Outreach workers: the most important people in health reform
June 25, 2009 - 9:46am - admin
Below is the excerpt of Chip Joffe-Halpern's 2009 Outreach Summit presentation given on June 11th at the Hoagland Pincus Conference Center in Shrewsbury, MA.
...I started Ecu-Health Care 14 years ago in 1995. I was previously a clinical social worker, but I wanted to move into administration. I knew little about the uninsured, but thought, heck, this would probably be a good thing to do for the community and I would hang onto the job for a couple of years until I figured what to do with the rest of my life.
So we started the Ecu-Health Care program and truthfully, for the first few months I was bored, I missed the intimacy and intensity of clinical social work, and pushing papers wasn’t exactly exciting. But then I started to so something important that social workers are supposed to do—I started to actually listen to the stories that uninsured individuals in our community were telling me; they included the following—and I’m sure many of these will sound familiar to you:
- … I interviewed a 25 year old woman at the hospital who had developed escalating back pains, she delayed going to the emergency room, because, she explained she was the kind of person who "likes paying her bills." Finally a family member convinced her to go to the emergency room where it was discovered she had developed blood clots in her lungs.
- I had interviewed a North Adams mother who shared with me: “Whenever my son hurts himself I feel around to see if he may have broken anything. I kind of guess and hope I’m right, because you see, we can't afford to take him to the doctors."
- I interviewed a 63-year old woman with colon cancer. After recent surgery, she learned that she had exhausted the limits of her health insurance policy for the year. She explained to me: "the diagnosis of no insurance was more terrifying than the diagnosis of colon cancer."
- ... I interviewed an uninsured woman in her 40s who explained that whenever she gets sick, because she couldn't afford to see a doctor, and despite not having any medical background, she diagnosed herself. If she thought she needed antibiotics, she goes to a feed and grain store and purchases antibiotics produced for animals; they are inexpensive and she could get them without a doctor's prescription. She shared that she knows others who do the same.
Besides not having health insurance, all of these individuals had one other thing in common; they had all been eligible for either Free Care or MassHealth but none of them knew it, nor did they know how to go about enrolling. And because of they didn't know, they denied themselves care and put themselves at medical risk. ...
Now, why didn't these people have health coverage if these programs already existed? Nationwide studies reveal, that in the US there are three major reasons why uninsured individuals don't access needed health benefits: lack of awareness a program exists, lack of belief that they are eligible for a program, and the difficulty of navigating the application process. ...
Click here for the
full text of the speech in PDF format.
Chip Joffe-Halpern is the Executive Director of Ecu-Health Care, a health care access organization located in North Adams. He is the President of the Board of Directors of Health Care For All, and was an original member of the Board of Directors of the Commonwealth Health Insurance Connector, where he served as chairman of the outreach and enrollment committee.
become a better outreach worker in the community.
Hello My is Renita Simpson
I have been worker with an Home Base org now for three months now.
I am ready to move on to a different place.
I have acheive 36 liberal art credis for college of new rochelle.
I'm now doing the second part of my ged in language art writing and in math.
I feel that i can give more of my out reach work to an different org.
Please e-mail me back in why i feel i do not want to stay where i work at now.
You're very "brave"...
"Jarrett,"
Activists love to cast things in black and white terms. I.e., corporations are evil and the people who take their money only use it to perpetuate inefficiency and preserve the interests of corporations. Activists present things this way to tap into people's anxieties and motivate them to action quickly. And activists have done amazing things in this country.
But if you're as smart as you imply, then you know that the on-the-ground reality isn't nearly as black and white as you're presenting here. Incremental change isn't a myth, and in the mean time outreach workers are dealing with real people who have problems right *now*. Outreach workers advocate for and help people who have no insurance, whose kids need coverage and a doctor and meds TODAY. Community outreach--even if funded by insurance money--may be a convenient scapegoat, but it's not the real villain. In fact, part of your trouble might be that there isn't one easy-to-blame, clear villain. This broken system is extremely complex, woven into the fabric of our culture, and will need a complex solution.
P.S. It's easy to be "brave" when you post anonymously on the Internet using false contact information!
Speaking of bravery
Bravery can and does take many forms. At times, anonymous action can be a smart and brave course of action. Decades long efforts to speak truth to power and challenge our perverted healthcare system is an act of bravery, especially when so few are willing to do it-- whether it be named or anonymously.
Silence in the face of injustice is actually an act of furthering that injustice, whether you want to face up to that or not as you year after year take Blue Cross and Blue Shield and other insurance co. money to pay your salaries. This is not a "black and white issue". It is a fact. Let's agree not to confuse the issue with charged slogans that distract from substance. Hush money is hush money.
The current dysfunctional health care "system" allows personal and corporate profit-making to take precedence over the well-being of people. This causes immeasurable amounts of suffering and early death, often after financial ruin. This is fact.
We who understand these complex and "no easy solution" issues, as do CP and other outreach workers, have an ethical responsibility to not only attend to immediate unmet needs--this sadly amounts to sticking our fingers in the dike and yes, it does help some people for some limited amounts of time, but simultaneously many others are being washed away--and we are equally obligated to speak truth to power as part of unyielding efforts to fundamentally improve the health care system and displace those who are abusing power at the expense of others' well-being.
I have no problem looking in the mirror, so to speak. (Nor in my bank account, either...)
What about you?
I think one of the reasons
I think one of the reasons health care reform is such a contentious issue among people who may share many values is because it tends to draw battle lines between people who are working within existing systems (helping individual clients, advocating for expansions of programs, etc.) and people who want to build new systems (such as single-payer health care). Though I'm writing from home, I'm on the staff at CP and one of the things I like about working there is that I get to talk with people coming from both those perspectives and more.
Your comment reminds me of how tricky this feels sometimes. I think it points to a debate and a tension that has much larger implications for how social change happens or should happen. It would be hard to argue against incremental change to someone who's up for an emergency appendectomy thanks to their Commonwealth Care coverage (which would be disrupted if the current system were abolished). And it's hard to argue against radical change to someone who couldn't possibly afford health insurance and can't get the care they need (or is tearing their hair out at the maddening confusion of it all). And when you look into the future, and try to imagine how long a system can sustain itself...
I imagine many people who would like to see a radically different system are living in that tension. I think this is a different thing than "hush money." I'm not being paid off.
Let's not lose sight of one of Chip's central points: that people didn't even know they could get health care until they talked to an outreach worker. Whatever health care system we have, we need outreach workers to help guide us through it. And I do think that we need smart & brave outreach workers to be involved in reforming/shaping any health care system we would expect to work.
Maybe you should ask how to get insurance co. donations
Chip knows all about taking money from Blue Cross and Blue Shield (BCBS MA) and other insurance corporations. You know BCBS MA--they're the insurance co that's a "Non-Profit" that paid their CEO over $19Mil in a Golden Parachute after the MA mandatory insurance law was passed in 2006. Sweet reward for getting a law enacted by the state forcing residents to buy your product. And for forcing taxpayers to pay through the nose for private insurance subsidies with ABSOLUTELY NO cost controls. Way to go. Here's your reward.
BCBS MA now pays their current CEO over $3Mil a year.
Seriously, now. Nothing's going to change in a positive direction within our broken healthcare system while the so-called "advocates" are relying on health insurance co. grants and "donations" aka hush money. Outreach workers are mostly just sticking their fingers in the dike under this approach. Come on, Outreach Workers--including Community Partners--you're smarter and braver than this.
Aren't you??
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