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ISSUES: Healthcare and the Uninsured
Access to reasonably priced quality health care is a challenge to many Virginians of all ages and backgrounds. Almost fifteen percent of all Virginians are uninsured, including over 100,000 children. As of October 1, 2004, 42,496 children in Virginia are eligible for FAMIS or FAMIS PLUS. (Medicaid but uninsured). Of the uninsured citizens of the Commonwealth, 75 percent work full-time or live with someone who does. Most of those persons work in businesses employing less than 10. This lack of insurance has a great impact on business productivity in the state, and the economic viability of families. When children are not provided with preventive care because of lack of insurance, their illnesses are more serious and can require expensive trips to the emergency room by parents who can ill-afford to lose time from work. The family suffers, then, not only from the illness but also from the loss in wages brought on the lost time from work; businesses suffer because the employee is missing.
Health care and insurance problems can be even more acute for many of our elderly population. Virginia is 3rd from the very bottom among the states in Medicaid reimbursement rates for nursing home care. Even with this low rank, our state’s spending on Medicaid now exceeds $2 billion per year, over 12 percent of the state's operating budget. The poor find it difficult to find quality assisted living care because of the low level of state reimbursement. And health care costs will only continue to rise as Virginians age. Today, one of every seven Virginians is 60 or older. By 2025, nearly one of every four will be in this age group.
To further complicate matters, based on present trends, the state is projected to have a shortage in certified nurses of 22,500 FTE positions in 2020. This will further increase pressure on costs and make access to quality care even more problematic.
State leaders have proposed some modest steps to improve affordability and accessibility to health care, but these problems will take years to solve. To more us forward, I support:
1. Expanding the number of children insured through State Children’s Health Insurance Program (SCHIP) by requiring registration in the program when a student enters school each fall and by allowing students eligible for free and reduced lunches to enroll in the Virginia program. The Warner administration has done a wonderful job increasing the numbers of children covered; we should continue these efforts.
2. Providing tax credits to employers who assist in the purchase of health insurance.
3. Expanding nursing care availability at child care centers.
4. Improving patient safety a means to cut costs. Preventable errors dramatically increase the cost of care, to the individual and to the state.
5. Greater state involvement in regional purchasing pools for medicaid purchases of prescription drugs. New Hampshire, Maine and Vermont saved almost 15 percent of their total medicaid drug budget by creating such pools.
6. Permitting Virginians to buy reasonably priced and safe prescription drugs from Canada.
7. Greater support for community based solutions such as free clinics, which can leverage more private and institutional monies to assist the poor and uninsured.
8. Embracing strategies that will ensure that the long term supply of nurses is sufficient to meet the future demand for nursing care.
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