October 23, 2014

Health Reform Task Force

To discuss and engage in the health care reform debate, interested ACU members have formed a Task Force to share information, respond to legislation, and advocate on behalf underserved populations. ACU is commited to the following principles:

1. In regards to the economics of health care, ACU endorses principles established by the Institute of Medicine.

  • Health care coverage should be universal.
  • Health care coverage should be continuous (portable).
  • Health care coverage should be affordable to individuals and families.
  • The health insurance strategy should be affordable and sustainable for society.
  • Health insurance should enhance health and well-being by promoting access to high-quality care that is effective, efficient, safe, timely, patient-centered, and equitable.

2. Access to health care should be a social right and not a byproduct of employment. Many persons in underserved populations struggle with barriers to employment that are both pervasive and permanent. It is important to remember that 17.2 % of full-time workers in this country do not have health insurance. Those residing within the lower economic rungs of our society are at a much higher risk of lacking health insurance because of unemployment, part-time employment, episodic employment, and employment that does not offer health insurance. Accordingly, we assert that access to health care should not be contingent upon a person’s employment.

We support the statement by the United Nations that, “everyone has the right to a standard of living adequate for the health and well-being of oneself and one’s family, including food, clothing, housing, and medical care.”

3. We assert that provider reimbursements should be determined by the complexities involved in effective care of each unique patient and the achievement of improved, sustainable patient outcomes. Many persons in underserved populations struggle with multiple acute and chronic health conditions as well as co-morbid conditions, such as mental health issues. Many also face barriers to accessing health care such as; transportation, ability to take time off from work, being able to afford co-pays, and a place to store medications. Older patients and refugees and immigrants from other cultures often have additional complexities involved in their care. High quality care for underserved populations depends upon having adequate time to spend with the patient, and adequate resources to address the complexities of their health care issues. The economics of reimbursement must match these needs in order to have better health outcomes for the patients we serve. Put another way, “people and their lives do not fit into fifteen minute slots.”

4. We encourage policy makers, providers, and employers to take into account environmental factors that impact the delivery of culturally appropriate physical, mental, and spiritual health and support an a comprehensive view of preventive care. Routine access to preventive care is critical for this population. Preventive care means not only access to standard medical care, but access to health related resources that are not necessarily a part of standard treatment, for example healthy foods and exercise. These resources are often not available to underserved populations and must be addressed at the level of community and place of employment. For example, urban inner city communities are often called “food deserts” because of the lack of access to affordable fresh vegetables for the community.

5. We support initiatives to recruit and retain a transdisciplinary team of health professionals and community workers trained in cultural, linguistic, and literacy competency for this population. Successful delivery of care in this population is highly contingent upon a dynamic relationship between the providers and the patient. This relationship is a product of both time and intention on the part of both provider and patient working together to create an individualized plan of care based on the patient’s specific needs both culturally and environmentally. This relationship is hard to create when clinics are only able to staff providers on a revolving basis and staffing does not include other crucial components of health care such as mental health, nutrition, health education, case management, etc. In this work, the role of the health promoter or promotora is essential to build “trust bridges” to the patient.

To learn more about the group or to become involved, please email acu@clinicians.org.