The TAP-IN Blog

The TAP-IN blog: What should it be? Where should it go?

Hello...

We've had a TAP-IN blog up for some time now.  We've posted some interesting articles and information, have posted some commentary, but just haven't had a lot of readership or interaction with it.

So, I ask you - where should this TAP-IN blog be heading?  What kinds of stuff should we be talking about?  What else should we be doing?

Interested in your thoughts...

thanks

Mike
Chief Program Officer, TAP-IN

GA Free Clinic article, TAP-IN's Dr. Filardi

This article is about the Good News Clinic in greater Altanta; Dr Filardi, quoted in the article, is a TAP-IN volunteer physician...

http://www.11alive.com/rss/rss_story.aspx?storyid=128375

Story on Free Clinic in Venice, CA

Here's a story posted on Time.com about the Venice Free Clinic in California:

 

 

The Free Health Care Clinic CEO - How Americans Spend Now - TIME

 

Free Clinic Sees Number Of Patients Skyrocket - NPR Story

Friends and Colleagues,

 

I invite you to listen to this program segment broadcast by NPR on April 25^th. It focuses on the activities of one of the Virginia Association of Free Clinics' member clinics and it is an example the pressure the health safety is experiencing in these difficult economic times.  

 

http://www.npr.org/templates/story/story.php?storyId=103495146

 

14,000 Americans losing coverage daily

A report by the Center for American Progress Action Fund (pdf document) claims that since the current recession began, the number of American's on the rolls of the uninsured has risen by over 4 million, with the number continuing to rise at a rate of 14,000 every day.

A one percentage point rise in the national unemployment rate causes 2.4 million people to lose employer-sponsored health coverage, according to Urban Institute researchers.3 Of these people, 1 million rely on Medicaid or the Children’s Health Insurance Program and 1.1 million end up uninsured.

A trillion here, a trillion there. Money to cover universal health care.

The amount of money being loaned, lost, borrowed and blown is beyond comprehension. Bailouts and deficits are now counted in the trillions of dollars. This after we'd had our minds exploded by the hundreds of billions spent on the war in Iraq. Not that sum pales in comparison.

So the shock of an estimate of $1.5 trillion over the next decade to pay for universal health care is buffered just a little bit. This number was arrived at by health care experts who advocate such a plan, but the Obama administration is not putting out such figures, obviously concerned that they would upset too many people.

On the other hand, has anyone come up with an estimate for the cost to all of us of having over 50 million people uninsured for those same 10 years?

The Subconscious Crisis of the Uninsured

Tap-In is trying to help find more doctors, nurses, PAs, NPs and dentists to staff free clinics. This dire need flies below the conscious radar of most Americans as they deal with what they've got on their own plates.

Unless you are uninsured, or have the prospect staring you in the face with a suspected layoff or failure of the business that employs you, you may not be aware of how ridiculously urgent the situation is becoming. Then again, maybe you've been uninsured before, or have gone bankrupt yourself from medical bills not covered by a health plan.

But if you're reading this blog, you're probably very much aware of the problem and how the economic crisis is adding fuel to the flames.

My scans of the news bring me stories like the following every day, and the curve is trending upward.

From Missouri: Study finds a third of state uninsured.

From North Carolina: Uninsured strain NC Free Clinics

From Georgia: Safety net health centers struggle to meet demand

Kansas City: Free clinics are flooded with new patients

Iowa Families Pack Free Health Clinics

Institute of Medicine sees "state of crisis" in health care

Reporting on the site of its sponsor, the Robert Wood Johnson Foundation, the Institute of Medicine (IOM) released America’s Uninsured Crisis: Consequences for Health and Health Care on February 24. (pdf)

The IOM issued 6 separate reports on the urgency of America's need to provide health care coverage to all. The most recent of these reports was released in 2004, but over the past 5 years, "there has been no comprehensive national effort to expand coverage to everyone."

The purpose of the current report "is to inform the health reform policy debate—in 2009—with an up-to-date assessment of the research evidence. This report addresses three key questions: (1) What are the dynamics driving downward trends in health insurance coverage? (2) Is being uninsured harmful to the health of children and adults? (3) Are insured people affected by high rates of uninsurance in their communities?"

The report confirms what would seem obvious - that people without health insurance are at much greater risk of getting serious illnesses - but it takes this kind of approach to bolster up Washington politicians to support bold action. And so the IOM recommends the following:

The committee recommends that the President work with Congress and other public and private sector leaders on an urgent basis to achieve health insurance coverage for everyone and, in order to make that coverage sustainable, to reduce the costs of health care and the rate of increase in per capita health care spending.

Health Workforce Solutions Now Available on the Web

It's not only our free clinics that are understaffed these days. The entire health care system is seeing critical shortages of doctors, nurses and allied health care workers, all across the country.

The U.S. Department of Health and Human Services now provides a Web site called the Health Workforce Information Center (HWIC) where you can find "information on health workforce solutions in one centralized and easy-to-access online location."

Funded by the U.S. Department of Health and Human Services Health Resources and Services Administration and operated by the University of North Dakota (UND) School of Medicine and Health Sciences, the center will offer the latest on health workforce programs and funding sources; workforce data, research and policy; educational opportunities and models; and news and events, also available through e-mail updates.

Visitors will have a broad range of publications and other resources at their fingertips. The site also offers free, customized assistance from information specialists (digital librarians), who will search databases on workforce topics and funding resources, furnish relevant publications, and connect users to workforce experts and federal programs, among others.

“Many people in government and private and nonprofit organizations need access to the type of quickly assembled, user-friendly data the center will make available,” said Kristine Sande, HWIC deputy director at the UND School of Medicine and Health Sciences. “Accurate information on the health workforce will be vitally important in the ongoing health care debate, and we provide a way for individuals to get it from a single, trusted source.”

ERs are the New (Beleagured) Safety Net

In California, the wave of unemployed and uninsured is breaking on hospital emergency rooms, over-taxing staff and resources, and putting a dangerous load on hospital finances. The overload situation is having increasing impact on seniors.

When Dr. Tony Musielewicz walks through Dominican Hospital's emergency room, he muses that it often "looks like a nursing home."

But Musielewicz, the emergency department's medical director, doesn't mean that in a bad way. In fact, he's angry about the rising numbers of Medicare patients who are forced to rely on the ER or urgent care clinics to treat common problems that should be monitored by a primary care physician.

"One is too many if there is even one senior citizen who doesn't have access to a primary care physician," said Musielewicz, who has worked at Dominican for 10 years.

The problem: Fewer primary care doctors are opening practices in Santa Cruz County because of low reimbursement rates compared to counties over the hill. Those who have patient openings are likely to accept the privately insured over retirees bearing Medicare cards. Even seniors who have regular doctors sometimes are forced to wait weeks to get in.

Given all this, "We're the safety net for everyone," Musielewicz said.

* * *

At San Joaquin General's emergency room, Dr. Richard Buys has seen a marked increase in volume, while at the same time, hospital admissions from the ER have been flat.

That tells him that people who normally would have gone elsewhere for care, such as a physician's office or same-day clinic, are seeking out the ER because it does not require payment upfront.

"On a personal note, I've noticed more often that when I ask a patient if they need a note for school or work, the answer used to be 'yes' or 'no.' Now it's, 'I just lost my job.' The number of times I used to hear that was virtually nil. It puts a more human touch on what is going on, and they don't say it with a smile," Buys said.

* * *

Urgent care clinics also see a wave of seniors who can't get into their doctor or can't find one. The Santa Cruz Medical Foundation, which is part of the nonprofit Sutter Health network, has a freeze on all new Medicare patients who are not part of an HMO network, but will continue to see seniors in its urgent care areas.

Dr. Lawrence deGhetaldi, the foundation president, said urgent care doctors in his six clinics are seeing older patients for high blood pressure, diabetes and medication refills. But when the seniors seek ongoing general care, they are shut out because the clinic's primary care doctors are at capacity for Medicare patients.

And that is a shame, Musielewicz said.

"Our health care system is breaking," Musielewicz said. "The fact that the elderly have difficulty finding primary care is something the community, the county, the state and the nation have to work on as a whole."