Los centros de salud comunitarios de Colorado, que atienden a todos los pacientes independientemente de su capacidad de pago, llevan ya un mes en su nuevo año fiscal. Pero el Congreso aún no ha aprobado su financiación anual.
Stephanie Einfeld es consejera delegada del Northwest Colorado Health, que atiende a residentes rurales en Craig y Steamboat Springs. Afirma que la alta calidad de la atención médica, conductual, dental y de otro tipo que prestan los centros de salud está en peligro. Necesitan fondos federales para evitar que se reduzcan las horas de funcionamiento y las listas de espera.
"Para continuar haciendo lo que hacemos, necesitamos apoyo federal," asegura Einfeld Y nuestros legisladores necesitan escuchar eso. Necesitan priorizar primero, continuar con nuestra financiación federal y luego aumentarla."
A diferencia de la mayoría de las empresas que se enfrentan a los aumentos de costos laborales y de otro tipo, afirma que los centros de salud públicos no pueden transferir esos gastos a los pacientes. Los centros de salud atienden de forma desproporcionada a pacientes de Medicaid y son especialmente vulnerables al aumento de los costos de atención no compensada tras el fin de la cobertura continua a principios de este año, una medida que dejará sin seguro a 325,000 habitantes de Colorado.
Los centros de salud tienen múltiples fuentes de ingresos, como la facturación a los pacientes y los subsidios.
Pero el Dr. Simon Hambidge, de Denver Health, dice que la financiación federal es importante y que los centros de salud han contado con un fuerte apoyo bipartidista durante más de 60 años. Con frecuencia, los centros de salud son los mayores empleadores de las comunidades a las que atienden, emplean directamente a más de seis mil personas en Colorado y crean un total de más de 11,000 puestos de trabajo indirectos.
"Se calcula que el impacto económico total de las operaciones de los centros de salud en Colorado supera los 1.7 billones," informa Hambidge. "Y los ingresos fiscales que generan los centros de salud en sus comunidades superan los 1.2 billones."
Los centros de salud comunitarios también hacen lo que parece estar fuera del alcance de prácticamente todos los demás aspectos del sistema de atención de salud del país: ahorrar dinero a los contribuyentes. El año pasado, los centros de salud de Colorado ahorraron a los Centros de Servicios de Medicare y Medicaid más de 15 millones de dólares al atender a casi 14 mil pacientes.
"Existe un retorno documentado de la inversión de los centros de salud. Los centros de salud ahorran a Medicaid el 24% de los costos totales por cada paciente de Medicaid que es atendido," concluye Hambidge.
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People who are part of the Deferred Action for Childhood Arrivals program, known as DACA, will be dropped from their CoveredCA health plans at the end of August.
The move comes after the Trump administration changed a Biden-era definition of "lawfully present" to revoke health care eligibility for thousands of immigrants.
Christine Smith, policy and legislative advocate for the nonprofit Health Access California, said people only have a few weeks to get medical appointments in before their coverage ends.
"If you're enrolled in Covered California and you're a DACA recipient, the Trump administration just ended your coverage," Smith emphasized. "People should use as much of your health care as you can before the August 31st deadline."
The Centers for Medicare and Medicaid Services defended the move, saying it will save taxpayers money. CoveredCA estimated the change affects about 2,400 DACA recipients in the state who make too much to qualify for Medi-Cal and have jobs not providing health insurance. They can still buy private insurance but it is much more expensive. People who prepaid for their coverage can seek a refund.
Smith predicted it will be a blow not just to those who lose coverage but to the state's health care system as a whole.
"The lines in the ERs are going to be longer because people are not going to be able to get affordable preventive care," Smith projected. "They're just going to get sicker and then end up in the ERs. People will overall incur more medical debt. Hospitals will have more uncompensated care."
The change is nationwide. As of mid-July, about 538,000 people in the DACA program across the U.S. are ineligible to enroll in any state-based insurance marketplace and are unable to access premium subsidies or cost-sharing assistance.
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Artificial intelligence is appearing more prominently in many aspects of life and research suggests older populations are curious, yet remain wary of using the technology in their everyday lives.
According to Stats Indiana, there are more than 1.5 million Hoosiers aged 65 and older, or 18% of the state's population. Experts said it is likely the demographic will use AI in some form in the next few years, either by choice or necessity.
Dr. Shaun Grannis, vice president of data and analytics for the Regenstrief Institute on Aging, said AI offers real benefits.
"It can reduce loneliness through conversation, provide reminders for medications and appointments," Grannis outlined. "It can support cognitive stimulation via games, storytelling, news updates."
The technology can also offer a low-pressure way to access information on public services, he added, which is valuable for those with mobility issues or those who feel intimidated by technology.
Grannis cautioned any tool which can be used for good can also lead to problems. He noted AI can create a false sense of companionship and mask social isolation. Overdependence is a legitimate concern, he argued, if the technology becomes a "crutch" for all forms of interaction.
"All cognitive activities or decision-making, it can actually lead to and create a negative feedback loop, lead to a decline in engagement and even basic self-management skills," Grannis explained. "This is risky."
Grannis believes one solution is designing AI systems to complement, not replace, human interaction. He stressed it can be done though building broader support ecosystems including family, friends, caregivers and community services. Grannis emphasized it would encourage real-world activity, prompting the user to go for a walk, call a grandchild or attend a local senior event.
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If you have an extra five minutes, you can save a life because you can learn cardiopulmonary resuscitation at no cost from a new mobile, hands-only CPR kiosk.
The new kiosk is in the lobby of Saint John's Health Center in Santa Monica. The machine's touch screen gives a brief overview of hands-only CPR and you can practice right there, on a mannequin.
Dr. Rigved Tadwalkar, cardiologist at St. John's, said it is an easy way for people to get more comfortable giving chest compressions in an emergency.
"It's a lot like a video game but of course, a lot more important than a video game," Tadwalkar pointed out. "It gives real-time feedback about the depth and rate of compressions, proper hand placement, which are all factors that influence the effectiveness of CPR."
The American Heart Association operates the St. John's mobile kiosk and a stationary model at L-A-X with support from the hospital. Santiago Canyon College in Orange County also has a mobile hands-only C-P-R kiosk now through September, sponsored by Edwards Lifesciences.
Steven Munatones, an Orange County business owner, said he survived what's known as a "widowmaker" heart attack which led to cardiac arrest nine years ago, thanks to his 17-year-old son, who gave him immediate CPR with instructions from a 911 operator.
"You don't have to put your mouth to anybody's mouth," Munatones explained. "You just put your hand on their chest and pump. He saved me, and others can do the same, anywhere. So, it's absolutely a lifesaving, heroic act that anybody can do."
Statistics show 350,000 Americans suffer from cardiac arrest outside a hospital each year and about 90% die, in part because they do not receive CPR. About 70% of those cardiac arrests happen at home, so people often depend on family or friends to give CPR before an ambulance arrives.
Disclosure: The American Heart Association Western States Region contributes to our fund for reporting on Health Issues. If you would like to help support news in the public interest,
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