Health Delivery Inc. Shows a Link to National Reform

Health Delivery Inc. is a federally supported provider of medical and dental services that supports more than 55,000 patients across 14 counties in mid-Michigan.

An unemployed or low-income person can schedule a doctor appointment for as little as $20, or obtain even the most costly prescription for as little as $4.

A brochure proclaims: “Health Delivery Inc. provides many services to everyone in the community so no one goes without quality medical services. .... Health Delivery’s experts are committed to providing the highest quality of care in an atmosphere that nurtures healing and growth.”

And so why the need for national health care, when we have sources such as Health Delivery? What’s all the fuss about so-called Obamacare, and the symbolic vote to repeal that took place with the Republican takeover of the U.S. House of Representatives?

Jim Hayden, Health Delivery’s chief of staff and a veteran of nearly 50 years in the profession, explains that while Health Delivery serves an important function, it is merely a “medical home” that promotes prevention and early detection.

This means that if a doctor discovers a risk factor such as high blood pressure or Type 2 diabetes, Health Delivery can arrange ongoing checkups and affordable medicine.

But if a doctor diagnoses cancer in a long-neglected patient, for example, although Health Delivery strives to work with regional hospitals, funds are not available for surgery or treatment.

This is where Hayden says Obamacare comes into play, with first-time coverage for 32 million Americans and improved insurance for millions more.

Answering the Myths
     
Hayden says he bristles in response to criticism based on what he describes as false perceptions:

• “Death panels” do not restrict freedom of choice. This provision simply involves seeking a doctor’s advice regarding terminal conditions.
• “Rationing” basically is a question of doctors prescribing appropriate medicine and treatment for a patient’s specific condition. Rationing does not restrict the amount of care or the amount of medicine for anyone.
• “Socialized medicine” is a misnomer. Even if Obama wanted universal care, he couldn’t come close to gaining the votes in Congress. He wasn’t even able to pass a public option. Obamacare sticks with the private sector, in fact too much for the likes of Hayden, although he says he recognizes the political realities that required Obama to compromise.

Health Delivery operates on a $27 million budget. Some $24.1 million is from payment by patients and their insurance carriers, including Medicare and Medicaid. The remaining $2.9 million is from federal grants.

About one-third of patients are uninsured. Another half qualify for Medicaid or Medicare. The remainder have private insurers or are self-paying.

Hayden says expansion of clinics could play a key role in health care reform.

Basics such as calling people with appointment reminders are important, he says. Low-income people who have gone for years without so much as a doctor appointment often are fearful of what a check-up may uncover, he notes, and they may resist the medical system even when help and support are made available.

Debate over Obamacare’s budgetary impact continues to rage, with supporters and foes picking their own numbers, even choosing selectively from reports by the neutral Congressional Budget Office. Supporters say the federal deficit will shrink, while foes insist the debt will skyrocket.

Regardless, Hayden says private sector savings should occur by reducing uncompensated visits to emergency rooms by poor people and the uninsured. Despite millions of bankruptcies caused by hospital billings, hospitals rarely collect. The cost of uncompensated emergency care is transferred to regular hospital billings. In other words, everybody ultimately pays the cost. This drives up insurance rates and co-pays, costing an average household in the range of $1,000 to cover the costs of people who don’t (or cannot) pay. If emergency costs are reduced by adding coverage for 32 million Americans, says Hayden, the question is whether insurance companies and hospitals will share the savings with ratepayers and patients.

Another key way to reduce health care cost inflation, says Hayden, would be to end a fee-for-service system that encourages providers to accept as many patients as possible, leading to those notorious five-minute doctor appointments.

Hayden says Health Delivery avoids this quagmire by limiting patient visits for each doctor on staff, and that the government instead could adopt a performance-based system for providers based on patient outcomes.

“The medical community has many different methods to measure performance,” he explains.

Health Delivery’s Roots
     
Lyndon Johnson is rightfully credited with establishing Medicare and Medicaid, which both were described as “socialized medicine” by opponents back in 1965. But the spark for clinics operated by sources such as Health Delivery came not only from Johnson, but from the supposed conservative who followed him into office, Richard Nixon.

California was Nixon’s home state, and Hayden notes and this was the venue where the Kaiser Permanente health maintenance organization took root. This approach was considered revolutionary at the time, and Hayden perceives that the impact caused Nixon to adopt “some fairly progressive views” regarding government’s role in health care.

Nixon first applied the concept to migrant health care. Mid-Michigan was home to hundreds of seasonal migrant workers. Hayden was employed at the Saginaw County Department of Public Health, and he was placed in charge of the first $75,000 migrant grant, which arrived in 1969.

Hayden strived to find Spanish-speaking staff members. Among his recruits was Dave Gamez, at the time a registered nurse at what was then Saginaw General Hospital. Gamez showed strong organizing skills in setting up the migrant clinics, and Hayden eventually promoted him.

Meanwhile, Gamez worked to achieve a graduate degree in public health administration from Central Michigan University. This provided his qualifications to eventually take Health Delivery’s reins, where he has worked with public officials to gradually build a widespread net for clinics across the region.

Medical clinics offer family practice, prescriptions, family planning, immunizations, x-rays, mammograms, emergency/acute care and other services. Dental clinics provide full services. For all facilities, free transportation is offered.
     
Here’s a listing:

• Bayside Health Center and Dental Center, 3884 Monitor Road, 671-2000.
• Bridgeport Community Health Center, 6297 Dixie Highway,759-6460.
• David R. Gamez Community Health Center, 501 Lapeer, Saginaw, 753-6000.
• Janes Street Academic Community Health Center/OB Services/Pharmacy, 1522 Janes, Saginaw, 755-0316.
• Roosevelt S. Ruffin Community Health Center, 229 Gallagher, Saginaw, 755-3619.
• Saginaw High School School-Based Health Center, 3100 Webber, 399-6120.
• Shiawassee Community Health Center, 729-4848.
• Smiles Are Everywhere Community Dental Program, Saginaw, 759-6432.
• Wadsworth Dental Center, 2308 Wadsworth, Saginaw, 754-7771.  

Health Delivery also operates seasonal migrant health sites; the HDI Express Care walk-in facility in Saginaw, 755-0316; HDI OB/GYN & Midwifery Services in Bay City, 667-3377; and the Hearth Home in Saginaw for people living with HIV/AIDS, 753-9011.

(Recommended reading: “The Healing of America,” by T.R. Reid; “Deadly Spin,” by Wendell Potter. Check your local public library for availabiliy.)