I recently celebrated my fourth anniversary of working at HCF. It has been an honor to be associated with such a compassionate and ethical Board of Directors. The Community Advisory Committee (CAC) has provided our board and staff with useful and fair feedback and has done an outstanding job of vetting potential board candidates. HCF associates are simply the best. Their dedication and leadership to adhering to the mission of the foundation is impressive.

In our first four years, HCF has approved approximately $70 million of grants to organizations that serve the health and health care needs of the uninsured and underinsured in our service area. The agencies we fund have been remarkable partners in serving our targeted client base. However, I would be hard pressed to argue that health conditions for the poor are better today than they were four years ago. Current economic conditions, job losses, and cuts in government funding have caused a serious increase in demand for social services like I have never seen before in my lifetime. In light of these tough times, I'm very proud that our Board has agreed to increase our funding in 2009 by $1.5 million to total $26.5 million.

While our efforts to increase the cigarette tax in Missouri were not supported statewide, we are proud to have supported efforts to make clean indoor air a commonplace in most areas of our region.

The four years have gone by very quickly. Our Board, CAC and associates are more dedicated than ever to fulfill our mission of providing leadership, advocacy, and resources that eliminate barriers to quality heath for uninsured and underinsured in our service area. We’ve worked very hard to treat others the way we want to be treated -with dignity, respect and honesty. It has been our honor to work with you in this noble effort. We have much more work to do -- together!

Last week President Bush’s administration published a new federal rule giving states the sweeping authority to charge Medicaid recipients premiums and higher co-payments for doctors’ services, hospital care and prescription drugs. If they can’t afford the payments, providers would then have the authority to turn them away (except for life-threatening circumstances).

This new policy was designed to save money, but many experts claim the bulk of the savings will be the result of low-income individuals not getting needed care. While this may be a short term advantage for the government in curbing cost, delaying medical care could lead to more serious health problems, which ultimately is more expensive. Rather than trying to find a way to provide quality health care for all, the government has found a way they believe will force poor people to pay more.

State lawmakers now have a decision as to whether to incorporate these premiums and co-payments into their state system. For most states facing budget shortfalls, this will be tempting. But this new rule does not get us closer to providing quality health and health care for all – it takes us in the wrong direction. Let’s hope Governor-Elect Nixon and Governor Sebelius will not choose to take this route.