As organizations across the United States mark Cover the Uninsured Week (April 27-May 3), so will the five community health centers of Cape Cod and Martha’s Vineyard, which are working to implement the state’s landmark health care reform legislation. As a result of this legislation, approximately 340,000 individuals are newly insured statewide. Yet, 18.4 per cent of all Cape Codders are without health insurance coverage, according to The Human Condition Report 2007. The inability to afford medical and dental care and prescriptions is a major concern for 74 per cent of our population.

Even so, providing health insurance coverage is only one part of the equation. Providing access and containing costs are equally important. Recent reports and opinions have focused on the challenges: the unanticipated oversubscription of enrollees into the newly minted Commonwealth Care and Commonwealth Choice health insurance programs, the underfunding of these programs by the original legislation, and the resulting strain on the health care delivery system. On Cape Cod and the Vineyard, these challenges are exacerbated by the regional shortage of primary care providers, the high cost of living, the shortage of affordable work force housing, and the refusal of some private practitioners to accept Commonwealth Care and Commonwealth Choice health insurance programs. The good news is that this oversubscription means more people are entering into the health care stream than ever before, some for the first time. There are greater numbers of newly insured individuals on Cape Cod. The bad news is that there are fewer access points to seek out care given the limited number of private practitioners accepting the new insurance programs, and as a result there are longer wait times to get care at access points, like the region’s five community health centers, which are accepting Commonwealth Care and Commonwealth Choice insurance programs. In terms business people can understand: demand is outstripping supply.

The Cape and Vineyard Community Health Center Network, made up of the five community health centers on Cape Cod and the Vineyard, remains committed to reaching out to the uninsured on Cape Cod and the Vineyard. It is committed to the successful implementation of health care reform. Unique regional challenges, such as our diverse and fluctuating populations, seasonal workforce, and tourism-related economy all contribute to the magnitude of the problem of the uninsured.

Network members strive to mirror the communities they serve, with staff that speak the languages and understand the cultures of their patients. This may be their greatest strength, allowing for the creation of a welcoming and comforting health care home for the delivery of high quality, comprehensive patient care. Last year, local health centers accounted for 114,800 patient visits and enrolled 4,500 previously uninsured individuals. “We see the faces of the uninsured every day and know their stories,” said Claire Goyer, chief executive officer of Duffy Health Center. “They are our hardworking neighbors and friends whose jobs do not provide them insurance or who cannot afford private coverage. We are proud of our role in keeping the uninsured healthy and out of hospital emergency rooms by providing affordable and accessible health care.”

Community forums on health care issues, insurance enrollment events and expanded access to health care through a mobile medical clinic and new or expanded facilities are just some of the ways the Cape and Vineyard Community Health Network is working to balance the components of health care reform.

If you are uninsured and need primary care services, please consider your local community health center. We are available to assist you with insurance enrollment and we thank our patients who have entrusted us with their care. We want to be your medical and health care home.

Cynthia Mitchell lives in West Tisbury and is executive director of the Island Health Care Rural Clinic.