"Unless you haven't had health coverage, you don't know what it's like. You put doctor visits off because you don't have the money. And you feel OK, like I did before they found the tumor."

- Lula Quinney, CHP member

Eleven percent of Indiana's population is without health coverage at any given time; 85% is uncovered for less than two years, 50% for less than half a year. Extrapolated to St. Joseph county, approximately 27,500 people in St. Joseph County are without coverage as you read this.

Who are the Uninsured?
I have read that 46 million Americans are without regular health coverage, and I'm surprised that we're having difficulty finding one of them. For those 46 million, acute care and primary care are often identical. Most of those 46 million Americans are high school graduates, most of them work and most of them are struggling, stranded between Medicaid and employer-provided insurance.

They are the Americans that President Clinton spoke of when he proposed health care reform. But his program was too ambitious, stepped on toes, turned too widely in the halls of congress and was eventually seen as impossible to feed and house. The reform effort lumbered off to die, but the 46 million Americans remained behind, ignoring the disquieting lumps, bouncing aspirins off serious symptoms and not quite getting their children in for regular check-ups.

They are the people that we want to link to CHP, a hospital-funded effort to provide for the health needs of the working poor, on a small scale, locally, as a pilot program, serving those between affluence and government assistance; those who otherwise wait out an illness, watching it, hoping it will expire; seeking treatment long after it would be most effective.

Where CHP fits in
The Community Health Partnership wants to change that expensive, acute-care, hope-for-the-best-and-treat-the-worst behavior with a safer and less expensive model.

Begun in 1994, CHP provides 2 years of health care for people who would otherwise skip routine checkups, ignore the need for health screenings, wait too long to investigate symptoms and too often use the ER as a source of primary care.

In the first three years of its existence, CHP causes the rate at which members use the emergency room to drop 97%, lowers the hospitalization rate 60% and creates an estimated savings of $826,047 to the health care system.

Ninety percent of the members served by CHP reported that the program meets their needs, 98% respond positively to the case management part of the program, and 100% say that they'd recommend the program to a family member or to a friend.

In addition, CHP crowds together, on a regular basis, neighborhood groups, health care providers and social service agencies. Trapped together, like labor-management negotiators, representatives of those institutions confuse, confront, trouble and frustrate each other. They also discover each other's talents and see health care from different perspectives.

But the most notable result of the program's first years is packed into a word often used by CHP members to describe the program: they call CHP a "blessing."