AAFP chapters join grass-roots effort to cover the nation's uninsured -- March 2003 -- FP Report

March 2003 • Volume 9 • Number 3

AAFP chapters join grass-roots effort to cover the nation's uninsured

BY CINDY McCANSE

A little more than a year ago, the Robert Wood Johnson Foundation and an unlikely coalition of business and health organizations launched an unprecedented national advertising campaign highlighting the plight of America's uninsured.

The coalition includes such diverse groups as the American Federation of Labor-Congress of Industrial Organizations and AARP, Families USA and Commonwealth Fund -- and the AAFP. By signing onto the Covering the Uninsured initiative, each member signaled its dissatisfaction with the status quo. Go to http://www.coveringtheuninsured.org for more information on the coalition and its objectives.

"When you're uninsured, life turns out differently," the initiative's ads declare, offering an unabashed look at how health insurance coverage can literally mean the difference between life and death. A young girl in danger of losing her mother to cancer, a young boy whose father's life is threatened by heart disease. The images are evocative, bringing viewers face to face with the grim reality confronting more than 41 million U.S. residents -- eight out of 10 of them members of working families.

Last September, the coalition (now numbering more than 100 regional and national members) announced another first: a weeklong series of nationwide activities designed to draw yet more attention to the crisis.

Cover the Uninsured Week kicks off March 10 with an event in Washington and continues through March 16. Activities scheduled during the week include town hall meetings in cities across the country; educational forums at schools of medicine, nursing and dentistry; health fairs; presentations to business and labor leaders; and discussions with spiritual leaders of all faiths. The effort is being co-chaired by former presidents Gerald Ford and Jimmy Carter.

One goal of Cover the Uninsured Week is to raise public awareness of the dilemma faced by those whose lack of health coverage leaves them without a regular source of health care. Data from the 2001 U.S. Census Bureau report tell the story:

Uninsured women who contract breast cancer are twice as likely as insured women to die from the disease.
Uninsured men are nearly twice as likely to be diagnosed at a later, less treatable, stage of colon cancer as are insured men.
Uninsured children who need medical or surgical care are four times more likely to go without that care than are children covered by insurance.

Several Academy chapters are slated to participate in Cover the Uninsured Week. For Kim Bullock, M.D., president of the District of Columbia AFP, participation will mean highlighting some of the results of another RWJ initiative specifically aimed at identifying health disparities that exist largely because of differences in access to health care across ethnic and cultural lines.

"I'm going to be working with Minority Health Communications. They are involved in a Robert Wood Johnson grant to look at health disparities -- specifically, four health indicators -- across all 50 states and the District of Columbia," said Bullock.

Minority Health Communications was the driving force behind the establishment of National Minority Health Month in April 2001.

Academy continues to champion health coverage for all

The AAFP's participation in Cover the Uninsured Week as well as its continuing efforts to bring the message of health care coverage for all to the U.S. Congress were touted in a Feb. 3 American Medical News opinion column by J. Edward Hill, M.D., of Tupelo, Miss. Hill, a family physician, is chair of the AMA Board of Trustees.

Go to http://www.ama-assn.org/sci-pubs/amnews/amn_03/edca0203.htm to read Hill's article, which discusses a resolution passed by the AMA House of Delegates at its interim meeting last June. That resolution, which the Academy took the lead in developing, calls for the AMA to advocate a bipartisan congressional resolution to achieve health care coverage through a pluralistic system for all persons in the United States by Jan. 1, 2009.

Visit http://www.aafp.org/fpr/20030200/14.html to read more about AAFP's role in passing the AMA resolution. To read AAFP's proposal, "Assuring Health Care Coverage for All," visit http://www.aafp.org/unicov.xml.

"Here (in Washington), they've developed a detailed mapping of all the wards in the district that showed some interesting disparities in infant mortality and in the rates of cancer, HIV infection and cardiovascular disease," Bullock explained. "What I'm hoping to do is use that as a springboard for presentation during that (Covering the Uninsured) week."

In Chicago, members of the Illinois AFP will be on hand at a health fair scheduled for March 12 on the campus of Truman College. There and at satellite fairs to be held at other clinic locations around the city, physicians and other health professionals will be providing a wide range of services.

Screenings offered will include cholesterol tests, glucose screens, eye exams, blood pressure measurements and bone density tests. Community members attending can also update their vaccination profiles and receive educational materials about health promotion and disease prevention.

Syed Ahmed, M.D., associate professor in the Department of Family and Community Medicine, Center for Healthy Communities, at the Medical College of Wisconsin, Milwaukee, has seen the problem of being uninsured from both sides. His story appears on the coalition's Web site at http://coveringtheuninsured.org. Click on "Personal Stories" for a list of persons who have shared their experiences.

As a graduate student "barely scraping by" nearly two decades ago in Houston, Ahmed was injured in a car accident. Lying bleeding in the middle of the road listening to the ambulances coming closer, he said all he could think about was how he was going to pay the emergency room bill.

Ahmed now serves as director of Reach Out of Montgomery County, Ohio, where a network of volunteer physicians, nurses and others provide free health care two nights a week to people without health insurance. Nearly all of them, he said, are working poor who either are not offered health coverage through their jobs or, if they are offered insurance, don't make enough to afford the premiums.

"We are the richest country in the world, and we have a brilliant, technically advanced health care system. But if it doesn't reach all of our citizens, what good does it do?" Ahmed said. "Everyone in this country should have health insurance and access to affordable health care. I remember that feeling of helpless- ness when I needed treatment and I knew I couldn't pay for it. It breaks my heart to see my patients struggling with those feelings every week at our clinics.

"As a family doctor, I know ignoring an illness never cures one. And I know ignoring the uninsured issue will never cure it."

To reach writer Cindy McCanse, e-mail cmccanse@aafp.org.

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