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The Honolulu Advertiser
Posted on: Tuesday, September 20, 2005

COMMENTARY
We need healthcare system that serves all

By Dr. Robert E. Suter

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The United States is home to the best healthcare in the world, but too many Americans — more than 45.8 million according to the U.S. Census Bureau — lack health insurance and have difficulty accessing the healthcare they need.

No one understands or sees this challenge more than those of us who are on the front lines of healthcare delivery — particularly emergency physicians who often serve as the point-of-entry into the healthcare system or see the medical consequences of delaying care every day.

Emergency physicians are required by law to provide medical care to everyone, regardless of their ability to pay or health insurance status.

But our ability to continue providing high-quality care is deeply affected by cutbacks in Medicare, declining payments by health plans and a medical liability crisis, each of which contribute to an increasing number of patients (particularly those over 65), a shrinking number of emergency departments and a shortage of on-call specialists to provide treatment.

Since the mid-1990s, the number of uninsured Americans has been steadily rising. For years there has been finger pointing and little concrete action to address this problem.

What we need now are efficient and effective solutions to address the growing crisis. We need to build a healthcare system that is more rational and serves all segments of the population — including the uninsured.

There are a variety of options to help address this important problem — many of which are being debated in Washington and state capitals around the country. These solutions will take years to implement, but people, and the healthcare system, cannot wait.

An example of a successful public-private partnership is the Partnership for Prescription Assistance (PPA). This program offers a single point of access to more than 475 public and private patient-assistance programs, 180 of them offered by pharmaceutical companies.

The program combines the unique skills, grassroots membership and credibility of more than 1,200 national, state and local organizations that are committed to connecting individuals in need with patient-assistance programs.

Together, they have helped nearly 800,000 Americans in less than four months, but millions more are eligible and could benefit from this assistance.

The challenge is to inform individuals in need of the programs that exist. A recent survey conducted for the PPA, for example, reveals that nearly 65 percent of patients in need are unfamiliar with the patient-assistance programs available to them.

As emergency physicians, we believe three fundamental things must happen to address this problem.

First, we must increase awareness of the existing healthcare crisis, and the impact it has on millions of people.

Second, we must develop better and more effective methods to reach those in need of options that will help them better manage their healthcare.

Third, additional public-private partnerships should be created to help the people in our communities who lack healthcare coverage to better manage their healthcare and access the healthcare system.

Until the nation can come together with a permanent and lasting solution, it is time for all players in healthcare to come together to find and develop programs that provide immediate help for American's uninsured. If not, we can expect another ominous report from Census Bureau next year and for years to come.

Dr. Robert E. Suter is president of the American College of Emergency Physicians, an association of more than 23,000 emergency room physicians across the nation.