Make MetroHealth more welcoming, and widely supported

by Gail Long

Saturday July 26, 2008, 10:00 PM

The United States is the only industrialized nation that does not require health care coverage for all citizens. In this country, access to health care is not a human right but based on one's ability to pay. As long as health care remains a for-profit enterprise, systems like MetroHealth will struggle. Some, eventually, will close their doors. We cannot allow this to happen to MetroHealth.

Keeping MetroHealth strong and vibrant requires an alliance of five entities: the hospital, policymakers, voters, the two major health care systems and the community at large. Each has a role to play:

Gail Long is the former executive director of the Merrick House.

The number of uninsured and the cost of doing business climb every day. MetroHealth's challenge is to survive as a public institution where all who come to its doors are given medical care regardless of their ability to pay. MetroHealth has taken immediate steps to treat its financial woes: reducing staff and cutting expenses. What else can it do?

• Promote itself through aggressive marketing. Make glitzy brochures available to anyone who has Kaiser as an option through their employer and let them know that MetroHealth can be their primary source of care. For west-siders, in particular, this would be appealing.

• Work with the county commissioners to make MetroHealth an option in any health insurance plan serving county employees.

• Expand the sliding fee scale. The Cleveland Clinic's scale reaches 400 percent of poverty, so should MetroHealth's.

• Make it easier for people who are not rated to make appointments. Currently, someone whose ability to pay has not been evaluated by MetroHealth's finance department and assigned one of six ratings is not given an appointment -- and can access care only through the emergency department. MetroHealth should restructure its rating system so that an unrated person can be rated and seen by a doctor on the same day.

Major health systems

The Cleveland Clinic Foundation and University Hospitals share the responsibility of serving the medically indigent at all of their facilities. Stabilizing patients in an emergency room and then sending them to MetroHealth is not a good definition of "sharing the responsibility" of serving the uninsured. Stabilizing them and then caring for them as outpatients is. Aggressively informing the public of their sliding fee scale and encouraging the uninsured to use their services better defines sharing the responsibility.

Policymakers

They must continue to serve as watchdogs of MetroHealth. In particular, they must ensure that as MetroHealth makes changes to strengthen its ability to survive financially, it remains true to its mission, serving all regardless of ability to pay. Policymakers must make sure that appointed board members support this mission. In addition, they must support indigent care through the allocation of funds from the county's Health and Human Services levies. Finally, elected officials must insist that the other major hospital systems share the responsibility.

Voters

They must continue to support the Cuyahoga County health and human services levies that provide more than $30 million each year to support MetroHealth and its essential services.

Community

We must never take MetroHealth for granted. It is a public hospital, our hospital. We have the right to ask questions and expect answers. There is no reason to believe that MetroHealth President Mark Moran is insensitive to this. Organizations should invite him and his staff to community meetings and ask how we as a community can be supportive of one of the finest public hospitals in the nation. We should attend MetroHealth board meetings (they are open meetings). MetroHealth is not a closed system, and we should not treat it as such, nor should we let its leaders act as though it is.