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DETROIT MEDICAL CENTER PRESIDENT COMMENTS ON ACCESS TO HEALTH CARE

 DETROIT MEDICAL CENTER PRESIDENT COMMENTS ON ACCESS TO HEALTH CARE
 DETROIT, Nov. 27 /PRNewswire/ -- Following are remarks that were made by David J. Campbell, president and chief executive officer of The Detroit Medical Center, at a news conference today. At the news conference, Campbell talked about the possibility of the loss of health care services to low-income residents of Wayne County and his hope that such services will continue.
 "Within a few short weeks, 47,000 low-income adult residents of Wayne County may be dealt another severe blow. Just two months ago, most of these people lost public assistance. Now, on Dec. 27, unless the Legislature and governor act quickly, these same people will lose access to essential health care services. Not only will this spell tragedy for these low-income residents, the impact on the emergency medical system in Wayne County will affect everybody in need of emergency care.
 These 47,000 people until now have received care under Wayne County's CountyCare program. CountyCare was an ambitious experiment begun in 1988 to provide a broad range of health care services to the indigent in an HMO-like approach. For three years, the program has succeeded in controlling health care expenditures for this population and, most importantly, providing better access to health care through a coordinated system of care.
 The CountyCare program was structured as a public-private partnership involving state funding and guidelines, county funding and administration, and care provided through four private health care organizations, of which The DMC is one. However, one of the key partners, the state of Michigan, has since Oct. 1 pulled out of the partnership by failing to appropriate funds to meet its obligation. Wayne County and the hospitals and physicians who serve CountyCare patients have all continued to meet their end of the bargain, but we cannot continue the program without the agreed-upon support from the Legislature and the governor.
 State funding ran out on Sept. 30, but Wayne County has continued to fund CountyCare for the past two months, hoping that the state would realize the tragedy -- both financial and human -- the people of Wayne County face. Those hopes received another setback last week when a supplemental funding bill was passed in Lansing (Mich.) which again failed to include funds for CountyCare. The county has given these 47,000 people one last reprieve, through Dec. 27.
 If CountyCare is allowed to end, the results are frighteningly predictable. The recipients of CountyCare will lose access to medical care. Nearly 40 percent of the enrollees in the program suffer from chronic diseases, such as high blood pressure, diabetes, cancer, heart disease and asthma. Without ongoing medical attention and treatment, their conditions are likely to deteriorate rapidly. Because doctors will no longer be available to provide needed care in their offices or ambulatory facilities, patients will seek care in Wayne County hospital emergency rooms. This will be a more costly and less effective way of providing care than under the CountyCare program.
 Our hospital emergency rooms, already overcrowded as you know, will be called upon to treat an increased number of patients -- estimated to reach 6,000 additional visits per month. The Detroit Medical Center, through Detroit Receiving Hospital and Grace Hospital -- our two adult emergency facilities -- can alone expect to see one-half of these visits. A severe emergency room backup will certainly occur. EMS and private ambulances, carrying seriously ill and injured patients, can expect to be rerouted even more frequently than they are rerouted now.
 Many of these patients will require hospitalization. Many of these admissions could have been totally avoided under CountyCare which supports a system of care involving both ambulatory and inpatient services. From a hospital perspective, the loss of CountyCare will bring serious financial distress. Wayne County has estimated that hospitals will be faced annually with as much as $100 million in new, uncompensated care. Speaking for The DMC, which already provides $75 million in uncompensated care annually, we simply cannot accept this additional financial burden.
 We, like other hospitals, will be forced to take steps to maintain our financial viability. We will not be able to increase staffing to accommodate the increased volume in our ERs and inpatient units. As necessary, we will be forced to more often reroute EMS vehicles. We will have no choice but to close the doors to some of our important outpatient clinics. And, if necessary, we will close down inpatient units to reduce the financial burden of increased uncompensated care.
 In Wayne County, we are faced with a truly ironic situation. At a time when the nation is finally beginning the serious debate over assuring access to health care for all Americans and seeking ways to contain health care costs, we are going in the exact opposite direction. At a time when legislative committees and task forces in Lansing are trying to address the plight of the nearly 1 million Michiganians without health coverage, the state is adding 47,000 more people to the problem. And at a time when the people in Pennsylvania have sent a clear, national message in support of access to health care, the people of Wayne County will be denied that access.
 It is our understanding that yesterday Gov. (John) Engler instructed his key department heads to find some way to identify funding to continue CountyCare. We would urge that process to continue quickly, so that when the Legislature returns to Lansing next week, threat to our health care system can be eliminated."
 -0- 11/27/91
 /CONTACT: Dennis Archambault, director of public relations and marketing, Detroit Receiving Hospital, 313-745-4717/ CO: The Detroit Medical Center ST: Michigan IN: HEA INS SU:


SM-JG -- DE015 -- 7826 11/27/91 15:16 EST
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Date:Nov 27, 1991
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