By Dale Quinney
Health care in Alabama faces uncertain and challenging times. Our health care system consists of many operating parts vital to the smooth operation of the entire system. This system is like the human body. If one or more parts are not operating properly, the entire system can be impaired or even threatened.
There continues to be debate over the effectiveness of the Affordable Care Act (or Obama Care) and the impact of changes to this program. While this program has resulted in more people having health insurance, it has also resulted in more people being underinsured because of the high deductible amounts that apply to this coverage. It must be expected that the eventual solution will be viewed as positive in many ways and negative in many ways.
One thing is certain: This issue will not be the last that our health care system will face. The health care needs of Alabama today are different from those in the past and will be different from those in the future.
The scrutiny of health care access that this issue is creating provides an opportunity to look for better ways to provide and receive health care. Rural Alabama is experiencing chronic shortages in health care access. Our goal is to keep the doors of hospitals and clinics open tomorrow. We are so involved in survival that we have not developed a long-term plan.
Our health care industry is subject to the laws of supply and demand. We tend to concentrate on the supply side. To meet the needs of health care today, we must keep our hospitals and clinics open and attract more health care providers to practice where the needs are greatest. Alabama has seven rural counties with no hospital. The majority of our rural hospitals are operating at a loss with many facing threats of closing. Only two of Alabama’s rural counties (Pike and Coffee) are considered to have the minimal primary care practitioner service needed.
What about the other side of the supply-demand issue? What can be done to decrease the demand for health care over the long-term? An obvious answer is that prevention must be given greater emphasis. A second strategy should be the promotion of a better educated population. There is a strong relationship between education, income, and health status. Better education results in a potential to earn a higher income and practice better health behavior.
This relationship exists for diverse causes of death. For all causes, the death rate for those with less than a 9th grade education is more than twice the rate for those with a high school education. Those with a high school education have a death rate more than twice that for those with any college.
Having a better educated population should be a long-term health care strategy!
Dale Quinney is executive director of the Alabama Rural Health Association, 1414 Elba Highway, Troy, 36081.