Op-ed
For low income Islanders, health care obstacles remain
By Sarah Kuh - August 2, 2007
As director of the county's Vineyard Health Care Access program, I feel compelled to comment on Michael Moore's new documentary, SiCKO. Thoughtful viewers of Mr. Moore's films will likely agree that it is best to take his sweeping generalizations with a grain or teaspoon of salt, whether or not one embraces his central messages. In this movie, Mr. Moore lambastes the U.S. health care system - or, perhaps more accurately, as others have characterized it, our "disease care" system. He focuses on health insurance companies and their skewed incentives against providing essential care to insured patients. I left the film feeling disheartened about our values as a country, especially compared to those nations that choose to provide health coverage to all of their citizens, although I doubt they are as flawless as presented by Mr. Moore. I suppose that is how I was meant to feel, and I am nothing if not a member of the choir to which Mr. Moore is preaching - a bleeding heart liberal (and then some) who believes unashamedly that health care is a right and not a privilege. This position is supported, albeit in an incremental and imperfect way, by our state's progressive approach to providing health coverage to its residents.
Massachusetts now leads the U.S. in efforts to provide coverage to most residents. The 2006 health care reform law created new forms of affordable coverage for lower income, uninsured people. The intent of the law is to distribute responsibility for coverage evenly among individuals, employers and government, while leaving the private insurance system intact. The Vineyard Health Care Access Program ("the Access Program") has been actively engaged in outreach and enrollment activities for these new programs. Since October 2006, we have assisted more than 600 Islanders to qualify for the new affordable insurance plans. Most of these 600 people were previously uninsured and had the usual difficulties getting the care they needed to maintain their health. Although certain glaring problems remain, such as access to affordable oral health care, in general our Commonwealth has implemented a generous approach to health care services for vulnerable residents. On balance, we can be proud of our successes in covering the uninsured.
On the Island, we have a reasonably robust safety net given that we are an isolated, rural community. Our hospital covers emergency care and certain other services to qualified residents under the Free Care program. Island Health Care provides primary and urgent care to low-income uninsured patients. The Island Counseling Center offers affordable mental health services. Members of the Wampanoag tribe have access to care via tribal health services. Affordable women's health care is available at Family Planning of M.V. Many providers, both traditional and alternative, have made arrangements for lower income, self-pay patients to help them out. Several have joined one of the Access Program's discounted care programs, which include the reduced fee plan for primary and alternative care, the dental access program, and the specialty network for the uninsured.
However, our safety net, like the rest of the U.S., is not without its gaps. One of the issues that we all grapple with, if we are assisting the most vulnerable members of our community, is that of prescription medication. Because of this, we established the David Kurth Memorial Fund, in honor of David Kurth, a native Vineyarder who was born and raised in Chilmark. He did not have health insurance. In the summer of 2000, David got very ill with flu-like symptoms. He was so concerned about having a bill for medical care that he waited to recover from his illness rather than seeking care. When he finally went to the emergency room, he was so ill that he was airlifted to Boston. He died shortly afterwards of tularemia, at the age of 43. His death could have been prevented if he had received care sooner.
The fund is used for low-income uninsured Islanders who need emergency financial assistance for prescription medication, medical supplies and transportation to medical facilities. Since 2004, the Access Program has distributed more than $40,000 in emergency assistance to more than 500 needy Island residents. In 2006 alone, we helped fill 450 prescriptions and provided $18,000 in financial assistance. Funding is contributed from many sources, including individual donors and Island businesses, and local funding sources such as the Rotary Club of Martha's Vineyard. If you agree with Michael Moore that something should be done, and you want to make a difference right here and right now, please contribute by sending a donation to the Vineyard Health Care Access Program, P.O. Box 1298, West Tisbury, MA, 02575. It's a lot easier than moving to Canada, and nowhere near as cold.
