With the recent closing of San Mateo and San Francisco Individual Practice Association's, leaving a huge gap in medical services and little more than Mills-Peninsula to answer the call for health coverage, it is no wonder that San Mateo county has been coined as the 'Bosnia' of the health care crisis. It is also no wonder that the San Mateo City Hall Council Chambers were packed last night when Sen. Jackie Spieir (D-San Mateo / San Francisco) came to town to hold a town forum on the topic.
Spieir was flanked by Daniel Zingale, former patient activist and Director of AIDS Action, who has recently been appointed as the Director of California's Department of Managed Care - armed with a $45 million budget to address the concerns of patient care. In the audience were an assortment of representatives from healthcare providers, community members and physicians - who all for obvious reasons had interest in the subject matter.
Early on, Spieir made the comment that "It's not my intent to point a lot of fingers but solve problems."
After that, however, the gloves came off and the town forum took on the appearance of a Senate hearing, as she is the Chair of the Insurance Commission, and has been the go to for many area patients when they find difficulties in getting their HMO's to respond to their medical needs.
Spieir and Zingale posed poignant questions to all levels of healthcare coverage, while community members in the audience nodded their heads in approval.
On the administrative level one obvious problem that the health care providers were having with meeting the needs of their patients is the lack of doctors.
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"I've been with an IPA for 18 years and we've weathered a lot of storms. Seen a lot of changes. I agree with you, we are in a state of crisis," said Lisa Kraymer, CEO of the San Mateo Individual Practice Association - which is now in the process of closing its doors after over twenty years of service. "You are going to continue to have crisis in terms of physicians not being in the county," Kraymer added. She said doctors were not getting reimbursed fully for their services and admitted that her organization still owed over $1000,000 to local doctors for services rendered.
Dr. Brian Roach, president and CEO of Mills-Peninsula even upped the ante at this point calling San Mateo the Bosnia of the health care crisis.
"We need some realistic expectations about what we want managed care to be. We can't be all things to all people," Roach added.
He said the limited approach that Mills-Peninsula takes in providing care is, in part, reason why they are still financially solvent while other providers are going out of business.
He also stated that there was no way that the Mills-Peninsula Medical Group could take on the some 60,000 people in the county that would be left without care providers. "The life boat's only so big. We don't want to swamp the last stable provider in the County."
One community member gave a very personal account of how managed care has worked, or not worked for her family. Her husband was diagnosed with a life threatening disease. "I always thought if you pay your premiums on time, care would be provided. I found out that wasn't the case."
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