Hood River News

By ESTHER K. SMITH
News staff writer
May 6, 2006

“The good news is, there is a lot of attention being focused on covering the uninsured — the bad news is, it’s not a collaborative force.”

That is the state of affairs today regarding the uninsured, Louise Hoy, government relations coordinator for Providence Health Systems, told a roundtable of local health care providers and business, religious and government leaders Thursday morning.

Providence Hood River Memorial Hospital held its third annual “Covering the Uninsured” prayer breakfast at Down Manor, as part of the 2006 National Cover the Uninsured Week Hoy was one of three speakers who examined the problem.

Hoy said that the growing interest in health care reform has led to the initiation of several movements, studies and proposals: the Archimedes Movement, headed by former governor John Kitzhaber; the Citizen’s Healthcare Working Group, by Senators Ron Wyden and Orrin Hatch; Basic Health Care for Every Oregonian, by Gov. Ted Kulongoski, and the Senate Commission on Healthcare Access and Affordability, introduced by Sen. Peter Courtney.

Other efforts toward health care reform include the Health Care Task Force, spearheaded by the Oregon Business Council; and some ballot measures: HOPE for Oregon Families, (Initiative 40); Healthy Oregon Plan, (Initiative 111); and the Family Health and Wellness Act , (Initiative 143).

Tina Castanares, M.D. — who has 25 years’ experience as a family doctor to low-income people, including immigrants, inner-city, rural, end-of-life, and other populations — viewed the problem from the perspective of immigrants, legal or otherwise.

“We don’t fix immigration policy at a patient’s bedside,” she said.

Castanares said that even a 75-year-old widow who had lawfully entered the United States four years ago would not be eligible for Medicaid. There is a five-year waiting period for those who have achieved “qualified alien” status; that is, aliens lawfully admitted for permanent residence under the Immigration and Nationality Act.
The problem, she said, is that there are flaws in our society’s planning.

“We’ve created a health care system that is dependent on insurance,” she said. “But if everyone isn’t ‘in,’ it’s a poor creation.” Most of the immigrants are working, she said, but are working mostly in industries where job-based insurance isn’t available.

She also pointed out that a giant increase is projected in the number of people needing care, but a tiny increase is expected in the care-giving population.

“The U.S. needs a permanent, secure, robust and reliable immigrant workforce for health care, personal care and other work,” she said. “There simply aren’t enough native-born workers.”

Maria Elena Castro is cultural relations manager at Providence Hood River Memorial Hospital. She said that while the hospital spent $3 million in charity care last year, there are many people who can’t get to the hospital for help.

Last year, the hospital board and administration decided to take initial health services to the people through the use of a medical van and a resource center. Castro is project manager for the new Medical Mobile Unit.

“The mobile clinic system will provide quality health care services to the most vulnerable people in our community: the uninsured and underserved Hood River County residents,” she said.

Providence hopes to have the 35-foot recreational vehicle — nicknamed “Van-derella” — transformed into a mobile clinic by September. The main goal of the unit and resource center will be to promote prevention, Castro said.

“The bottom line is: This project is not the solution,” she said. “It’s part of the solution.