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Over 40,000 people in Buncombe County do not have health insurance: that's over 20% of our population. As healthcare costs rise faster than inflation --- and increasingly expensive treatments become available --- affordable healthcare is the number one issue for many of us. We feel it more here too because the average age in Western North Carolina is much older than the rest of the country.

This, of course, has an immediate impact on healthcare providers and businesses. The number of citizens in Buncombe County that are recipients of Medicare and Medicaid is much greater than the national and state averages. Almost two thirds of patient revenue at Mission Hospital is derived from Medicare, Medicaid, and uninsured patients. Because the government pays healthcare providers in many cases less than what it cost to provide these services, these providers shift the cost to commercial payers, driving costs up. Cost-shifting in healthcare is a national problem and the problem is more acute in Buncombe County.

These are complex issues that defy easy solutions, but there are several things we can do locally to begin to fix them --- and because we are 20 years ahead of the nation in aging, we must find creative and proactive ways to reduce health care costs.

• Buncombe County provides primary care through the Buncombe County Health Center. The Health Center is the largest primary clinic west of Charlotte, serving around 18,000 Buncombe County residents. For a complete list of community health clinics, click here.
  
  These clinics provide a more cost-effective alternative for delivery of non-emergency healthcare services than the hospital emergency room. As a result of the efforts of the Health Center and our community clinics, area physicians, Mission Hospital, and other providers, the most recent community health survey noted that over 90% of Buncombe County citizens had a primary care doctor.
  
  
• We also participate in the Asheville Chamber Healthcare Roundtable to find innovative ways we can locally address health care. And our prescruption prescription drug program through NCAO saved county residents $3 million last year on their drug costs at no cost to county taxpayers.
  

But we're not stopping there. As a member of the Board of Health, I have advocated for the creation of community partnerships between businesses, healthcare providers, government, and our citizens to meet these challenges.

The Eblen Kimmel Foundation's partnership with Three Streams Clinic helps businesses provide their employees with ancillary medical services, including weekly workplace screenings at the workplace. For a great story on this in the Mountain XPress, click here.

Prevention and wellness efforts are cost-effective, common-sense solutions to reducing healthcare costs and improving the quality of life. Mission Hospital's Lighten Up 4 Life is a wonderful example of a community-wide initiative to reduce health care costs and improve quality of life. I ran (well, tried to run) the Chamber Challenge 5K in June to support this great program. Click here to see the results of the race. I think I did pretty well ;)

The county is also proud to partner with WNC Community Health Services to expand access to primary care at no additional cost to county taxpayers. WNCCHS is highly regarded throughout the state for their excellent mental health services and medical care, most notably their work with people living with HIV & AIDS.

Buncombe County has also partnered with Mission Hospital and the Buncombe County Medical Society to establish Project Access, a nationally recognized program to address the problem of the low-income uninsured. This program results in over $10 million per year in charity care provided by area physicians delivered in a cost efficient manner. By addressing basic primary care problems at early stages, this program saves critical healthcare dollars by reducing emergency room utilization, treating chronic illnesses, and providing need pharmaceuticals that prevent more serious health problems.

Project Access has received awards from the National Association of Counties (NACO), the Innovations in Government Award from Harvard University’s John F. Kennedy School of Government, and awards from the International City/County Management Association (ICMA). I have continued to support these programs and the county has increased our financial commitment to Project Access to fund needed medications.

I have also supported our area's employers when they identified high healthcare costs as one of the primary impediments to growing their businesses here. Buncombe County assisted funding a healthcare study along with Volvo Construction, Sonopress, Blue Ridge Paper, Ingle’s Markets, and other large employers. The county has participated in the Chamber Business Healthcare Roundtable and recently their work has led to the creation of a small business healthcare plan.

The county has financially supported efforts such as these in recognition that problems of this nature can only be solved when area business leaders, physicians, the hospital --- and other important players --- can reach consensus on a proactive action plan.