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Spokane Alliance tackles complex issues of health care system

Because options for health care and players in the health system abound and compete, Karen Hyvonen brings to bear her experience as teacher as she works with the Spokane Alliance’s Health Care Research-Action Team to discern winnable proposals for action.

 “Many are dazed by the complexity.  We need to simplify presentations of the issues,” she said.  “To create an ideal system is daunting with the many competing interests—insurance companies, technicians, nurses, doctors, hospitals, drug companies, high tech firms, researchers, governments and patients who want more than they can afford.

Karen Hyvonen
Karen Hyvonen

Several years ago, Karen’s pastor at Westminster Congregational United Church of Christ in Spokane urged members to learn about the Spokane Alliance and to see how the church might become more involved.

That led some members into leadership training, a decision by the congregation to become a member and participation of church members in “listening seasons”—small group discussions about their concerns. 

Churches adopt some issues as their goals and forward issues too big for them to influence alone to the alliance, which, with input from other institutions, determines priorities for action.
Health care, sustainable jobs, environment, STA accountability and taxation are issues
alliance research-action teams study in depth to propose actions for members to rally to support.

Karen chose to focus on health care and was the one from the team presenting their proposals at the recent Fall Leadership Rally.

The Health Care Research-Action Team, which formed in 2001, is addressing concerns of member institutions about costs, quality and access. 

Victories include 1) helping pass the Prescription Drug Bulk Purchasing Bill and minimize cuts to funding for the state’s Basic Health Plan; 2) convincing the Spokane Valley City Council to increase its contribution to Project Access for low-income prescription drug benefits from $5,000 to $25,000, and 3) organizing Eastern Washington opposition to Premera’s effort to switch from nonprofit to for-profit status.

In October 2003, Karen joined 150 in the alliance, walking door-to-door in several neighborhoods to connect people with Health for All, part of the Health Improvement Partnership (HIP), which helps match people without health insurance to appropriate coverage.  They visited more than 1,000 households and tripled the number of contacts Health for All normally receives in a week.

The alliance also promotes Project Access, a local effort to connect physicians and hospitals who volunteer their services with patients who meet certain criteria and have no insurance. 

“Initially, we have focused on health care access and prescription drug costs,” she said.

The team learned that employer-based health insurance began after World War II; that the government-sponsored health care debate began in the 1950s, and that the Medicare national health care program for people over 65, began in 1965.

Among the problems the team has recognized are: 1) increased prescription drug and insurance premium costs, 2) 550,000 uninsured in Washington, 3) $19 million in uncompensated care in Spokane County, 4) low Medicare reimbursements in Washington, and 5) political posturing of major players that creates gridlock.

The team also found:
• Rising costs pressure individuals and institutions. 
• Many uninsured are employed, the uninsured drive up costs in the whole system, uncompensated care leads to layoffs and financial stress. 
• Many doctors are refusing to serve Medicare patients.
• Reforms require citizens and consumers to become major players in health care politics.

Statements of national UCC, United Methodist, Catholic and Lutheran churches help motivate. They say health care is a basic right that must be affordable, accessible, available and accountable, and that government has a role in ensuring access.  The U.S. Catholic bishops have called for a national health insurance program as part of the “sanctity of human life” and the dignity for all people, “who are made in the image of God.” Lutherans call members to “faithful moral discernment” related to participation and policymaking in health care services.

Alliance criteria for health care issues are to increase access and affordability, improve equity, have cost-sharing between public and private sectors, minimize bureaucracy, regulations and profiteering; promote consumer responsibility and be “winnable,” Karen summed up.

This fall, member institutions will look at three universal health coverage reform options: tax-financed coverage, market dependent coverage, and a mix of mandated employer contributions and government safety nets.

At the fall rally, the team presented action options related to Project Access expansion, mental health equity and local treatment funding, Premera nonprofit status, reimbursement rates for Medicare, prescription drug purchasing pools, more choice for small business insurance, Basic Health Plan expansion, Care for Kids benefits, risk-pooling to reduce costs, more local medical training programs, reducing barriers to children’s access to Medicaid  and urging Congress to pass a Health Care Access Resolution.

“For the coming year, we hope to do something more cohesive, actions that together move toward positive systemic reform that deals with the big picture,” Karen said.

Karen, the mother of three grown children, sees need for strong national leadership on health care: “The lack of leadership leads to patchwork solutions,” she said.

“Most people in our church understand the need to address issues.  We have a sense of responsibility to care for our neighbors, and see this as integral to caring.
“While many people from church traditions see self interest as a broader concept than what affects one as an individual alone, I think many who are not from church backgrounds have a similar broad understanding of what that means,” Karen said.

Because many churches focus on building community as part of their mission, they may find it natural to share personal, purposeful conversation in various settings—a core piece of alliance life as we identify the passions and values of members,” she said.  “The alliance provides a step beyond a food bank, so people might not need a food bank.

“Involvement has brought energy to our church.  While everyone is a member by virtue of being part of the congregation, 15 have participated in the Leadership Institutes, about 25 attend assemblies, 40 have participated in listening seasons each year and 10 are part of a core team.  Others joined the STA Campaign and green-building initiatives.

Beyond winning issues, Karen appreciates that the alliance’s goal is to help people be more effective in the public arena:  “We work only on issues people agree to act on.  We can work on other issues in other venues using skills learned with the alliance.”

As people who do not know each other become acquainted and talk “about substantive issues out of the values we have as individuals and share as a church, she finds  they experience a fellowship and connection that goes “far beyond the coffee hour after church.”

For information, call 532-1688.

By Mary Stamp, Copyright © October 2004 - The Fig Tree