Pass the Bill, Not the Buck

President Obama and members of the House and Senate are meeting Thursday to see whether health-care reform can make it to the president's desk. The political questions are coming fast and furious: Can Senate Democrats overcome the loss of their 60-vote supermajority to pass a bill? Is budget reconciliation a viable mechanism to merge the House and Senate bills, or will Senate Republicans simply filibuster-by-amendment? How will these processes affect midterm elections?

These questions, while important, tend to obscure the most important question of all: if health-care reform dies, how will the American people survive the status quo?

I am the chief executive officer of an integrated not-for-profit health system that operates six hospitals and a health-insurance plan. We are based in Akron, Ohio, which is a fairly typical American city. When it comes to health care, I'm afraid that our experience is very typical of most cities and towns. As our government meets at Blair House, I thought I'd take a moment to describe what has happened in our community since the health-care debate began a year ago.

Our families have been hurting. Since last January the unemployment rate in Akron has jumped from 8.1 percent to 11.4 percent in the last year. Our local home-foreclosure rate has increased 14 years in a row, with many counties in northeast Ohio experiencing double-digit increases. The number of citizens receiving emergency food assistance has jumped by 28 percent since 2006. Nearly one in three of the hungry are children.

As health professionals, every day we see more people who need care but cannot afford to pay. Ohio's free clinics have seen a 30 percent jump in the number of patients in the past year. At one local clinic, it typically takes three months to fill the slots open each quarter for new appointments. Last January it took three days. This January it took three hours, as people who used to work as volunteers at the clinic signed up to receive care themselves.

Within our own primary-care center, nearly one in three patients has no health insurance. We set a record in 2008 by providing $57.6 million in net uncompensated care, including nearly $23 million in direct charity care. Those numbers climbed by more than $5 million again last year and, so far, we're on pace to shatter that record again in 2010.

The vast majority of the uninsured we see are working families. They either have employers who cannot afford rising premium costs, are self-employed and cannot afford the cost of health care themselves, or cannot find coverage due to preexisting conditions. The economic cost is staggering, but the human cost is beyond any dollar figure: just ask any nurse who has looked into the eyes of a parent, ashamed that he or she cannot provide for family members until they are so sick that the emergency room is the only answer.

We're all trying to do our part to help. At the system level, our hospitals continue to treat everyone, regardless of ability to pay. At a community level, our health professionals volunteer in free clinics, accounting for more than 150,000 hours of personal time last year. At the county level, public-health officials are working with local hospitals to address the root causes of chronic illness. At the state level, legislators are working to stretch depleted tax coffers to keep up with burgeoning Medicaid demand. Unsung heroes at nonprofit, faith-based, and community organizations continue to fill the gaps.

What we really need is for the federal government to do its part, too—to finish the job it started a year ago and pass some form of health-care reform. Is the compromise bill proposed by the Obama administration this week perfect? No. Will everybody be able to find fault with parts of it? Yes. But we are far beyond the point at which our elected officials can allow the perfect to be the enemy of the good.

The truth is, there are parts of the bills that have already passed the House and Senate that would make an enormous difference in the lives of the people who are lining up around the block at free clinics across Akron: subsidies to help working families and businesses afford coverage, the end of discrimination against patients due to preexisting conditions, and steps to keep premiums affordable.

We need our elected officials to do what our physicians do every single day: if you can't diagnose or treat the whole problem, then at least start somewhere. We cannot wait much longer.