Let’s expand the tent of health care

Prevention is the key to a healthy life and affordable health care. So why is it so hard to achieve?

As president of the New Hampshire Nurses’ Association, I have had many conversations with nurses around the state about the delivery of high-quality health care. I have yet to have a conversation that does not conclude with someone stating the obvious – we have to figure out how to bring everyone under the tent so we can get serious about prevention.

One Fund Boston collected over $25 million in one week to help cover the health care costs associated with the serious injuries suffered by dozens of innocent victims at the Boston Marathon bombings. Driven by the inescapable horror and our feelings of helplessness, we opened our hearts and our wallets. On a very basic level, we knew that helping victims get the treatment they needed was the best help we could give. Ensuring they get high-quality care and can return home to their jobs and families gives them — and us — a way to heal from this tragedy.

Fortunately, most health problems are neither as unexpected nor as horrifying as injuries from a terrorist attack.

Most health problems start small and our ability to get prompt, affordable treatment will decide whether that health problem is cured, controlled, or drives us into an emergency room in crisis in the middle of the night.

We, as a state, as a nation, face a real challenge in getting more people the care they need before they reach a crisis – bringing them under the tent.

New Hampshire has an opportunity, right now, to advance this laudable goal. Our Legislature will soon decide whether to accept federal funds allocated to our state to extend health coverage to thousands of people currently without health insurance.

For the next three years, the federal government is offering to pay 100 percent of the costs to insure, via Medicaid, more low-income workers and their families.

Estimates suggest this would help as many as 58,000 Granite Staters by 2020. Starting in 2017, New Hampshire would gradually contribute toward the cost, but never more than 10 percent under federal law.

Most of the people who would be helped by the expanded coverage are employed and hard-working, but they lack the education or opportunity to secure a position that offers health benefits. To leave them outside the tent means they have no easy access to preventive care – no check-ups, no screening colonoscopies, no nutritional guidance or smoking cessation support.

The irony about our current system is that these folks will get treatment in a crisis. New Hampshire hospitals support a robust system of financial assistance, funded largely by the premiums charged to those of us who are privileged enough to have health insurance.

Unfortunately, paying to care for someone with colon cancer is hundreds of times more expensive than paying for a colonoscopy that allows for early treatment to prevent the disease. Doctors and nurses cannot educate patients about prevention if they only see their patients when they are sick. In the end, we all pay for the lack of prevention.

Extending Medicaid to more people benefits us all and moves us closer to a health care system focused on prevention rather than crisis.

Judith Joy, a registered nurse, is president of the New Hampshire Nurses’ Association.