Printer Friendly

FIRST CHOICE HEALTH NETWORK: THE PROSPECTS FOR NATIONAL HEALTH CARE REFORM -- PIECES OF THE PUZZLE

 SEATTLE, April 26 /PRNewswire/ -- The following Op/Ed piece was released today and written by Clayton S. Field. The article originally ran on the Op/Ed page of the Seattle Post-Intelligencer on April 14, 1993.
 Field is president of First Choice Health Network, Washington's largest statewide preferred provider organization (PPO), which manages health care services for more than 305,000 people working at 4,000 companies. He served on Gov. Lowry's health care transition team and is a member of U.S. Sen. Slade Gorton's health care advisory group.
 It has been a few months now since the names James McElveen and Benny Milligan were in the news. Even if you heard or read about them, you've probably forgotten their story. But I still find haunting the names and fates of these convicted felons who have been sentenced to prison for mail fraud, wire fraud and conspiracy to defraud the U.S. government. And I can't help but think that they are not unlike you and me.
 That may seem like an outrageous statement, until I remind you of the circumstances behind the criminal collusion -- a story which made national headlines -- committed by these two friends.
 When James was critically injured in a fall, Benny raced him to the nearest hospital emergency room. Knowing James had no medical insurance, and terrified by accounts he had heard of hospitals that turn away uninsured patients, Benny checked James into the hospital using his own (Benny's) insurance i.d. card.
 James underwent spinal surgery and recovered. His $41,000 bill was sent along to Benny's health care insurer -- the federal government.
 It didn't take long for authorities to discover the deception. When they did, both men were tried and convicted. (James became aware of the "switch" when hospital staff called him "Benny." But in the fog of pain and medication, he had kept silent.) Benny subsequently got nine months in prison and was fired from his job. James got seven months. Said Benny, "I did what I thought I had to do at the time."
 What Benny and James did was wrong, but it was also so unnecessary. It's just one small piece in America's intricate health care puzzle. Like James, millions of Americans are uninsured or underinsured. Their impact on all of us is enormous, both financially and personally. Given a choice between prosecution and doing what we would have to do to save a critically injured friend or family member, you or I might have made a similar decision to the one Benny did.
 As it turns out, the hospital to which James was taken probably would have treated him, even without Benny's insurance card. Most hospitals will always at least stabilize a critically injured patient. Beyond that, the ability to pay is not considered by most hospitals to be a condition for treatment -- and should not be.
 But you need not have an accident to find yourself uninsured or underinsured. Thousands of Americans face that dilemma when they change jobs or health plans. Clauses in insurance policies commonly exclude, for a time, coverage for "pre-existing conditions."
 Efforts have been made to solve parts of the puzzle, with limited success. But the big picture is still disjointed and unclear. Who will pay for those who can't afford insurance? How will we contain costs? What about expensive, experimental treatments? And so, as I watch First Lady Hillary Rodham Clinton travel the country listening to average Americans tell of their nightmares with health insurance or the lack thereof, I realize that Americans are looking to the Clinton Administration for substantial health care reform. But what can and should we reasonably expect from the new team on Pennsylvania Avenue?
 Meaningful and comprehensive health care reform cannot and should not be handled in haste -- it is simply too big, too important an issue. Health care accounts for a staggering 13 percent of our nation's gross domestic product. It's heading toward 15 percent and will get there soon. Any proposed changes in a system that big and complex create instant controversy.
 The solution to our health care problems will come over time. We can reasonably expect some of the first pieces to be identified fairly soon by the president's health care task force headed up by Mrs. Clinton. But expecting more than a good start is simply unrealistic. Meaningful national health care reform will take at least two years to achieve -- well beyond the magical "100 days" hoped for by some observers.
 It would be wrong (and foolish) to assume that health care solutions that have been effective in one state (or another country, such as Canada) would automatically work on a national level in the U.S. But some of those pieces may fit well.
 Minnesota, for instance, has enacted a meaningful health care code that today allows more of its citizens to receive the health care they need and deserve. Whether the new delivery system results in lowered health care costs is yet to be determined, but results are being closely monitored -- with high hopes.
 Closer to home, the Washington legislature has just passed a health care act that will put the state in the vanguard of the national health care reform movement. The new bill is the product of two years' work by an able and dedicated health care commission. Among other things, it would guarantee all residents access to health insurance that may not be available through their employer or other traditional sources, and would regulate health care costs. Governor Lowry has made health care reform a priority and is expected to sign the landmark legislation enthusiastically. This bill will likely help fill in the missing pieces of the evolving national health care puzzle. At some future time, our state program might either be melded into or superseded by a national plan.
 As patients, we expect our health care professionals to act deliberately, but not in haste. As the doctors say, "First, do no harm." We don't expect them to perform miracles. Our elected officials need and deserve the same kind of patience as they struggle to solve America's health care puzzle. We must give them that patience -- as well as our encouragement to look for and find solutions to our health care problems, wherever those solutions may be found.
 -0- 4/26/93
 /CONTACT: David Endicott of Communication Northwest, 206-285-7070, for First Choice Health Network; or Clayton Field, president, of First Choice Health Network, 206-292-8255/


CO: First Choice Health Network ST: Washington IN: HEA SU:

SW-LM -- SE017 -- 1059 04/26/93 19:14 EDT
COPYRIGHT 1993 PR Newswire Association LLC
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1993 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Publication:PR Newswire
Date:Apr 26, 1993
Words:1093
Previous Article:KEY INTERESTS RECOMMEND NEW STATE WATER POLICIES, WASHINGTON STATE DEPARTMENT OF ECOLOGY SAYS
Next Article:WASHINGTON MUTUAL ANNOUNCES FINANCIAL CENTER CONSOLIDATIONS
Topics:


Related Articles
STEVENS MEMORIAL HOSPITAL BECOMES FIRST CHOICE PROVIDER
FIELD CALLS ON CONGRESS FOR HEALTH CARE REFORM
FUNDAMENTAL CHANGES TO HEALTH CARE SYSTEM CALLED FOR BY CEO OF NATION'S LARGEST HMO; ALSO URGES GREATER ATTENTION TO QUALITY AND INNOVATION
HEALTH CARE DEBATE GOES ELECTRONIC; I-MODE PUBLICATIONS AND RELIANCE MEDICAL INFORMATION ANNOUNCE THE NATIONAL HEALTH CARE DEBATE ON CD-ROM
BLUE CROSS OF CALIFORNIA NOW ACCEPTING TRANSACTIONS ELECTRONICALLY ON THE NATIONAL ELECTRONIC INFORMATION CORPORATION (NEIC) NETWORK
FIRST CHOICE HEALTH NETWORK: WASHINGTON RESIDENTS THINK CONGRESS FAILED ON HEALTH CARE REFORM
MONTHLY WASHINGTON HEALTH CARE POLL FINDS RESIDENTS DEEPLY DIVIDED ON BEST COURSE FOR REFORM
FIRST CHOICE HEALTH NETWORK EARNS STATE LICENSE
Admar Corporation Signs Agreement With Baptist St. Anthony's Health System To Expand Texas Service.
AMA Convenes Nation's Health Care Leaders To Seek Universal Health Coverage for Americans.

Terms of use | Copyright © 2016 Farlex, Inc. | Feedback | For webmasters