"When Bull Elephants Fight . . .
Let's Not Dismantle Health Care Reform"
by Pamela Taylor
I have to agree with President Obama; as "humbling" as the mid-term election results might be for his policies, Americans do not "want to re-litigate the health care reform debate or repeal some of the more popular consumer protections," provided in the recently passed Affordable Care Act. Health care reform has been a long-time coming. "Tweaks"? Of course, but starting over is unthinkable.
There has been no shortage of strongly debated presidential- led efforts to provide some type of government-sponsored health care for more than a century now. Beginning with the Progressive Era ushered in by President Teddy Roosevelt to Presidents Franklin Roosevelt, Truman, Johnson, Nixon, and (most memorable for me) Clinton. Each failed.
Just as history repeats itself, each effort failed for some combination of the same reasons─competing special interest group agendas, ideological and policy differences, anti-socialism sentiments, federal versus state government advocates, small versus big business proponents and on and on.
The Affordable Care Act that was signed into law this past March is not everything to everyone. But it can transform the nation's health care system and level the playing field for minorities and the poor.
Not all Americans have equal access to health care, nor do they have similar health care outcomes. Low-income Americans, racial and ethnic minorities, the elderly and other underserved populations often have higher rates of disease, fewer treatment options, and reduced access to care. Many are also less likely to have health insurance than the population as a whole.
The Affordable Care Act law offers new strategies for managing chronic diseases, such as diabetes, kidney disease, heart disease, and cancer, all of which disproportionately impact minorities. Because infant mortality and post-birth complications are also higher in minority and low-income groups, the law includes funding for home visits for expectant mothers and newborns.
The new rules in the Act provide immediate relief to many Americans and promise hope to millions more who might be only one illness or accident away from medical and financial disaster.
The Act also eliminates many health insurers' discriminatory practices, expands Medicaid coverage, and even creates health insurance exchanges to assist consumers in finding higher-value, lower-cost coverage. There is no doubt the Affordable Care Act will assure a new health insurance marketplace by the time it is fully implemented in 2014.
By improving access to quality health care for all Americans, the Act will definitely help to eliminate health disparities and also reduce health care costs, while emphasizing prevention and wellness. It offers individuals and families more control over their own care.
These and other initiatives in the Act also increase racial and ethnic diversity in the health care professions, strengthen cultural competency training and increase funding to the nation's community health and primary care centers.
Community health centers serve an estimated one in three low-income people, and one in four low-income minority residents. The new resources in the Act will enable health centers to double the number of patients they serve. Combined with investments made by the American Recovery and Reinvestment Act, the new law is expected to support 16,000 new primary care providers.
The Affordable Care Act is making an unprecedented investment in training and education opportunities for the nation's frontline healthcare workforce.
Frontline workers fill about half of all health care jobs, and they deliver most of the nation’s direct patient care and public health services. However, their potential for delivering more and better care and filling critical vacancies in professional positions goes largely untapped. This frontline workforce touches more patients than most other health care providers, and includes nurse, dental and physician assistants; laboratory technicians; paramedics; orderlies; substance abuse counselors; and medical records and administrative staff, among others.
Currently, numbering well over six million, the health care workforce is growing at a rate twice that of non-health employment, and especially among key frontline care-giving occupations. The Bureau of Labor Statistics predicts dramatic growth for all of the key frontline occupations. Nursing aides, orderlies and attendants are projected to grow at a rate of 25 percent; home health aides up to 47 percent; and personal and home care aides projected at over 60 percent by the time full health care reform is implemented.
The Act is not perfect; concern about its impact on small business is legitimate. The constitutionality of forced participation is being challenged in state courts throughout the nation. However, to lose sight of the remarkable reform initiatives based on partisan politics would be devastating and likely set US health care back another 100 years. As the African proverb reminds us─when bull elephants fight, the grass always loses.
Pamela Taylor is a communications consultant with McKinney & Associates and manages the strategic communications campaign of Jobs to Careers, a skills training and career advancement initiative for frontline health-care workers, funded by the Robert Wood Johnson and Hitachi Foundations.