MANAGED HEALTH CARE: "Take one aspirin and call your primary provider during normal business hours."

The managed health care issue has expanded from the purchase of health services for a defined group; i.e., individuals that receive some form of medical assistance and that are enrolled in Prepaid Medical Assistance Program to HMOs quality of services and more specifically to you the tax payer, wondering about your own health care.

Time magazine in their December 8, issue, the "Dr. Clinton Scrubs Up" article reported that The American Medical Association has sided with the President for the 1998 debate on health care. Quite a change from four years ago! "Welcome to the next health care debate. This time it’s not about Washington changing the system but about keeping the free market from changing it too quickly." (emphasis added). The article further states that the health care debate has shifted from a debate about the 41 million without insurance to the 70 million who have enrolled in health maintenance organizations. The debate is more about "rationing procedures", a "narrower choice" of doctors and a patients "bill of rights." In December, there was a six part Star and Tribune Special Report on health care, and in the St. Paul Pioneer Press, a minimum of seven articles/editorials. The main theme seems to be access to care, the quality of it, and at what cost.

Janice’s job in the debate is to make sure individuals have health access which is affordable in Ramsey County. Though the debate has shifted, a decision on the proposed "Multi-tract Delivery Model for Ramsey County" and the purchase of medical services is just a springtime away. Commissioner Rettman’s main question of mandated services having to be funded with county tax dollars has still not been answered. Some counties, including Washington, have chosen not to participate at this time.

Oh for the good old days when you actually called your Doctor direct and the doctor answered and said, "take two aspirins and call me in the morning"—a real voice, perhaps a bit sleepy, but a real caring individual.

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