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Expanding health insurance coverage important for all Virginians / March 20, 2014
The inability of so many of our fellow citizens to access basic health insurance coverage represents a public health crisis that is undermining the well-being and security of the most vulnerable in our community.

As a cardiologist in the Halifax Regional Health System, I, along with all of my colleagues, am on the front lines of this crisis every day. Through no fault of their own and due to economic circumstances often out of their control, hundreds of thousands of Virginians do not have health insurance coverage. In rural communities like Halifax County where as many as 40% of our adult population is uninsured, this crisis has reached catastrophic proportions.

For those of us who are fortunate enough to have health insurance coverage, it may be difficult to relate to the daily lives of those who are not. But the truth is the uninsured are a valuable part of our community. The vast majority of people who are uninsured work hard – sometimes holding down two or three jobs in order to make ends meet – and they contribute in many important ways to our society. They are the farmers who grow our food, the restaurant employees who serve our meals, the caretakers who tend to the elderly, and the sanitation workers who help keep our communities clean.

For these hardworking Virginians, the current social safety net of universal access to emergency room care is not working. Uninsured patients who suffer from chronic illnesses such as heart disease, diabetes or cancer are not receiving the long-term preventive care they desperately need. Too often, they are forced to resort to the emergency room only when their conditions reach a dangerously critical stage. This approach severely limits the ability of our medical professionals to effectively treat these patients, and it adds exorbitant, unnecessary costs to our healthcare system.

Halifax Regional Hospital and hospitals across Virginia strive to provide their uninsured patients with compassionate care. Our hospitals donate hundreds of millions of dollars every year in charitable care for the uninsured. Our dedicated medical professionals do the best they can with the tools and resources they have, but there are limits to what they can accomplish with emergency room care alone.

Emergency room care is simply not capable of providing the coordinated, preventive treatment that is essential for achieving positive health outcomes over the long term. The emergency room is set up to treat patients with acute conditions requiring immediate, but short-term attention. It is not designed to treat serious chronic illnesses like cancer, diabetes, hypertension, chronic heart disease, and obesity. In addition to long term treatment and drug therapy, these conditions require preventive measures such as routine check-ups and monitoring by a primary care physician or specialist, as well as wellness programs promoting a healthy diet, exercise, and weight control. This approach is by far a more effective and cost-efficient way to treat our patients. But without health insurance coverage, our uninsured patients are unable to access this type of comprehensive care.

Our current system carries tremendous implications not just for the uninsured, but also for our entire healthcare system, as well as our society as a whole. Emergency room care and subsequent hospitalizations are extremely expensive, and hospitals and other care providers are forced to absorb some of that cost. Ultimately, this puts a strain on our resources and hinders our ability to meet the needs of our other patients. In addition, the community absorbs a significant amount of these costs – privately insured patients pay higher premiums and out-of-pocket costs, and businesses that provide coverage to their employees see their expenses rise, which limits their ability to grow and invest in the economy.

It is imperative for the Virginia General Assembly to address this healthcare crisis by expanding access to health insurance for all Virginians. Some lawmakers have proposed using federal dollars to expand eligibility for our state’s Medicaid program. Others, concerned about the growing cost of Medicaid, have proposed using those same federaldollars to create a more cost-effective “private option” that would offer private coverage to the uninsured. Either way, it should be a priority for the General Assembly to ensure that all Virginians are adequately covered.

It is time to stop wasting precious resources on ineffective healthcare when we can achieve better outcomes with far fewer dollars by providing insurance to all Virginians. Doing so will improve the health of everyone in our community and make wiser use of our healthcare dollars.

Dr. Bassil is a board certified cardiologist in South Boston, Virginia and serves as Director of Cardiology at Halifax Regional Hospital. He is a Consulting Associate in Cardiology at Duke University Medical Center. Dr. Bassil also serves as a member of the Halifax Regional Health System Board of Directors.

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