By Hisam Goueli / For The Herald

As a physician who specializes in family medicine and psychiatry, I’ve watched the vulnerable patients I treat grapple with the grim realities of seeking health care coverage amidst the covid crisis.

The lucky ones retain access through some mix of public services such as Medicare and Medicaid, but many more have lost their employer-sponsored coverage and either pay out-of-pocket or, more often, simply go without. Health care access will only become a more pressing issue when we emerge into some semblance of a post-pandemic reality, and it’s up to lawmakers to create the infrastructure that will ensure all Washingtonians have access to universal health care coverage.

That’s why I’m supporting Senate Bill 5399 in the Washington state Legislature, concerning the creation of a permanent universal health care commission. The commission would first convene the key stakeholders who govern the provision of and access to health care coverage in the state to design and implement the necessary components to ensure Washingtonians have universal access to comprehensive health care coverage. The legislation has passed Senate and House and awaits the governor’s signature.

Fundamentally, this will alter the model of health care coverage in our state from a patchwork consumer good that doesn’t consistently meet the needs of patients like those who come into my clinic, to a more uniform public health good that we all can choose how to benefit from.

Importantly, the bill explicitly addresses dramatic racial disparities in health care access highlighted by the pandemic by requiring specific outcomes that address historical inequities that have plagued our health care system for far too long. The universal health care commission will be composed of, and be guided by, communities most affected by the absence of coverage from start to finish.

Since March of last year, 14 million Americans have lost access to health care through their employer-sponsored plans. This has disproportionately hurt front-line workers, communities of color and those already living paycheck-to-paycheck. We must act to address ever-widening gaps in coverage that are so critical to securing the health and well-being of all Washingtonians.

Through this work, I believe we’ll also have an opportunity to expand health care coverage to envelop an inclusive definition of services that capture a more holistic vision of how best to care for vulnerable patients in our communities. Things like mental health care access, substance abuse recovery services, dental care and nutrition assistance are just a few examples of the many factors that flow together to determine health care outcomes for a given patient.

The commission’s scope of work will also give us an opportunity to partner with our federal delegation while they determine the next iteration of foundational national investments through programs like Medicaid and Medicare. We want to ensure we’re being smart about maximizing state and local efforts to leverage future funding streams that may flow from the other Washington.

We know that patients without health care coverage have worse outcomes over the course of their lifetimes and are more likely to die prematurely from chronic disease or unexpected illness. When vulnerable patients fall through the cracks, our communities suffer, and the cost of our health care system spirals out of control.

One-size-fits-all single payer solutions aren’t enough to match the growing complexity of our ecosystem of health care coverage in Washington state, and we need all stakeholders at the table to be a part of the solution if we truly mean to make progress on this important issue. While our lawmakers grapple with an historic public health response, the solution set we put forward needs to be nimble enough to address the changing needs of impacted communities over time.

Ultimately, ensuring universal health care coverage access to all Washingtonians will require us to align a diverse community of stakeholders with sometimes competing priorities around a unified vision for providing healthcare coverage to all our citizens. We must hold ourselves accountable to achieving this important goal, but we must be purposeful about shaping a new system that maximizes opportunities for collaboration and reorients our care delivery system to cater to a more holistic vision of the whole patient.

SB 5399 strikes the right balance of engaging key stakeholders, centering the conversation on communities most impacted, while giving our state clear requirements on how to achieve implementation.

Dr. Hisam Goueli completed a dual residency in family medicine and psychiatry at Case Western Reserve University. He specializes in the medical and psychiatric care of geriatric patients in Seattle. He has received national recognition for his work during the pandemic in treating psychiatric patients and has worked around the world to develop successful health care solutions through engagement with diverse communities.