Dr. Herbert Smitherman with Wayne State University School of Medicine, Dean Robert Mentzer, M.D.
“Taking Care of the Uninsured: A Path to Reform,” which President Reid called “a powerful little book that shows what can be done to confront this critical issue,” details the 10-year path of the Voices of Detroit Initiative. That project, launched in 1998 with a $5 million grant from the Kellog Foundation, sought to ease the strain on emergency rooms used by the uninsured as primary care facilities by providing access to true primary care.
“I’m so proud of the City of Detroit for what we have done as a community for the people of Detroit,” said Dr. Smitherman, who also serves as assistant dean of Community and Urban Health for the School of Medicine. “In the book, we are really only cataloging what we have done. This is 10 years of our lives. We started with a $5 million grant. That money is now gone, but we’re still here. That is a testament to the City of Detroit.”
Joining Dr. Smitherman in writing “Taking Care of the Uninsured: A Path to Reform” were James D. Chesney, Ph.D; Cynthia Taueg, B.S.N., M.P.H., D.H.A.; Jennifer Mach, M.D., M.P.H.; and Lucille Smith, M.Ed.
“The School of Medicine is absolutely committed to this issue,” said Dr. Robert M. Mentzer Jr., dean of the School of Medicine and senior advisor to the president for medical affairs. Dr. Mentzer introduced Dr. Smitherman at the Dec. 14 book presentation. “This is the most critical issue facing the city and country today. It’s in the conscience of every American. This book shows us a wonderful model.”
Originally tasked with addressing the primary care needs of 27,500 patients, the initiative far surpassed that goal by assisting 33,093 uninsured Detroit residents. That number represents slightly more than 13.8 percent of the uninsured residents of the city. A majority of those cared for under the initiative were African-American (92.4 percent). Fifty-seven percent of enrollees were women and 69 percent were single. Sixty-four percent represented households with incomes of less than $1,000 per month.
The program continues today.
“Collaboration was key,” Dr. Smitherman noted. “If we got the enrollees out of emergency rooms and into a primary care setting, they stayed.”
The program established 11 new primary care access sites in addition to providing primary care for the uninsured and easing the strain on emergency rooms.
Co-author Dr. James Chesney, a member of the Policy Initiatives Consulting Group, based in Ann Arbor, noted the timing of the discussion of the Voices of Detroit Initiative and the release of the book coinciding with the ongoing presidential debates.
“Like politics, health care is local,” Dr. Chesney said. “The presidential candidates must be made to understand the role of local input. This will not be solved at the national level. We have the model; we know it will work. The leap has been taken.”
To that end, the authors developed policy recommendations that include supporting community initiatives for the uninsured, universal coverage and care, funding primary care linked to the continuum of care, funding specialty care linked to the continuum of care and organizing charity care.