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Health Care in America at a Crossroads

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Taken by CW Twin Cities


America is the land of the free, a place of opportunity and a country of more than 28 million uninsured citizens.

Emily has been living without health insurance for a few months. "It's been a little bit scary. Luckily, it's affected me much less than I kind of anticipated it would because of clinics like this." She’ s a patient at the Neighborhood Healthsource, which has been providing primary health care in the Twin Cities for more than 45 years, for those covered by insurance and those who are not. "As an FQHC, we're able to offer our patients who qualify a sliding fee schedule for all of the services we provide which means their faced with only having to pay a percentage of the total cost of their care," explains Steve Knutson, the Executive Director of the community based clinic. He says the percentage is based on a combination of their household size and their income levels.

Healthcare cost in Minnesota has skyrocketing in recent years. In 2016, the state's department of health reported the rate of Minnesotan's without health insurance has reached an all-time low. Today, about 4.3 percent of Minnesota's population is uninsured.

"Minnesotan's want to be able to get the care that they need, when they need it and not have to worry about the bills right away," says Jim Schowalter, president of the Minnesota Council of Health Plans. He says our medical care cost so much because we keep finding new and better ways of technology. "They help us treat things that we couldn't dream of treating before, but they also come at a great cost and we haven't ultimately figured out how to tame that cost or share that cost."

As health care expenses continue to spike, Minnesotan's are spending more on prescription medication and supplies and less on care provided by physicians and in hospitals and more on care provided by other health professionals and in outpatient clinics. "About 19 percent of our medical bills are for hospitals, but 19 percent are for outpatient care. That's a big change from where it use to be. Doctors are still about 25 percent roughly of our total medical spending. That's changed over time in percentage, but it's not like there's less money going there, it's just that there are other things growing faster like prescription drugs."

Obamacare

The Affordable Care Act, known as Obamacare is still the law of the land. Passed in 2009 and implemented in 2014, Obamacare expanded insurance coverage, but did little to tackle inadequacies that are fundamental in American medical practice. Republicans fell short the first time around to repeal the Affordable Care Act, but pulled their efforts for a second try, this time passing the bill and introducing The American Health Care Act. "This is not just about repealing the Affordable Care Act, this is about global health care reform," says Minnesota Congressman Jason Lewis. "We've got to go back to HIPAA, we've got to go back to 1965, the advent of the entitlement state and get a hand on a health care reform that will work overtime. "

This is beyond repeal, this is reform.

The American Health Care Act is projected to raised premiums, increases taxes on the elderly and 23 million Americans may lose their health insurance. Under the new health care bill, Congressman Lewis is hopeful Minnesotan's will see premiums drop, especially for younger, healthier people who have been priced out of the health insurance market. "I'm confident people can buy an insurance plan that fits their needs."


Helping senior immigrants adjust to the U.S. health care system

There are 41 million immigrants from every corner of the world that live in America. Many come to live out their dreams, start anew and create a better life. But coming to America is not as easy as it’s made out to be. A vast majority of immigrants who reside in the United States are at risk for inadequate health care.

That prompted Awol and Abdullahi Sheikh to teach a 6-week course to help East African seniors in their community learn about the importance of taking care of their health as they age.

The course, taught at the Brian Coyle Center, is aimed for seniors in the Cedar Riverside neighborhood who are over the age of 60. Many of the attendees are Somali and Ethiopian immigrants.

In their home countries, seniors were used to walking long distances to buy food. But in the Cedar Riverside community, many live in small apartments, where access to food is readily available. The lack of physical activity is causing the recent immigrants to have chronic health issues like diabetes, high blood pressure and high cholesterol. "In African and Arabian countries, the health [care] is different," says Ahmad, an attendee of the course. "I'm very happy to get this course because I've learned more things that I did not understand before. When you come here, this country has a lot of problems, like stress, the winter, the snow because we [were] born in Africa. And Africa is hot."

Many seniors who come to the U.S. experience cultural shock and stress, which can contribute to health issues. The class aims to help them take on these challenges by working with the health care system. "What we are doing is to make them understand that their condition is part of conditions they can control through food, through walking, through better sleep, through exercise," says Sheikh.

To help the seniors understand the essential of healthcare, the course is taught in their native tongue and has imbedded Qur’an verses explaining the importance of taking care of one’s health. "When we give them the health messages, they keep it in the Quran. They say this is a spiritual message because they are quotes relevant to our health," explains Sheik.

Awol says this course has been immensely healthful for the seniors in their community. "It's just telling them to use their knowledge." Sheik says the main message is that their health is their responsibility. "The medical providers will only support you if you're able to maintain a healthier body through eating, through exercise, through mediation, through walking."


What are American’s seeking in our healthcare system?

In 2010, 48 million American's were uninsured. Although there was a significant drop last year, 28 million are still living without health care.

The Neighborhood Healthsource opens their doors for those with or without health coverage. Steve says, "Patients from all walks of life, patients from all income levels, all nationalities" walk through their doors everyday.

Emily found out about the clinic through her roommate after having a break in her insurance. "There's no way I could afford an ER visit or just like a regular doctor's visit."

Places like here, Central Clinic and Planned Parenthood just have been life saving.

Healthcare in the United States has been through a long and bumpy road over the years, creating a dividing line for many across the country. The revised GOP bill of the Affordable Care Act could leave more than 23 million Americans uninsured by 2026. A recent Gallup Poll found that most Americans, including a majority of Trump supporters want Obamacare to work. Jim Schowalter believes most Minnesotan's approve of Obamacare. "The key element is everyone should have the opportunity to get the care they need. I don't think anybody approves of all the policies and or all the ideas and even most people understand them. But at the end of the day, I think everyone wants to get care. And believes everyone else should too. And think the part it left out or really never addressed, is how to pay for really expensive care that keeps getting more expensive."

The new republican health care bill is projected to save 150 billion dollars over the next 10 years. By doing that, the American Health Care Act aims to eliminate tax penalties for those who don't have health insurance and end taxes on certain high income people, insurers, drug companies and manufacturers of medical devices to finance the existing health law.

For now, the future of the American Health Care Act remains in the hands of the senate. And although republicans are one step closer to abolishing Obamacare, it's likely the new bill will face major revisions in the Senate.


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