California Endowment Blog posting - CHCs and national health reform

[Guest guest]

http://tcenews.calendow.org/pr/tce/blog-post.aspx?id=596

Dr. Ross is the CEO at the California Endowment.

If I Had a Hammer: The

Question of National Health Reform

Wednesday, October 31, 2007 | 9:43 AM

K. Ross, M.D.

The question for the week: if you were czar (or at least the President) who

would you pick to draft a plan to fix the U.S. health system?

While you take a moment to ponder this utterly hypothetical question, I can

save you the energy of exercising your brain cells, because I have the best

answer. Forget about the prestigious think tanks, liberal or conservative.

Forget about the high-priced consulting firms. Pass on the university hotshots

with hundreds of academic publications and well-researched books on their

resumes. And pass on us high-falutin’ private foundations who seemingly

have policy briefs to address any civic challenge.

For my money, I would entrust the overhaul of our ridiculously

expensive and dysfunctional health system to directors of community health

centers. I would put a dozen of them in a room for a weekend, shove a pizza

under the door every few hours, and within a couple days I would have a

sensible, affordable plan for health reform.

For too long, America

has viewed community health centers quite uni-dimensionally: as the place where

poor people and the uninsured can access health services. While this is true,

it is a limited view. Community health centers (CHCs in shorthand) represent

this nation’s best investment of this nation’s health care dollar;

no other dollar spent comes close.

The CHC movement (and it is a movement) is now, unofficially,

close to four decades old. They started as “free health clinics” in

the '60s and '70s, and they have matured, evolved and grown since then. Have

they grown enough to entrust their leaders with intellectual custody of

designing a new U.S.

health system with $1.7 trillion in spending? You bet. And here are five

reasons why:

1.

CHC

leaders would begin a conversation about health reform with two words that are

important to American health consumers but rarely uttered in current discourse:

“mission” and “values.” Terms like dignity,

respect and patient-centered would drive the planning, rather than being

relegated to an afterthought (which is what we have in national and state

reform discussions now).

2.

While

developing a mission-driven, values-based plan, CHC leaders are best equipped

to craft an approach that is also hard-nosed with respect to costs. During the

past decade, CHCs have been perfecting the art and science of delivering

quality health care services at a reasonable cost to virtually anyone who shows

up at their doorstep.

3.

CHCs

would advance a paradigm shift with our health care system that is badly

needed. They would develop a system that is more heavily focused on

community-based prevention and primary care, and they are experienced in

understanding how to reduce unnecessary emergency room visits and

hospitalizations. We can no longer afford to view hospitals at the center

of gravity for the U.S.

health system.

4.

No

segment of the U.S. health

system is better experienced at providing health services to a racially and

ethnically diverse America.

CHC’s are governed by boards of directors and professional staff that

closely resemble the communities that they serve. They also represent an economic

engine for working-class neighborhoods, generating decent jobs along the way.

5.

CHCs

and their leaders represent the most credible and admired segment of our health

system. As nonprofit entities, they avoid the wrath of Americans’

distrust of the profit motive in providing health services. As private sector

providers, they do not carry the “big, inefficient government”

label. CHCs are admired and supported by Democrats and Republicans alike for

providing quality, cost-effective care. They are health care’s good

guys – and this label is well-deserved.

Millions and millions of dollars will be spent over the next two

years hiring lobbyists, consultants, and political strategists to wrangle over

needed changes to our health system. For the cost of a hotel conference

room and a couple of pizzas, a group of community health center leaders are

fully capable of telling our President and Congress what we need to do to fix

it.

Ruiz

Director, Health

Systems

National

Association of Community Health Centers, Inc.

7200 Wisconsin Avenue Suite 210

Bethesda, MD

20814

(301)

347-0442

(301)

347-0459 FAX

(202)

365-0154 Cell Phone

jruiz@...

www.nachc.com

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