Berg, Chesbro hold health care meeting
by Sara Watson Arthurs, 12/02/2005
”I think we’re right on the cusp of where this whole thing’s going to collapse.”
Dr. Ellen Mahoney summed up many speakers’ comments on rural health care at a meeting on the topic held by Assemblywoman Patty Berg, D-Eureka, and state Sen. Wesley Chesbro, D-Arcata. About 50 invited attendees -- doctors, hospital administrators, nurses, county government leaders and nonprofit agency representatives from Humboldt, Del Norte and Trinity counties -- shared their views at a three-hour meeting titled, “How to Improve Healthcare in California’s Rural Areas.”
Seventeen speakers were given five minutes each to speak on topics ranging from how to provide health care across vast geographical areas to the way mental illness and substance abuse affect the primary care system. Berg and Chesbro primarily listened to others’ comments.
Mahoney’s comments focused on Medi-Cal and Medicare funding to rural areas, which she said often pay rural physicians less than their urban counterparts for the same procedure.
Dr. Luther Cobb, president of the Humboldt-Del Norte Medical Society, spoke on the lifestyle of a rural physician: Cobb said he often works seven days a week, and on some days may be at work from early morning to late evening. Cobb said his intention wasn’t to complain -- “I absolutely love what I do” -- but the reality of rural life makes it hard to recruit physicians who could work fewer hours in bigger cities.
Jeanette Lackett, director of nurses at Mad River Community Hospital, said it’s also hard to recruit in other health professions such as radiology technicians and physical therapists.
One method could be to start a medical residency program in Humboldt County, allowing physicians to get experience in a rural area, said Lauri Medeiros of the California State Rural Health Association.
Carole Peet, assistant administrator at Sutter Coast Hospital, said the hospital’s emergency room is frequently full of non-emergency patients who have nowhere else to go. She said patients with acute psychiatric illnesses and no health insurance are among the most common.
Transportation was another issue. One scheduled speaker, Jim Sato of Mountain Community Medical Services in Trinity County, was unable to come to the meeting because of a rock slide.
The group also discussed the complexity of health care.
”We have eight more employees just making the paperwork happen in our office than we used to have, and we still can’t keep up,” said Dr. John Gambin.
And health care is such a fragmented system that one person’s efforts might wind up saving or costing someone else money, said Martin Love of the Humboldt-Del Norte Independent Practice Association.
”When you do a good job and the insurance company saves money, it doesn’t get transferred back to you,” said Jerry Simone, CEO of United Indian Health Services.
Another topic was how to create public policies that recognize investments. Dr. Wendy Ring, medical director of Mobile Medical Office, said she’s trying to get Medi-Cal to recognize xylitol gum as a drug it will pay for. The gum can prevent cavities, which will save Medi-Cal’s dental program money, but Medi-Cal’s pharmaceutical branch may not recognize that, she said.
Chesbro, chairman of the Senate Budget Committee, said budget discussions often focus on specific expenditures and revenues without looking at how they relate to one another -- meaning it’s hard to recognize that an investment in one area saves money in another. As one example, he noted that early intervention with troubled children can reduce criminal activity years down the line -- but it’s hard to pay for because the state isn’t good at thinking long-term.
Simone said efforts toward health care reform start with small local movements.
”We need to change our priorities, but it has to start in the community,” he said.
Berg and Chesbro said the meeting will help guide them in future legislative decisions.
”This is, basically, just the beginning,” Berg said.
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