By Milton Howard

The Daily News - Guest Column 

Published May 1, 2008

This is National Cover the Uninsured Week, a national effort to highlight the fact that too many Americans live without health insurance and to demand solutions from our leaders. 

Some 47 million are uninsured, nearly 9 million of them children. More than eight out of 10 are in working families. They are our friends, neighbors and colleagues, forced to gamble every day that they won’t fall sick or be injured. In Galveston County, we estimate that 85,000 residents are at or below 200 percent of federal poverty level, which for a family of two is an income of less than $28,000 annually. 

While it is not a solution to the problem, residents of Galveston County have two federally qualified community health centers — the Galveston County Health District’s 4Cs Clinics in Galveston and Texas City. Approximately 88 percent of the patients seen in the clinics last year lacked insurance. 

That is good news and bad news. Good because our county has these clinics — many don’t. Bad because demand for uninsured health is increasing and may exceed the 4Cs clinics’ capacity to care for all and because 4Cs revenue potential is limited. 

The average federally qualified health center in the United States has about 30 percent of its patients covered by Medicaid and Medicare. The 4Cs clinics have less than 10 percent, limiting revenue that helps support the cost of care for those unable to pay and resulting in increased bad debt. 

As federally qualified health centers, the clinics do not turn away patients because of their inability to pay. However, patients’ ability to pay is determined using a sliding fee scale based on their financial status. Even so, collection rates are low and socio-economic issues impacting health care are very high. 

Despite daily challenges, staffs in the clinics are dedicated to serving the general public, as well as the most vulnerable of those who may be uninsured or underinsured. 

While the 4Cs clinics can address many health needs of the uninsured, it is not a total solution. Only one of every four uninsured 4Cs patients accesses specialty care, so more serious issues may go unaddressed and eventually lead to costly emergency-room visits, hospitalizations and, eventually, preventable early death. We need a solution!

Our health-care system leaves too many citizens without the resources necessary to buy and keep dependable insurance coverage. Despite local and national efforts, history shows it has been difficult to agree on large-scale solutions that can solve the problem of the uninsured. 

During Cover the Uninsured Week, the 4Cs governing board and Galveston County United Board of Health encourage everyone to become more aware of the issue by recognizing the costs to society of the uninsured and becoming advocates for a sustainable solution to the problem. 

Most importantly, we ask everyone to take the time to hear a story about uninsured care. It won’t take long. What can we do together to help? 

Dr. Milton Howard chairs the 4Cs governing board and is a member of the county’s United Board of Health.