D.C. doesn't know how far patients go

 

February 15, 2018



Having health care in rural areas can be taken for granted, but when it is gone the effects are immediately noticeable.

Congress’ recent stop gap budget to keep the government running did not take into account community health centers (CHC), which are at risk without a long-term budget. These types of smaller health care clinics serve about 10 percent of Montana (roughly 100,000 residents), a state where there should be one lower tier of population designation past “rural.”

The wave of CHCs began with Lyndon B. Johnson’s war on poverty, and the movement experienced a swell under George W. Bush. The Affordable Care Act bolstered low-income patients’ ability to access care at CHCs. These centers were the closest thing to a healthcare “fix” this nation had come up with for accessing healthcare facilities.

CHCs were created when a doctor practicing medicine in under served areas applied the same formula to the U.S. healthcare system. CHCs have historically been a vector of bipartisan support in the debate of how to better provide care for citizens.

In Montana, some CHCs are facing closure because Congress failed to pass a long-term budget, causing a very real 70 percent drop in federal grant funding. Without a long term budget to bank on, CHCs across the country could start to run out of money by the end of February.

The total proposed funding or CHCs is a drop in the bucket, compared to other proposals on the national stage. CHC funding without lapse amounts to about $7.4 billion. Compare that to the $18 billion proposed for the first phase of the border wall, or the $1.5 trillion resulting from a corporate tax cut (down to 21 percent), CHC funding may be the most cost-effective, cost-beneficial, and potentially life-saving proposal being considered.

It is estimated that Montana’s 17 CHCs, connected to 40 satellite sites, served 106,342 patients in 2016, with a total of 407,084 visits. As expected, about 85 percent of these patients are low income, who would have difficulty affording care at facilities other than CHCs. Reports show CHCs have 24 percent lower costs, saving taxpayers about $134 million in Medicaid costs.

In Montana, a single closure could result in patients having to drive hundreds of miles for affordable primary care. Larger hospitals and clinics may not be ready to handle the increase in patient loads. Without a doubt, wait times certainly increase.

It was pointed out recently in the Billings Gazette that, “Congressional dysfunction is hazardous to Montanans’ health. The four stopgap spending bills that have dribbled out of Capitol Hill since the last fiscal year ended on Sept. 30, have left 100,000 Montanans and millions of other Americans behind.”

In early December, Sen. Tester and Sen. Daines received letters from Montana CHCs asking for much needed support of a multi-year funding extension. Without that kind of financial foresight, CHCs cannot bring stability to the patients they serve. Many have established hiring freezes, federally funded residency experiences and outlying training programs are on hold, and creating a budget as a CHC is nearly impossible without some kind of stable framework.

Providers, patients and supporters are hoping for a longer-term solution after Thursday’s vote in DC. CHC funding is just one of the many side notes in a tangle of issues to be voted on.

For those in the elected seats with voting power, access to healthcare is uninterrupted. They do not feel the pinch in the wallet when trying to purchase lifesaving medications, or when an appointment is canceled at a CHC because of closure, resulting in rescheduling months out, over a hundred miles away. Many in those seats do not understand the meaning of “rural” or the implications distance can have in an emergency.

The only way they can know is by hearing from regular citizens through emails, letters or phone calls. Otherwise, they may think that what the American people really care about is on cable news. One look around Montana, and one can see that the worries portrayed on cable news are not the day-to-day worries of Montanans.

 

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