From the Chair...

Standing Committee on Pro Bono and Public Service

In the context of efforts to reform America’s health care system, lawyers have an opportunity to play a vital role by working with healthcare professionals to ensure the best outcomes for patients.  Healthcare reform is focused on increasing access to health insurance, increasing the efficiency of the healthcare system, and helping people gain access to prevention and wellness programs. Lawyers have the ability to help obtain these goals by participating and supporting medical-legal partnerships (MLPs).  This preventive law model, similar to preventive medicine, allows lawyers to stop legal issues from developing, address legal issues before the point of crisis, and resolve any existing legal issues.

Health is greatly affected by social circumstances. Low-income households are overwhelmed by legal problems related to their basic needs of housing, income and stability.  About 50% of low-income and moderate-income households have a least one  unmet legal need with low-income households averaging between 1-3 legal issues. These legal problems at times have a detrimental effect on health and cannot be cured with a prescription. MLPs aim to address the social determinants that create hardships for vulnerable populations by integrating legal assistance in healthcare settings. For example, an uninsured child with chronic asthma will never breathe easier if she is relying on the emergency room for care; returning to a home with mold, rodents or cockroaches; or is unable to continue prescribed breathing treatments at home because the utilities have been shut off.  Furthermore, many child health conditions can be linked to social factors that are potentially cured by enforcing existing laws and regulations.  However, discrepancies in implementation result in denial of services leading to poor health outcomes. 

Services and benefits that are available to vulnerable populations, even if expanded, are not accessible.  Programs provided by local, state and government programs can pose significant hurdles to families trying to access the services, including health insurance.  It is estimated that 46 million people in the US are uninsured including 9.4 million children.  The uninsured are less likely to receive preventive care, more likely to seek care in the emergency room, and more severely ill when diagnosed. Although the estimates vary on the total number of patients that die every year because they do not have insurance, we know patients who are uninsured are more likely to die that those with health insurance. Children are at the greatest risk. Uninsured children who are hospitalized for illnesses are 60% more likely to die than children hospitalized with health insurance. Through medical-legal partnerships, doctors and lawyers work together to ensure that patients are receiving benefits such as health insurance.

In addition to securing health insurance for patients, lawyers at  MLPs can address numerous legal issues that are damaging to health such as substandard housing conditions, utility shut-off, lack of food subsidies and income benefits, special education services, and domestic violence. Upon the discovery of a legal problem, doctors refer the patient to a lawyer at the health center just as they would refer a patient with a heart problem to a cardiologist.  Since lawyers are the best resource to make sure that the laws and regulations intended to protect people are enforced, MLPs provide a more holistic approach to patient care. Additionally, MLPs help communities by engaging a range of community stakeholders to invest in legal solutions that will promote health and well-being. 

Lawyers may not be able solve health problems, but we have an integral part to play in helping vulnerable populations live healthier lives.  For information about the ABA Medical-Legal Partnership Pro Bono Support Project, how to develop a program in your area or participate in an existing program please visit www.abaprobono.org/medlegal.