Thursday, September 03, 2009
Editorial: Addressing health at the grass roots
A health care authority in Virginia's coalfields has a from-the-ground-up plan that might serve as a model. National reform would help.
From the RoundTable blog
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Appalachia is among the hard-pressed parts of America where the failures of the nation's health care system are an everyday fact of life. So people haven't just been waiting around for Congress to deliver reform. Ultimately, though, success is likely to depend on its doing so.
This week, the 3-year-old Southwest Virginia Health Care Authority released a strategic plan, "Blueprint for Health Improvement and Health-Enabled Prosperity." It is meant to address gaping health disparities that, in two planning districts in Virginia's far Southwest, translate into a premature death rate 26 percent higher than the state's as a whole, a picture of poor health the region desperately needs to improve.
As the plan notes, greater educational and business opportunities and a healthier population are interconnected, each a necessary part of a whole strategy to improve people's lives in a naturally beautiful, culturally rich, yet chronically depressed region of the nation.
The local leaders who drew up the plan hope it will be a model for all of Appalachia. But the blueprint deals specifically with the Cumberland Plateau and Lenowisco planning districts in Virginia's coalfields. Lenowisco encompasses Lee County, the city of Norton, and Wise and Scott counties.
Together, the seven counties and city make for a grim microcosm of a region: significantly poorer and less educated, with a lower percentage of working population than in Virginia overall and a high percentage of people without health insurance.
The authority was given considerable power when the General Assembly created it three years ago -- to receive appropriations, issue bonds, invoke eminent domain and more. Enough to effect real change.
Under the chairmanship of Del. Bud Phillips, D-Dickenson County, it has laid out a blueprint of solid goals -- pages of them -- to build an infrastructure both to deal with acute health needs and create good jobs.
Some, such as plans for a dental clinic in Wise County, are near-term objectives well on their way to being met. Other goals are further off: to build a dental school, for example, and a training center for medical specialists, identified as intermediate goals seen as three to nine years away.
Not all of the objectives deal with bricks and mortar. Among the plan's soft targets are strategies to improve health literacy, encourage physical activity and combat substance abuse.
With enough state and local effort, the authority can facilitate success in all these areas.
Others would seem to depend on larger forces: payment parity for primary care providers; higher enrollment levels in FAMIS, Virginia's State Children's Health Insurance Program; better access to and portability of patient health information.
The authority has made a good start toward building a model public-private health care system for Appalachia. It needs comprehensive reform to go the distance -- as does all of Virginia, and the nation.
