"We have to do a lot more than just give people an insurance card," he says. Look at Massachusetts; "a card isn't enough," he adds.
The strain on the safety net could become overwhelming, he acknowledges, with thousands more turning to emergency departments, and the lack of primary care physicians. For many of the poor, and currently uninsured, they see their main option for care as the ED, Siegel says. "They either don't know about the alternative, or the alternative isn't there," he says, referring to a family physician, for instance.
Educating patients is extremely important, and will become an essential part of the evolving NAPH framework, he says, especially for those patients who speak little English or have English as a second language.
"We have a small window to get ourselves ready," he says referring to the potential influx of the uninsured into the healthcare system. "We have insured who have chronic diseases, and (healthcare) systems are fragmented, and overwhelmed."
Siegel is a polite, dignified man with a gentle demeanor. But as he says, one of his biggest roles will be that of lobbyist for the hospitals. The need is dire.
According to an August NAPH report, "Safety Net Health Systems: An Essential Resource During the Economic Recession," member hospitals have reported a 17% increased in uncompensated care costs, on an average member basis, compared to the beginning of the recession, averaging more than $4.6 million per member, with some incurring more than $30 million in additional costs. These health systems also have treated up to 15% more uninsured and Medicaid payments at a time when states are facing large budget shortfalls. An addition 23% more uninsured patients have been treated under the "safety net" since the beginning of the recession, the report states.
"America's public hospitals are in a precarious situation and Medicaid cuts at the state level will hinder their ability to continue serving as our nation's health care safety net, the impact will weaken the fragile viability of the nation's safety net and force public hospitals to close their doors due to inadequate financing," Larry S. Gage, the NAPH President, has stated."