MEETINGS FOCUS ON PRIMARY HEALTH CARE

Missouri health officials hope a new access plan will pave the way for people to get the health care they need.

Meetings are being held around the state asking health-care providers and consumers to identify the need and explain how they can best be met.

The first Southeast Missouri meeting was held Monday at Perryville.

A Cape Girardeau County meeting is scheduled for 7 p.m. July 29 at the Cape Girardeau County Health Department, 1121 Linden. Another meeting will be held in Sikeston on July 28.

The purpose of the meetings are to determine what local residents believe are gaps in local medical care.

George Thomas, program coordinator in the Bureau of Primary Care, Missouri Department of Health, is coordinating the meetings. The local effort is part of a national project to do primary care access planning.

Plans will be used by the federal government when making budget decisions, Thomas said.

"One of the things we're doing is kind of town hall meetings to secure information from the general public as to what they perceive are the needs," Thomas said.

He said data doesn't exist about the health-care systems people use and need. "I can tell how many doctors you have in Cape County, but I don't know if you go to those doctors," said Thomas.

Thomas said the state has compiled a large amount of data from computer records.

For example, Cape Girardeau County has 141 licensed physicians. Of that number, 30 are general practitioners, family practitioners or internal medicine specialists; seven are obstetricians-gynecologists; five are pediatricians; six are general surgeons; 16 are classified as other surgeons; 8 are psychiatrists; 69 are other specialists; 32 are licensed dentists; and 52 are pharmacists.

In Cape Girardeau County, there are 2.22 physicians per 1,000 population.

"We've sent that material ahead for people to look at so we can talk about what kind of gaps exist," Thomas said.

Similar meetings have been held in other parts of the state already.

"About 20 to 25 people are showing up," he said. "Physicians have been coming and health department people, pharmacists, nurses, long-term-care people, all kinds of people."

In addition to providers of health care, consumers are also invited to speak, he said.

"We had an elderly couple come at Hannibal who wanted to know what could be done about health insurance. Their health insurance costs were out of sight; they couldn't afford not to have it and they couldn't afford to have it.

"That's one of the gaps we seem to have identified," Thomas said, "Low-cost health care and low-cost insurance have got to be developed somehow.

"Obviously we have a shortage of health professionals in rural areas all over the state. Our average state ratio is one-to-4,000 population. A shortage is considered one-to-3,500," Thomas said.

"People are telling us the truth. They don't have enough doctors. They also don't have enough Medicaid providers doctors and dentists. They don't have transportation, and scheduling is a problem so they are misutilizing ambulances."

A shortage of alcohol and drug programs, school health programs and sick-baby day care are other issues that have been identified at the town meetings. People attending the meetings will be asked their opinion on how to best meet those needs.

"Our goal is some type of access for people to medical care," said Ron Cates, district administrator for the southeastern district of the Missouri Department of Health.

"We can't deny there is a problem with access," Cates said. "But we have to sit down and say, Here's where we are, here's what our problems are, and where can we go from here?

"There are a multitude of issues," Cates said. "Obviously there are financial concerns people who cannot afford primary care.

"But there are transportation issues. Even if we had a place for people to go, if it is 20, 30, 40, 50 miles away, they have no way to get there."

"We hope that there will be some consensus on where we can go from here," Cates said.

In the end a written document will be drafted outlining access needs for the state, county by county.

"We have imposed a deadline on ourselves of 1993," Cates said. "That's not very far off, but everybody feels that this issue has become so critical we need a pointed time line."