Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, September 22, 1993 TAG: 9309220152
SECTION: VIRGINIA PAGE: A-1 EDITION: METRO
SOURCE: By CAROLYN CLICK STAFF WRITER
DATELINE: LENGTH: Long
The first chapter in that revolution will be written tonight when President Clinton unveils his plan to overhaul the nation's health care delivery system and implement proposals that he says will extend medical coverage to all Americans.
Some who will be watching tonight's televised speech cannot wait.
For individuals like Tim Lawson of Roanoke County, who is trying to figure out a way to finance a cure for his sick baby son, tonight's televised address by President Clinton is coming none too soon.
Eighteen-month-old Jonathan needs a bone marrow transplant - considered experimental by Lawson's insurer - to treat a rare, malignant brain tumor. The family must come up with $150,000 before the child can undergo the operation at Duke Medical Center, Lawson said. The total cost of the operation could soar as high as $250,000 to $300,000.
"We work for a living. We're not rich," said Lawson. His Blue Cross and Blue Shield insurance has paid 80 percent of the cost of chemotherapies and other treatments for the baby, but the family must shoulder the burden of the remaining 20 percent while figuring out how to raise private donations for the transplant.
Whether Clinton's massive health care reforms will resolve the plight of families like the Lawsons is anybody's guess.
Dick Robers, president of the Blue Ridge Regional Health Care Coalition, noted that the speech will be only the "first salvo" in a battle that is likely to last several years and involve bitter debates and fierce lobbying on Capitol Hill.
"Personally, I have sort of a wait-and-see attitude," said Robers, whose coalition of businesses brokers health insurance coverage to 35,000 employees and 80,000 family members throughout the area. "I truly believe that what comes out tomorrow night is the first salvo. What comes out tomorrow night will be the foundation for how we finally build this system."
Before a final plan is enacted, "I think it's likely we will see some real substantive changes," said Rep. Bob Goodlatte, R-Roanoke. "This has a long way to go before we know how it will affect the health care system."
For health care providers, the speech will end some of the suspense that has surrounded one of the most controversial undertakings of the young administration.
"This is an exciting time, but it is a time of unknowns," said Dr. Jack Ballenger, president of the Roanoke Valley Academy of Medicine.
"I'm cautiously optimistic, and I think that's what a lot of physicians would end up saying. One of my biggest concerns is how you are going to cover the number of people that need to be covered and pay for it without compromising what we already have in the system."
The outline of the reform proposal that emerged in the last week suggests the practice of medicine will undergo dramatic changes, with physicians and hospitals banding together in provider networks to treat patients who would be pooled in large regional alliances.
A patient's choice of physician may be limited by the alliance or the network chosen by his or her employer; if fee-for-service options are offered, they will likely be more expensive.
"That concerns me," Ballenger acknowledged. "One of the most important small businesses in this country is the small practice of medicine, and in many ways it appears to be in jeopardy.
"I would hope that the patient-physician relationship be disturbed as little as possible, and secondly, that physicians who want to remain in small private practices be allowed to do so under a new health care system."
There will likely be a change in the nature of the competition between the Carilion Health System - which owns Roanoke Memorial Hospital, Community Hospital of Roanoke Valley and a network of smaller hospitals in Southwest Virginia - and Lewis-Gale Hospital, owned by Hospital Corporation of America.
Already, said Robers, the hospitals are positioning themselves to offer the kind of health plan options the administration envisions.
But John Presley, director of the Salem Veterans Affairs Medical Center, believes there will be a growing alliance among the region's health facilities.
"The local private hospitals have long since recognized our potential clientele," said Presley. "I see a lot of cooperation and sharing and a lot of trade-offs."
Under the Clinton plan, veterans hospitals, which now treat primarily veterans with service-connected injuries and those who cannot afford health care, will be enlarged to care for more veterans, Presley said.
"We will be sort of like an HMO and they [the VA] will pay for the service-connected veterans and the poor, and then I think they will give an option to have all the veterans join the HMO.
"I'm looking at it broadly, and I'm looking at it for Joe Q. Citizen," said Presley. "We will maintain our identity as a VA hospital, but I can see all kinds of things happening in the future."
Some Virginians will be listening with trepidation to Clinton's speech, including those involved in the state's tobacco industry. The administration has called for a substantial increase in the cigarette tax, a move critics say will be disastrous to the state's agricultural economy.
Keywords:
INFOLINE
by CNB