Health care was the topic at a congressional campaign stop for Sen. Jack Goodman, R-Mt. Vernon, on Thursday.
Goodman made a listening tour stop at Access Family Care’s Mary Ann Bradley Building in Anderson. Most patients in the Access system are underinsured or uninsured and the discussion turned quickly from health care to budget concerns. Goodman assured attendees that he sees the care provided by federally qualified health centers (FQHCs) as valuable and commended their efforts.
“I have long believed and long publicly said that FQHCs are the most effective healthcare delivery system,” Goodman said.
He lauded the comprehensive services offered at sliding scale fees over the bureaucracy of Medicaid, noting that patients with a health care home get better care and have fewer emergency room visits.
“I would like to see a government paradigm shift to this kind of system,” Goodman said.
Access medical director Dr. Charles Bentlage agreed, pointing out the use of defensive medicine in an emergency room setting where a headache could be just that, or an indication of something more serious like a hemorrhage or a tumor. Doctors have to make the call right then or risk the individual not getting care and that non-relationship, he said, leads to more tests and lower quality care.
“In the ER, it’s an anonymous one-time relationship.” Bentlage said.
Last year federal funds accounted for 23 percent of Access Care’s budget. State money made up 8 percent of the non-profit provider’s budget, and with cuts trickling down from the state budget, they are concerned.
“The 8 percent does hurt because we’re on a really tight budget,” said Don McBride, Access CEO.
With the current economy Goodman said he could make no promises that further cuts would be withheld, but believes fellow Senators will try to protect FQHCs from severe cuts.
“I think there will be a broad voice that understands the value of your services,” he said.
The budget, he said, is in a continual state of flux. Constitutional deadlines have to be made, but the information to complete the budget is still coming in and the numbers keep changing. Senators are making an effort to cut $300 million in anticipated federal funds from the next state budget. Leaner state operations are one of his goals.
“This fiscal crisis gives us a very necessary opportunity to eliminate some duplications, and inefficiency,” Goodman said. “And what I believe we need to do is look at structural reforms and cost savings within the structural existence of our government while at the same time working very hard to continue the operation of services like we see here.”
At Access, 47 percent, or roughly half of their patients, are on Medicaid and 45 percent are uninsured. They saw a 26 percent jump in visits last year.
“We can serve a lot more if we have facilities and funding,” Bentlage said. “The need is there.”
They have already cut programs to trim the Access budget. A dental van program, and an early detection effort funding mammograms and pap smears for those who cannot afford them, were axed this year. He hopes they do not have to trim hours or staff.
“People need jobs,” said McBride. “To me that should be the main focus.
Jobs, McBride said, are key to helping people help themselves. The increase in visits at the clinic, especially increase in visits from individuals, tells him that people do not have jobs or the insurance they need.
The group discussed the impact of the federal health care bill. Goodman noted that although there is room for change in the current system he found the versions of the legislation he has seen “fundamentally un-American.”
The potential for profit drives innovation, Goodman said, noting his disapproval for mandated state spending and requiring taxpayers opposed to abortion coverage to pay for the procedure.
“My opinion is we have the best health care system in the world in America,” Goodman said. “80 percent of what we have works very well.”
Anderson, Mo. —
