increasing sharply. In 2001, spending rose 8.7
percent, to $1.4 trillion, and accounted for 14 percent of the total
U.S. economy, according to a government report published in the journal
Health Affairs. Medicaid spending rose by 10.8 percent.
Prescription
drugs are the fastest-growing category of health spending. Americans
spent $140.6 billion on these medicines in 2001, up 15.7 percent from
the prior year. In Tennessee, prescription drugs for 1.4 million
enrollees of the TennCare program for Medicaid and uninsured residents
will cost $1.8 billion in the current fiscal year. That's more than a
third of the program's budget.
It's no wonder that employers and
employees are looking at all options to pay for coverage, and the United
Methodist Church is struggling like everyone else. For example, health
care costs for the 750 employees of the Detroit Annual (regional)
Conference have risen by 75 percent in the past three years, says Anna
Morford, conference treasurer.
The conference has switched from a
traditional indemnity plan allowing for open access to providers to a
preferred provider network (PPO) and the accompanying co-pays and
co-insurance. That will convert what would have been a 34 percent
increase into a 10 percent reduction for the conference, Morford says.
Meanwhile,
hospitals are closing under the burden of reduced payments from
Medicare and Medicaid. The Rev. Ed Kail, president of the United
Methodist Rural Fellowship and pastor of a United Methodist church in
north central Ohio, says people in small towns have been hit especially
hard by hospital closings. "Hospitals are under stress and are
disappearing," he says.
Kail also points out that people in rural
areas are hurt by the lack of mental health services, which are often
not commensurate with physical health benefits. The United Methodist
Book of Resolutions affirms the right of individuals to have access to
all types of health care.
Reaction to crisis
Taken
together, the mounting problems make health care bills a legislative
priority for United Methodists, says Jaydee Hanson, a staff executive
for public witness and advocacy with the Board of Church and Society.
"In the last 10 years, what Congress has been dealing with is the two
ends of the age spectrum - children and seniors," he says. "But
because health care costs have spiked up so much and more people are
losing their jobs, Congress has to talk about how everybody has health
care. We are talking about the security of our country."
In
general, the church supports bills that provide the broadest level of
coverage, so that any measure providing prescription drugs for seniors
would be favored for providing the greatest benefit, Hanson says. The
church also is working for mental health parity, which President Bush
has proposed, but legislation may not find support with so many other
priorities, inside and outside health care.
On the other side of
the country, the Oregon-Idaho Conference has been involved in helping
children find insurance benefits through the state health program, says
Kathy Campbell-Barton, a health care liaison for the Bishops' Initiative
on Children and Poverty. Some $1.5 million in funds from the Robert
Wood Johnson Foundation will help pay for outreach materials through the
Oregon Health Action advocacy group.
Campbell-Barton has been a
health care advocate for years, "even when nobody wanted to hear it,"
she says. In part, that's because she is living what she is preaching.
Her husband, Kent, has struggled to maintain health care benefits for a
liver transplant and later for cancer treatment.
Now, the couple
deals with the high cost of prescription drugs, and her adult son is
uninsured while the Oregon Health Plan covers her grandchild. "It took
me every moment of my being to fight for my husband's health care,"
Campbell-Barton says. "Universal health care seems the best solution.
It's a crisis point, and people aren't getting their health care needs
met."
Campbell-Barton is among the United Methodists helping
organize local activities for Cover the Uninsured Week, March 10-16
(www.covertheuninsured.org). Primarily financed by the Wood foundation
and the W.K. Kellogg Foundation, the event will feature forums designed
to highlight the uninsured.
The week's activities planned in the
targeted cities include an interfaith prayer breakfast, community health
fairs and forums at universities featuring the new generation of health
care leaders. Labor and business leaders are also involved in the
events.
"This is a very serious thing for our country," says
Bishop Talbert, who represents the church on the National Religious
Advisory Board for Cover the Uninsured Week. "We are simply trying to
get the message out that there are many uninsured and we need to do
something to call attention to the government."
The Rev. Carol
Chandler, a United Methodist deacon in Arizona, recently attended a
conference sponsored by Families USA, which dealt with justice in health
care. She concluded that universal health care is the only answer. "It
may be the only answer to this crazy system we have. We have a very
inequitable system. The only way you have choices is if you are educated
and powerful and strong, and that leaves out a whole lot of people."
The clinic model
In
Hilton Head, Dr. McConnell had been struck by the disparity between the
rich who retire to the resort beach community and the poor who work as
house cleaners and grounds keepers. Deciding not to wait on the
government for a health care solution, McConnell developed a plan to
provide free local medical care. That led to the first Volunteers in
Medicine (www.vimi.org) clinic.
He enlisted help from
businesses, politicians and others, who responded by donating building
materials, labor, equipment and medicines. Retired doctors, nurses and
dentists got involved by donating their time. Since the clinic's opening
in 1994, its caseload has grown from 5,000 patient visits to 23,000
visits last year, McConnell says.
He believes the problem of the
uninsured could be solved if at least two-thirds of the nation's
150,000 retired physicians agreed to provide some free care each week.
In
St. Charles, the Volunteers in Medicine clinic has been able to attract
just enough doctors to volunteer at the clinic, but finding specialists
who will take referrals for free is a constant problem, nurse Hockett
says. Neurology is now one of the gaps, she adds.
Hockett is
among the United Methodists who helped develop the clinic, which is
housed in the non-denominational Oasis of Love church.
"Because
of our association with the clinic, health care issues and rising
medical costs are more out front with us than they otherwise might be,"
says the Rev. Jeff Spaulding, senior pastor at Faith United Methodist
Church. Spaulding serves on the board of directors for the St. Charles
clinic. "It's an extremely valuable ministry," he says.
Last
year, the clinic spent about $24,000, most of it for prescription drugs,
Hockett says. It secures free samples from some drug companies and gets
donations from local pharmacies, but finding and paying for the needed
drugs is still a struggle, she adds. The clinic has about 35 volunteers
and had 2,178 appointments in 2002. The staff asks for a $3 donation,
but the amount a patient gives is more or less. "One person had $1 worth
of change, and I said, no, I wouldn't take it," Hockett says.
Clinics
are continuing to open around the country in as many locations that
want them and can get them off the ground, McConnell says.
"I
don't know of a solution anywhere close to as spiritual as this one," he
says. "What's better than giving services to those Jesus said were the
most important? These are the ones who come to us."
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*DuBose is a free-lance writer residing in Nashville, Tenn.
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