Key to delivery of health services - money

In Hayti, Mo., Pemiscot Memorial Health Systems operates a hospital and four rural health clinics serving mostly elderly, poor or disabled patients in Pemiscot, New Madrid and Dunklin counties. Without the availability of these services, many residents of that area would have virtually no access to health care.

So when Pemiscot Memorial's top administrator says he needs more money to meet the medical needs of this largely rural area, he is also saying that a lack of adequate funding could mean less health care in an area that already feels it is deprived.

That was just one of the messages delivered recently at a hearing in Sikeston, Mo., where the Missouri Foundation for Health began a series of meetings around the 84 eastern counties of the state to find out what's lacking in health care.

The foundation, which was created two years ago as part of a settlement that allowed Blue Cross and Blue Shield of Missouri to become a for-profit company after decades as a not-for-profit charitable organization, certainly has the means to make a significant difference. With assets currently valued at nearly $1 billion, the foundation can, in the years to come, fill a lot of gaps in health services for the needy.

At the Sikeston hearing, foundation officials heard from residents who need health care, officials of local government and those who struggle to provide care to a population that can scarcely afford to pay.

Among the points made were comments about the need for transportation and funding for community-based organizations that deliver services directly to a specific group.

One person described the futility of health screenings that indicate the needs for medical attention. If you're poor, you can't afford to go the doctor. If you have no vehicle, you have to rely on others for transportation -- or don't go. If there is no doctor in your area, you might be inclined to forgo seeking treatment.

The Missouri Foundation for Health is just starting to take applications for grants for many of the services described at the hearing. Other hearings will, no doubt, describe even more needs that aren't being met because of a lack of resources.

If the foundation's aim is to deliver health services to those in need, it couldn't pick a better place to start than Missouri's Bootheel. While demands from inner-city St. Louis may involve a larger population in need of assistance, the needy in Southeast Missouri have problems that are just as difficult to resolve as any group in the state.

The first major test for the Missouri Foundation for Health will be to see if it listens to what it is being told at these hearings. If it hears what is being said in places like Sikeston, the response from a billion-dollar foundation should be obvious.