Iveson's Issues: Health Care
Single Payer
The Missouri Foundation for Health has reported that there is enough money in our current health care system to improve outcomes and lower costs but it is not distributed effectively. Administrative overhead accounts for much of the current cost. Single payer is the only way to make a significant dent in administrative costs but will be very difficult to sell politically, or to implement in individual states, without federal leadership.
State Child Health Insurance Plan (SCHIP)
President Bush's decision to veto recent legislation expanding the successful SCHIP program is pitiful. Bush has twice vetoed this legislation, even though the most recent compromise proposal offered only modest expansion; extending coverage for 6.6 million that are currently enrolled plus an additional 4 million. Unfortunately, without the votes needed to override in the House, Congress had to settle for a simple stop-gap extension through March 2009. It is good that 6 million children who already have care won't lose their coverage but it is sad that another 6 million eligible children will not be able to enroll. And sadder still that children's health care is reduced to a mere political strategy.
Missouri has been a leader on insuring children under SCHIP. Our plan allows coverage for children up to 300% of the federal poverty level. In the last couple of years, we have seen some setbacks in coverage due to legislative mistakes. While most of those have been corrected, a number of children who were lost as a result of these mistakes have not re-enrolled. In many cases that is because their parents, who used to get coverage if the family earned less than 100% of the federal poverty level (FPL), were completely cut from the program. When mom can't get insurance, she is less likely to get it for her children.
Access to Quality Care
Even when insured, many Missourians have difficulty getting the services they need. More rural areas of the state may not have enough service providers to meet the need. Other areas may have providers but still lack access if those providers cannot afford to serve those who depend on public insurance like Medicaid and Medicare. Public insurance often repays the providers less than the cost of services. Many providers may have to limit, or be unable to serve patients who rely on public insurance. This is a critical component of providing care to all Missourians.
Senior Citizens
As they age, our older citizens face special health care challenges. Some may require care during the day, others need long-term nursing home care. Many are best served by something in between, like home or community based services that allow seniors to stay in their homes for as long as possible. Our goal should be to make sure that seniors have information about all available services so that they can choose what best meets their needs. Public funding should support a full range of coordinated services for seniors. As with any other service, we should make sure that the services provided are of high quality, including adequate facilities and properly trained staff.
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