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What about health care? It’s confusing, isn’t it?
Both nationally and in local forums, people are at each other’s throats yammering at everybody who proposes something difference from their plan to reform health care insurance. Every faction has its own percentage of how many people don’t have health insurance. In the process, we all seem to be getting mental fatigue from the overload.
So I decided to try something different – to look at Wayne County, Indiana. What’s going on here? Who is not being covered for their health needs?
Let’s start with the most vulnerable – the children. According to the Indiana Health Institute, Indiana is better off than most of the rest of the country. Only 8% of kids are not covered by health insurance, compared with 12% nationally. Children in Indiana covered by private health insurance total 73%, compared with 65% nationally. That still leaves about 123,000 Indiana children without insurance. But it is estimated that 59% of those eligible for public health plans are not signed up for them – which indicates that a better “selling job” is called for.
Have you ever heard of Hoosier Healthwise? The state provides this program for families. Eligible families with income up to 150% of the federal poverty level receive free coverage. Those from 150% to 250% of the level are eligible by paying a monthly premium of $22 to $70. That still leaves about 50,000 family members leftover.
Now, back to Wayne County. What do we have here? Those without private plans can join Medicare, if you are old enough. Medicaid is available for low income folks, although doctors are reluctant to accept Medicaid patients, because they say they lose money on every one. So, you have no medical insurance? There are two “safety nets.” One is the Reid Hospital emergency department, which is required by law to accept anyone who walks in the door, from sniffles to a heart attack. Consequently, Wayne county set up the Wayne County Health Clinic, just west of the courthouse, to take the load off the hospital. Average fees there are about $21-$25 per visit, although they can go as low as $9 to $11, depending on income (and no one is turned away), according to Eric Coulter, director. Of course, there are a couple of private walk-in clinics and the Richmond State Hospital and Dunn Center for mental health care.
The Wayne County Health Clinic seems to be our “ace in the hole,” in a manner of speaking, which makes it worth knowing more about. It is interesting to note that Dick Lugar, when he was still mayor of Indianapolis, first endorsed this kind of service, known as community health centers. The local Clinic presently serves about 9,500 patients, which is up sharply by 1,300, or 14% from last year. Why the increase? Coulter says it’s the bum economy and the fact that the Clinic accepts Medicaid. Of course, you are wondering: Who pays for it? The picture is pretty good, better than most government agencies. About 70% of the Clinic’s yearly budget of $2.3 million is funded by fees from patients and those from its Environmental and Vital Records division (mostly restaurant inspections). Grants from the state, primarily derived from the tobacco settlement, usually add from $300,000 to $425,000 a year – which helps, such as paying for the new addition now being completed.
In case you want to know when you can sign up, Clinic operating hours are 8:00 a.m. to 5:00 p.m. Monday through Friday, with added hours of 5:00 to 8:00 p.m. Monday, Tuesday, and Thursday. In addition, the medical personnel is on-call 24/7 to perform a sort of “triage” to tell the caller to go to Reid’s emergency department or, I suppose, “take two aspirins and see me in the morning.”
All in all, that adds up to pretty complete coverage, don’t you think? The Clinic seems to be the linchpin of day-to-day health care for those who don’t have insurance. Wayne county has been credited with foresight in establishing this full-service health center, now recognized as one of the best anywhere. Yes, it costs some local money, but any way they slice the national “health care reform” we’ll pay for it. Also, working with local governing boards, as the Clinic does, has yielded admirable results. And as Coulter puts it, “Knowing local people (who allocate tax funds) is a huge advantage.”
I wouldn’t want to leave the impression that this rather brief overview of health care covers all the bases or answers all pros and cons of the raging “health insurance reform” debate. However, it might inform some of our thoughts and maybe justify asking again the question we started with: “In Wayne county, who is NOT being covered for their health needs?”

–Vic Jose

Vic Jose :: Oct.21.2009 :: Uncategorized ::

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