
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, February 14, 1995                   TAG: 9502180022
SECTION: EDITORIAL                    PAGE: A-6   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

HOSPITAL-IZED

INNOVATION, a necessity these days in the health-care industry, has found a little niche in Danville, Va. At the nonprofit Danville Regional Medical Center, poor patients are able to work off the cost of their treatment.

The key word is "able," for this is not a program of forced labor but an opportunity for people who want to pay their bills, but have neither the insurance nor the cash. So they give their labor - voluntarily.

As a nonprofit, the Danville medical center knows some of its patients will never be able to pay hospital bills. The center collects when it can, and writes off the debt when it cannot. This is cost-shifting, a move now familiar to a public that has seen health-insurance costs soar, sometimes right out of their job-benefits package.

A program to let some people work off what they owe is not going to solve that problem, or make a dent in health-care costs. So far the work ranges from housekeeping duties to some computer work, and in no case does it replace paid positions.

Such labor is at least symbolically interesting, though. It can help mitigate some of the effects of cost-cutting on a medical operation. It also can help proud people maintain the dignity that comes with their ability to do for themselves.

More basically, it serves to remind that the unreformed health-care business is producing a lot of people who are, in effect, poor, who cannot pay their own way because they lack insurance, or could not pay if they lost their insurance. Charity is no substitute for self-respect. People may lose their health when they become ill, but they should not have to lose their dignity.

The Danville medical center has a pool of job descriptions for work that can be handled by volunteers, and the program is coordinated through its volunteer office. How long a person must work to have his or her debt cleared is decided by that coordinator, based on the quality of the person's work and the dedication shown. The center does not attach an hourly "rate" and track a dollar amount of "earnings" against dollars owed.

A hospital spokeswoman explained there is not a lot of merit in looking at the program from the bottom line. It is less about money than it is about a human need to contribute - and a hospital's recognition that all patients fall into a category other than "the insured" or "the uninsured." It is "human beings."

by CNB