Go to a federally funded community health clinic, which offers health care priced on a sliding scale, several people said. Or maybe sign up for a public insurance, if you're eligible, or visit a community hospital.
“It's not a great solution by any means, but at least it's a partial solution,” said Tom Roberts, a physician and president of the Western Montana Clinic in Missoula.
In fact, many of those who testified or made presentations said the real solutions are national in scale, and perhaps too big for Montana alone to resolve.
“It's not that there is poor health-care planning,” Roberts said earlier in the hearing, when discussing the shortage of primary care physicians in Montana and nationwide. “There is no health-care planning. This is a complicated, difficult issue, and we really need some sort of concentrated (national) focus on that.”
Nonetheless, committee members spent two hours listening to people talk about problems with the health care system and efforts in Montana to solve them - and will do so again on Wednesday.
Sen. Roy Brown, R-Billings, who chairs the Senate panel, called the meeting to listen to leading health care executives in the state, as well as the public, on what is being done or should be done to address rising health care costs and shrinking access to care.
Joining Roberts before the committee were Sherry Cladouhos, president of Blue Cross/Blue Shield Montana, the state's largest private health insurer; Anna Whiting Sorrell, director of the state Department of Public Health and Human Services; and Dave Kendall, a Missoula health-policy analyst who's been working with the Montana Health Care Forum, a group looking at local reforms.
Brown said the issue has become more important as the economic recession leads to people losing their jobs and health insurance.
Cladouhos, Kendall and Whiting Sorrell each listed proposals that are under way or under consideration, such as expanding the Children's Health Insurance Plan, creating electronic health-information systems, encouraging more generic drugs, pushing preventive medicine, and revamping how primary-care doctors are paid.
The shortage of primary-care physicians - family doctors, internists and pediatricians - drew perhaps the most comment.
Cindy Stergar, who works at community health clinics in Butte and Dillon, said if the state could do one thing, it should somehow boost primary care because thousands of Montanans are without access to a primary-care doctor.
It could take the form of recruiting physicians or somehow encouraging Montana kids to go into medicine and be primary-care physicians, she said.
Roberts, an internist who stopped practicing because he couldn't make a living at it any more, said the pay for specialists is much higher with fewer hours, so medical students are gravitating toward those disciplines.
“Among the developed countries, the United States is lowest in primary care doctors, the lowest in health-care outcomes and the highest in cost,” he said. “It's important to understand there's a relationship between that.”
He said a good first step would be to find out how many primary-care physicians are practicing in Montana and how many are needed - something no one has done with any precision.
Don Judge, representing the Montana Nurses Association, said increasing the number of nurses in the state could help, because they can provide primary care.
Olivia Riutta of Missoula told of how she had been without health insurance until her partner got a job with the state university system, covering them both. It shouldn't be that way, she said.
“I'm a lucky one; I think the employer-based model of health coverage we have is hit-and-miss,” she said. “For too many people, it doesn't work for them. A system that works by chance just isn't acceptable.
“We're focused on working within a broken system. I think we need to open up the discussion.”
|
 |
 |
Add your comment now! Write your comment in the form below.
(Email address is for verification only. If you'd like to email a story, look for the link above)