Homegrown health care.

Byline: The Register-Guard

It's good news when a big problem gets a bit smaller, and even better news when the improvement results from an innovative, locally devised strategy. In that context, the fact that this year's United Way of Lane County community needs survey recorded a nine percent drop since 2004 in the number of Lane County households that struggle to pay for doctor and dentist visits represents a victory worth noting.

Also worth noting is that the improvement followed the formation of 100 Percent Access, a coalition of health insurers, health care professionals, social service agencies, employers and educators whose goal is to find collaborative ways to provide health care for the estimated 62,000 Lane County residents who have no health insurance.

Lack of money for doctor and dentist visits remains the No. 1 problem for about 26 percent of Lane County households, but that's down from 35 percent in the 2004 Community Needs and Assets Study. The inability to pay for medical insurance continued to be the No. 2 problem, with 25 percent of respondents stating it was an issue for their family this year. About 32 percent of respondents reported the problem in 2004.

Some of the improvement is undoubtedly tied to a rebounding economy and new programs that provide easier access to prescription drugs, but the coalition shares more than a little credit for moving the numbers in the right direction. Under the umbrella of United Way, 100 Percent Access uses a combination of communication, cooperation and creative problem-solving to match local health care resources with individual needs.

The genius behind the success of 100 Percent Access is the realization that it doesn't take a genius to come up with better ways to serve the needs of uninsured people. What's needed, most of all, is a broad-based commitment from local health care providers and others to work together to align resources, recruit volunteers and stay in constant communication so gaps can be filled as soon as they are discovered.

It's relentlessly hard work, as every one of the area's safety net clinic directors will testify. Matching the types of charity care available from local health professionals to the needs of patients is a gigantic and often frustrating administrative task. Donated drugs and clinical services don't just drop out of the sky. They exist on the other side of mountains of paperwork.

But the reward - in addition to helping some of the community's most vulnerable residents - has been tremendous enhancement of the interaction among health care providers.

As coalition partners, the primary care clinics that serve uninsured and low-income patients - White Bird Clinic, RiverStone Clinic, Volunteers in Medicine and Safe and Sound Homeless Clinic - now share information and provide referrals with greater understanding of each clinic's role in the safety net.

The collaboration has helped to focus outreach efforts on helping uninsured people manage chronic illnesses and obtain free or low-cost medications. This gives people with chronic illness the medical and educational tools they need to avoid a crisis that would typically force them to seek treatment at a hospital emergency room.

Multiple benefits issue from this approach. When people don't have health insurance or the ability to pay for medical care out of pocket, they head for the emergency room. This illogical mismatch of patients least able to pay with the most expensive form of health care is one of the key drivers of spiraling costs.

Unfortunately, health care costs and the ranks of the uninsured continue to climb. A survey released last week by the Kaiser Family Foundation and Health Research and Educational Trust reported that employer-sponsored health insurance premiums increased by an average of 6.1 percent in 2007. That's less than the 7.7 percent increase in 2006 but more than the 3.7 percent rise in employee wages and the inflation rate of 2.6 percent. This follows data from the U.S. Census Bureau documenting a 5 percent increase in the number of people without health insurance.

Since 2001, premiums for family coverage have shot up 78 percent, four times faster than wages, which have increased just 19 percent. Inflation is up 17 percent during the same period.

With the average annual premium for family coverage now topping $12,000, smaller employers are reducing or eliminating coverage for their employees. That increases the number of middle-class workers who are at risk of losing coverage or canceling their policies because they can't afford the increased costs passed on by their employers.

Many communities have simply resigned themselves to accepting this grim reality. There's faint hope that help will arrive soon from state or federal reforms. But in Lane County, the 100 Percent Access effort has proven that a homegrown, neighbor-helping-neighbor solution can make a real difference right now.