By Terry Schleder and Dr. Andru Ziwasimon
Community Coalition for Healthcare Access
University of New Mexico regents were asked by the governor to convene a statewide health summit to address concerns that University Hospital (UNMH) is putting its financial health ahead of patient care.
This landmark health summit will take place Monday in the Student Union. We hope the summit, along with proposed legislation to study the benefits of universal health care for New Mexicans, signals a commitment to reduce the health care access gap.
From our perspective, there is much to discuss at the summit. Our concerns about the county's public hospital include:
Insufficient accountability for budgeting hundreds of millions of tax dollars;
Inadequate interpretation services for non-English-speaking patients.
Discriminatory policies that are creating a two-tiered system of health care, with preferential access for insured patients and exclusionary barriers for the uninsured.
The hospital's strategic plan expresses its patient preference. It calls for expanding the number of insured patients— euphemistically called "improving the payer mix"— so the hospital can be on better financial footing. It is then assumed that there will be more money to pay for programs for uninsured patients.
This could be a welcome step if the extra money were explicitly dedicated to caring for uninsured patients. The hospital now covers only a small percentage— 11 percent— of eligible county residents on its UNMCare program.
This program was designed to provide the uninsured a primary care doctor in place of expensive ER visits, but it has barely expanded as the need has increased.
At the heart of the controversy is the question of leadership at the county's only public hospital. Critical decisions affecting thousands of people all over the state are being made in a vacuum. There are no uninsured people, no public health experts, no primary care physicians and no elected officials shaping hospital policies that would close health care access gaps in our dense urban center.
The hospital's administration must create a new strategic plan that honors the de facto service mission as it is understood by most doctors, staff and the public.
That includes hospital compliance with its contractual agreements to Native Americans and Bernalillo County. UNMH is a public hospital and must thereby serve all county residents regardless of tribal affiliation or citizenship status, as many public hospitals in comparable cities manage to do.
This plan should direct the full creative power of the university to solve the complex problem of paying for health services for uninsured patients, for which we notoriously rank among the worst in the United States. With administrative support, the hospital can become a shield to protect us all from the physical and financial dangers of being uninsured.
The new interim vice president of the Health Sciences Center, Paul Roth, has already committed to the creation of an Office of Community Affairs. This office has the potential to amplify the voices of the uninsured, Native American patients, small-business owners and outside advocates who have studied the health crisis as it looks from outside the walls of the university.
If given the power to participate in policy making, this new office can truly help UNMH find its place again as an innovative leader in community health.
We demand equitable access to the excellent care at our public hospital that was contractually promised and paid for. We also demand the rigorous fiscal accountability that must accompany the stewardship of public dollars.
UNM Hospital must return to its public roots. If it does not, the hospital's fiscal condition could come to resemble those who are turned away from its doors— broke, sick and with nowhere else to turn.
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