It’s about inequality
How to spend less on health care and obtain healthier communities
A carpenter can be a health-care worker. So can a bus driver or a teacher. Even a banker. This was my takeaway from a Safety Net Learning Institute seminar last month, sponsored by the Sierra Health Foundation.
Fixing our safety net so that our citizens have food to eat, receive necessary health treatment and have shelter is important work. And there is limited funding for these goals. The purpose of this seminar was to bring together government agencies, financial institutions and health organizations to have a discussion on how to get the biggest bang for limited dollars.
What do we need?
First, we need more community health clinics, which can provide more efficient and less expensive medical care. If set up correctly, community health clinics receive higher federal Medi-Cal reimbursement rates, making it feasible to treat low-income patients. This is crucial because more people have Medi-Cal now, due to the Affordable Care Act, but there are not enough health providers who are willing to accept Medi-Cal patients.
Secondly, we need more supportive housing with on-site health services. This has been very effective, both at keeping mentally ill people off the streets and reducing costs. It is cheaper and more humane to provide supportive housing than to pay for emergency-room visits, hospital stays and jail time.
Citing health-care data, seminar speakers pointed out that ending poverty is key to improving health care. Horrible housing, inadequate food, polluted air and water, and lack of jobs—these problems are correlated with health problems and early death.
And, by far the best solution for diabetes, asthma, obesity, mental illness and hundreds of other diseases is simply to avoid being poor.
In fact, paying carpenters to build safe, affordable housing may do more to improve health outcomes than hiring more doctors. More farmers growing fruits and vegetables may improve health statistics more than nurses.
It makes sense. But how do we end poverty? How do we establish a real safety net? It seems overwhelming. But it is important to remember our country’s wealth. It is important to remember that European countries are doing it. It’s all about priorities. They spend more of their resources on housing and food, and less on health-care expenses.
It is possible. And our country clearly has the resources. The problem is that the top 1 percent of our population receives too many of those resources. But we can change that. Just as we changed our tax laws to give the rich more, we can change them back. We can stop corporations from avoiding their fair share of taxes by canceling offshore tax loopholes. We can end energy-company tax breaks. We can increase the minimum wage. We can have hedge fund operators pay the regular tax rate instead of the lower capital-gains rate.
So, our discussion of health care led us to an examination of poverty, which then led us to a root cause: income inequality. We can fix this.