Health Focus: Ecu-Health Tackles Growing Needs

By Susan Bush
12:00AM / Friday, February 10, 2006

Ecu-Health Care Inc. Executive Director Charles "Chip" Joffe-Halpern

Ecu-Health Care Inc. Executive Director Charles "Chip" Joffe-Halpern recalled the plight of a woman who faced a life-threatening illness and the very real prospect of losing what little health care coverage she had.

"The comment I heard was a diagnosis of no health insurance was more terrifying than a diagnosis of colon cancer," said Joffe-Halpern during a Feb. 9 interview at his office.

Since 1995, Ecu-Health has endeavored to provide health care access to uninsured and underinsured residents of the Northern Berkshires and Southern Vermont. The private non-profit agency offers a dual-faceted approach; the group sponsors a voluntary physician program that permits reduced cost or free doctor's office visits to those who meet income guidelines as well as an initiative to assist residents in finding and enrolling in public and private health care programs. Prescription medication assistance is also available.

"We are one-stop shopping for the uninsured," Joffe-Halpern said.

And Ecu-Health is seeing more "customers," according to information provided by Joffe-Halpern.

Growing Need

In 2005, the voluntary physician program delivered care to 948 area residents, up 12 percent from 2004, when the program provided care to 844 people.

The dollar value of the care provided by Ecu-Health is on the rise as well, and appears to serve as proof of the ever-rising costs of, and the ever-rising need for, health care. In 2003, the physician program provided $139,166 in care, by 2004, participating physicians provided $179,135 in care to local residents. In 2005, that amount had jumped to $212,888.

There are a host of catalysts impacting need and cost, Joffe-Halpern said. New companies and small firms are very often unable to bear the financial burden of offering health care insurance to employees, and even companies that had offered plans are changing their ways.

The "Next Big Thing"

In January, the Boston Globe reported that the state-based Friendly's restaurant chain opted to cut healthcare benefits for full-time employees and offer what are known as "limited benefit" or "mini-medical" plans.

"The next big thing in health care is called 'consumer driven health care,'"Joffe-Halpern said, and added that "consumer driven" shouldn't be confused with "consumer friendly." "Many businesses will look at less expensive health care programs that will rely on people having 'health savings accounts.' These 'health savings accounts' will be used with high deductible plans. These programs favor people who are wealthy and healthy."

Joffe-Halpern is the president of the "Health Care For All" organization's Board of Directors.

"We think it's [the concept] terrible," he said, and when asked, agreed that for many families, generating any substantial "health care savings account" would be next to impossible.

Examples of Inequity in Health Care

Inequities in health care, including state and public programs, plague the population as well.

Joffe-Halpern is a grant reviewer for the Susan G. Komen Breast Cancer Foundation and said he applauds the progress made by breast cancer advocates. The MassHealth program, for example, has special considerations in place for women with breast cancer and those considerations can mean that life-saving treatment is provided to women who would otherwise be ineligible for MassHealth benefits.

The problem, said Joffe-Halpern, is that women affected by other types of cancer who may be equally disadvantaged are not receiving any health care considerations from MassHealth.

"That is crazy," he said. "What is it we are saying, that women with other cancers are disposable?"

Ecu-Health strategies include finding workable health care options for people.

Health care resources in the Northern Berkshire region, including Ecu-Health, are MassHealth, The Children's Medical Security Plan, Blue Health Plan for Kids, an insurance partnership that may benefit small employers, non-group insurance plans, Medicare Premium Assistance [also called MassHealth Buy-In] Citizens Health, SHINE program, Women's Health Network, and the Vermont Health Access Plan.

Breaking Down Barriers

There are those who do not seek health care assistance and Joffe-Halpern identified four prime reasons that keep people from investigating health care options.

In some cases, people are unaware that programs exist, he said. Of those who are aware of assistance, many believe that they are ineligible for services, and in other situations, the complexity of filling out confusing application forms and embarking on what many perceive to be an intimidating, frustrating application process keep people from acquiring health care assistance, he said. And there may remain a stigma about seeking help, he said.

"You do see certain characteristics among people," Joffe-Halpern said. "There are the parents who come in and say 'I don't care about myself but I want my kids healthy.' I have to remind them that the kids need healthy parents. Another thing that we see is people who cancel important doctor appointments, and I'm talking about appointments for cancer treatments and like that, because they lost [insurance] coverage."

And there are the people, many of whom are employed, who ignore persistent symptoms and do not seek medical care because they are uninsured and simply do not have the financial resources to pay.

"I was once called upon to interview a young woman who was at the [North Adams Regional Hospital] med/surg unit," Joffe-Halpern said. "She didn't have insurance and she had been ignoring some problems. She said to me, 'Sir, I had increasing back pain but I like to pay my bills.' She was unwilling to go to the Emergency Room. She did have an aunt and the aunt really pushed her to go, and finally she did come to the ER. This woman was a young mother, and she had blood clots in her lungs."

Situations such as the ones described by Joffe-Halpern are likely to increase, he said.

"Unless the government intervenes somehow, it's only going to get worse," he said. "Historically, there have been a number of attempts to contain costs; the last time was the 1990s with managed care. And the public rejected managed care."

"This Is Why I Come To Work Every Day"

And while the struggles go on, Ecu-Health bobs like a buoy in a sea of health care storms. Ecu-Health is not a cure-all for the ills of the health care industry, and Joffe-Halpern knows it. But the group has become a lifeline for hundreds of area residents.

Ecu-Health was involved in 3020 contacts in 2005, and referred 613 people to the MassHealth program. Of that number, 548 were approved for some level of MassHealth services. There were 749 instances of people seeking prescription assistance, including both acquiring medications and seeking help with the Medicare Part D program. The program funded $19,967 in prescription medications during 2005. Ecu-Health will work with dentists who agree to lower their fees; the program made 284 dental referrals in 2005.

The entity is funded through a series of grants, including revenues from the Blue Cross/Blue Shield Foundation of Massachusetts, $40,000 from the state's Division of Health Care, Finance, and Policy that targets the voluntary physician care program, a federal Health Care Access for outreach grant, the Berkshire United Way and an Ecu-Health Care fundraising campaign, Joffe-Halpern said.

This year, the federal grant expires and will be lost, he said.

As more and more companies opt to offer less and less in the way of health care plans, and more and more people struggle to pay for care for their families and themselves, Ecu-Health and Joffe-Halpern will work harder and harder, he said.

"People treat health care as a flexible expense, sometimes with catastrophic results," he said. "And that is why I come to work every day."

The Ecu-Health Care offices are at Room 209 of the former Doctor's Building at the North Adams Regional Hospital campus, adjacent to the Ambulatory Care Center. Hours are 8:30 a.m. to 5 p.m. Mon.-Fri, and while appointments are preferred, walk-ins are accepted. The telephone number is 413-663-8711.

Additional information about Ecu-Health Care, including program income guidelines, is available at a www.ecuhealthcare.com Internet web site.

Joffe-Halpern authors a health care column published in the North Adams Transcript newspaper.

Susan Bush may be reached via e-mail at suebush@iberkshires.com or at 802-823-9367.