Is West Virginia close to having universal health insurance coverage? It's hard to believe that after so many years of struggling for this benefit, we are close to the goal.
About 25 years ago, when the push for health coverage for all Americans became a priority for President Bill Clinton, we were still debating whether access to health care was a fundamental human right. That issue has long been laid to rest.
Back then we also debated the merits of the American health care system. The argument was that American medicine has given us the best and most sophisticated treatment in the world. Any changes will lead to poorer quality, long waiting lists and doctors fleeing the country. It was said, that patients were leaving the socialized health care system in Canada for treatment in the United States. Today, these arguments seem pretty lame.
Five years after passage of the Affordable Care Act (ACA) we have turned the corner toward universal health insurance coverage, a new partnership between public health and medicine to address our chronic disease problems, and new systems of patient-centered care. Even more hopeful is that the medical establishment, which resisted change for decades has joined the chorus.
More than 60 medical specialty associations have issued recommendations to their members to avoid more than 270 treatments that research shows are not proven to be effective and may actually be harmful to patients. Doctors are being encouraged to engage in conversation and partnership with their patients to decide on treatment. The all-knowing hero doctor and aggressive interventionist is a relic of the past.
New numbers from the Kaiser Family Foundation show that West Virginia has reduced the number of people without health insurance by about two-thirds. The Kaiser numbers show that 116,000 are still uninsured. Of that number, 56,000 are eligible for Medicaid and 31,000 are eligible for financial assistance to buy private coverage in the West Virginia Marketplace.
Starting November 1, 2015, through January 2016, West Virginians will have another opportunity to buy coverage through the Marketplace.
I will be the first to admit that applying for coverage through the Marketplace is way too complex and needs to be simplified. But it's worth the trouble.
Some people give up because the first numbers they see are the actual price of coverage and the high cost of the deductible.
Don't give up. Keep going through the process to see what financial assistance you will get for both the premium and the deductible. If you are worried about the increase in premiums, remember that most increases will be covered through financial assistance.
In 2014 and 2015, about 26,000 West Virginians got financial assistance through the Marketplace. I hear from many of them who have affordable coverage for the first time paying about $100 to $200 a month for the premium and getting a substantial break on the deductible.
Seek help from trained local enrollment assisters to guide you through the process. To find a trained person in your community to assist you go to bewv.wvinsurance.gov and click on "Local help for open enrollment."
We have turned a corner. We can get to universal coverage in West Virginia within the next two years.
With strong leadership we can cement the new alliance between public health and medicine and reduce our rate of chronic disease and disability. A partnership of government, the academic and private sector in West Virginia has worked for months on a plan for a new system of care. We are a long way from implementation, but strong agreement about goals across all sectors is very hopeful. As the world-famous Princeton health economist Uwe Reinhardt put it, "The issue of universal coverage is not a matter of economics. Little more than 1 percent of GDP assigned to health could cover all. It is a matter of soul."
Renate Pore is health policy director for West Virginians for Affordable Health Care.