Health Care
A Policy Statement of the North
Carolina
Council of Churches
Summary
Four years ago, the Council of
Churches issued a policy statement on health care that expressed concern about
the large number of North Carolinians without adequate health insurance and about the
high and increasing cost of health care. Our concern is especially great for
those most vulnerable in our society: the poor, children, people of color, and
the elderly. At that time, we called for a national health plan that would guarantee
universal coverage for health care, coupled with effective cost control, broad-based
and equitable financing, and assured quality of services.
In the four intervening years, it seems
that nothing has changed and yet everything is different. Reform efforts have
resulted in relatively minor changes in the availability and delivery of health
care. Changes implemented by the health care and insurance industries, especially
the introduction and rapid growth of managed care, affect millions of people.
Proposed and adopted changes in the structure and funding of federal, state,
and local programs providing health care for people in or near poverty threaten
to increase the numbers with inadequate access to health care.
The Current Status
·
In 1995, some 1.2
million North
Carolinians (17.4%
of the total population) were uninsured at one time or another. This includes
627,000 who were without health insurance of any sort (including Medicaid) for
the entire year. An additional 1.1 million were considered to be underinsured.
·
Thirty percent of
the uninsured are poor, 28% are near poor (100% to 200% of federal poverty level),
and 42% are middle class.
·
Nationally, health
care spending continues to grow at a rate about double that of inflation.
·
The number of health
maintenance organizations (HMOs) in North Carolina has increased by 120% over a two-year period.
About 10% of the state's population is enrolled in full-service HMOs.
Recommendations
We
continue to call for the establishment of universal health care coverage as
the only way to ensure access to basic health care for everyone. Until this
long-term goal is reached, we support the following interim measures:
- Strengthen the regulation of managed
care in order to provide greater protection for consumers. These protections
should include, but not be limited to, setting minimum access standards, guaranteeing
coverage of emergency room services when the patient had a reasonable belief
that emergency care was needed, including coverage of mental health services,
prohibiting discrimination against providers serving special populations with
higher than average health care needs, and including enrollees/patients on
managed care governing boards.
- Increase the use of Medicaid, especially
by increasing eligibility, improving outreach efforts to those who qualify,
and making services easier to access.
- Expand the use of school-based health
centers, especially in counties with high numbers of uninsured school-age
children.
- Assure access to health care, especially
for emergency services and deliveries, for immigrants.
January
1997