HEALTH-CARE REFORM NOT DEAD, HEALTH OFFICIALS SAY

Health-care reform isn't dead, but prescriptions for change likely will occur in incremental steps over years, Cape Girardeau and state health officials said Tuesday.

Southeast Missouri Hospital Administrator James Wente said the nation's health-care woes are complex. "To expect that it could be fixed overnight is not realistic," he said.

Wente said he is glad President Clinton's plan didn't proceed through Congress because it would have resulted in a huge financial burden to the nation.

"There is a lot more to reform than dealing with the payment issues," he said.

St. Francis Medical Center President John Fidler said health care shouldn't be controlled by national politics. "I think where it stalled in Washington was when it ceased to be a caring-for-people process and became a political process," said Fidler.

Health-care observer Mary Dunn said that while Washington has dumped health-care reform this year, reform is occurring in cities and states across the nation.

It is disappointing that Congress couldn't agree on insurance and tort reform, said Dunn, executive director of the Southeast Missouri Business Group on Health. "I guess I am disappointed in the politics of the situation," she said.

The Missouri Hospital Association's Dian Sprenger expressed disappointment in the demise of health-care reform efforts in Washington. Sprenger is senior vice president of the association, which represents 145 hospitals in Missouri.

"We had advocated a rather comprehensive reform of the health-care system," said Sprenger. "It is like a lost opportunity. We were definitely supportive of universal coverage."

She said the lack of national health-care reform will put increasing pressure on hospitals to provide deeper discounts on managed care, which will make it more difficult to provide medical services for the uninsured.

Dunn said Clinton's plan would have put an enormous financial burden on businesses. "We would rather see things fail than have poor legislation," said Dunn.

However, she credited Clinton with putting health-care reform on the national agenda.

Dunn predicted the real foundation for change will occur at the local and state levels.

Fidler agreed. "I look for health care to be solved locally. I would prefer a state approach to the problem," he said.

"I think our state is trying to take Medicaid out from under the federal mandate and move it into a statewide managed-care product," he said.

Wente predicted there will be some reform in the area of health insurance next year.

He said that locally, hospitals and doctors are already working together to improve the delivery of health care. He pointed to the recent establishment of MedAmerica HealthNet, a partnership involving five area hospitals and a number of doctors.

"There are a lot of things that are occurring within the health-care delivery system that are being done in anticipation of what health-care reform might look like," Wente said.