BUSINESS CONFERENCE PANEL TAKES LOOK AT HEALTH CARE CHANGES

Patrick Biri is concerned about shortages of primary care physicians.

Ruth Meyer Hollenback says if you're sick, the best place to be today is the United States.

Biri, administrator at Perry County Memorial Hospital, and Hollenback, regional vice president of Blue Cross/Blue Shield, were among members of a panel of local and state health care leaders who discussed the topic at the 1994 Business Conference Wednesday at the Show Me Center.

Others on the six-member panel were James Wente, administrator of Southeast Missouri Hospital; John Fidler, president of St. Francis Medical Center; Dian Sprenger, senior vice president of the Missouri Hospital Association, and Catherine Moore of U.S. Sen. Christopher Bond's St. Louis office.

The health panel, moderated by Karen Hendrickson, chief nursing officer at Southeast Missouri Hospital, was the second session on the business conference agenda, following a Boyd Gaming representative who discussed tourism aspects of riverboat gambling.

Following the health care program was Barry Hana, vice president and director of Employee Systems Division of Maritz Co., St. Louis, who was the conference's keynote speaker. He discussed employee motivation.

"We have the hospital institutions in Southeast Missouri, but we have a shortage of primary physicians," said Biri, who was first on the program, adding that Perry County had one physician for each 5,000 people.

"More and more physicians are specializing," said Biri. "The family or primary physician is a low growth area, and I can understand this. The specialty field is more lucrative financially. Many primary care physicians come out of college with a $100,000 debt to repay."

In addition, said Biri, the physician faces up to $40,000 a year for malpractice insurance.

The answer, noted Biri, may be in the form of more funding for medical schools, and the use of non-physicians, "mid-wives and nurse practitioners" in some areas.

Hollenback said, "People now want health-care miracles. Medical care in the U.S. is expensive, but we have some high cure rates for some previous killer diseases."

In 1936, a health insurance policy could be obtained for 75 cents a month, she said.

"But, there was no penicillin, no polio vaccine, no open heart surgery, no kidney dialysis," said Hollenback. "Transplants were unheard of. There were no health-care miracles."

Guns, gangs and unsafe sex have resulted in increased medical costs, noted Hollenback.

"It can cost up to $14,000 for treatment of a gunshot wound," she said. "At one time, this was not a big problem. Now six percent of the population suffers gunshot wounds. Sixty percent of the population tries cocaine or drugs. And, because of unsafe sex practices, AIDS is costing more than $6 billion a year."

She continued.

"Smoking results in more than $65 billion a year in health costs and drinking alcohol results in $80 billion annual medical costs. Exercise and seat belt use can decrease medical cost."

Hollenback said all persons should have medical care.

"Blue Cross/Blue Shield supports any health care action that would results in insurance for more Americans," said Hollenback. "I think a plan to mandate that all people have health insurance is a workable one. There's a lot of people out there who can afford insurance, but just don't want it.

"We don't need to dismantle insurance," she said. "We need to fine tune it."

Wente talked about health care and costs.

"In 1960, health care costs were about $27 billion nationally, representing about five percent of the gross domestic product," said Wente. "By, 1980 that cost had risen to $250 billion and about nine percent of the gross domestic product, and now we're looking at $800 billion and 14 percent of the GDP. That could go to 18 percent by the year 2000."

Wente added that trauma and violence had added to medical costs, along with the HIV epidemic, and stressed that people should take better care of themselves.

"If people would take better care of themselves, health care costs could be reduced," he said. "Health care is a household word. We need to look back at what we've done and get an assessment on what people think health care should be, and what is important to people."

Fidler added, "Health care promised nationally will be practiced locally. This country has the best health care in the world now, and health care in Cape Girardeau is good."

Fidler agrees that people should watch their lifestyles.

"Americans have the right to good health care," he said. "We want it, we deserve it, but we don't want to pay for it."

He added that there is "no free lunch" for health care and would like to see people, health providers and insurance companies all work together.

Moore discussed Sen. Bond's plan for an insurance plan to replace the Clinton plan.

"Bond does not believe President Clinton's plan will work," said Moore. "He feels the Clinton plan, which calls for businesses to pay 80 percent of health insurance costs for each employee, will result in layoffs and business closings that could cost the nation from 200,000 to 18 million jobs."

Bond's plan calls for universal coverage, mandating insurance for every individual, and more tax deductions for premiums.

Sprenger discussed Missouri House Bill 1622.

"The bill, which is in the second stage now, would move the state closer to universal coverage, integrated service network and offer some financial incentives," said Sprenger.