Uninsured public provides stiff challenge to healthcare officials
By JIMMY GALVAN

With the increasing number of people without healthcare rising, local hospitals are having to meet the needs of the uninsured public while providing quality care.

Chief Financial Officer for Christus Jasper Memorial Chuck Breidenthal said the issue "is a major problem for most hospitals in the state of Texas."

"Texas has one of the largest uninsured populations in the country," Breidenthal said. "So the problem facing uninsured patients is something all hospitals face on a daily basis."

In the city of Jasper alone, recent census figures indicate that 20 percent of the county's population is uninsured while the number is 28 percent for county residents.

Christus enforces a patient assistance program in its hospitals. The program provides needed medical services to families that are at 200 percent and below of the federal poverty guidelines.

"When uninsured patients come into the office, we tell them of this program and we help them with the application process," Breidenthal said.

The program requires patients document their income level through paycheck stubs or tax forms.

"We provide a lot of service in this community through this patient assistance program," Breidenthal said.

Tara Watson, marketing director for Woodland Heights Hospital in Lufkin, said the issue boils down to the uninsured and the underinsured.

"Regarding the uninsured, you are looking at hospitals and private medical practices having to deal with these patients," Watson said. "This requires hospitals to become more effective in delivering healthcare."

Watson said for the underinsured, healthcare plans have changed over the years with out of pocket needs being higher for patients.

In fact, in the fiscal year that ended June 2006, Christus Jasper Memorial provided more that $3.5 million in patient assistance services. This year, the hospital has provided more than $2.1 million already with four more months left in the fiscal year.

"As these figures grow, the medical community realizes that it has to do something," Breidenthal said.

Christus answered that need by providing discounted services to the uninsured that may not be at the 200 percent or below federal poverty level.

According to Breidenthal, Christus is working on a policy to answer these needs and provide discounts to the uninsured public that are at the 600 percent or below of the federal poverty guidelines.

"All hospitals are dealing with this problem of how you handle the uninsured," Breidenthal said. "And Christus is making strides in that regard."

"It's a vicious cycle for hospitals to be in," Watson said. "This is not just a problem for Woodland Heights but for every hospital in the nation."

Marketing Director Mark Durand stressed that Christus Jasper Memorial is a non-profit hospital.

"People don't understand that but we still have to take money in to pay salaries and bills," Durand said.

"No hospital or health organization, whether they are for profit or non-profit, can give away services," Breidenthal said. "Most businesses strive to have a profit margin. It's just what you do with that margin.

"For profit entities, pay it back to the shareholders," Breidenthal said. "Nonprofit agencies, we take that money and put it back into the community and services for the lower-income individuals."

Breidenthal said the benefits of having a faith-based hospital in its community are important.

A side issue is the ongoing problem that is the uninsured use the emergency room as a doctor's office for routine illnesses.

Because of federal laws, when people come to the ER, they must be evaluated to determine if their condition is stable or unstable.

"People without a medical home will come to the ER," Breidenthal said.

Durand said Christus Jasper Memorial sees approximately 1,500 a month in its ER.

"When a person comes in, we do triage and the most severe cases are seen first," Durand said. "When you get those who come in for non-emergency care, that forms the backup."

"That is what clogs up the ER," Breidenthal said. "People are seen in the ER not by arrival but by severity of their injury. If you are there with an ear ache that normally can be treated by a clinic, you are going to wait."

While stories of 12 hours and longer wait times in ERs are common in metropolitan areas, Durand said the average wait time at Christus Jasper Memorial is two-tothree hours.

Durand said an expansion of the ER is high on the list of improvements. It will give a better flow of patients.

"You are looking at about 35,000 people that are uninsured in Jasper County and most of them look at us for their medical care," Durand said. He added that many also come to the hospital from surrounding counties such as Tyler, Sabine and Newton.

"That is where our charity care comes into play because we provide services to the community," Durand said.

For Christus Jasper Memorial, the mission is set as "extend the giving mission of Jesus Christ."

"We do care about the communities that we have hospitals in," Breidenthal said. But you have to be able to fund the mission as well."