Accessing Health Care
August 1989

The black community is plagued with a disproportionate number of health problems due to insufficient access to proper health care, according to panelists on the seventh episode of North Carolina Public Television's ongoing series--Black Issues Forum.

The program, titled "Accessing Health Care" was taped before a live audience on the campus of the University of North Carolina at Wilmington. One way to access health care is through health maintenance organizations (HMO's). Dr. Charles Johnson, president-elect of the National Medical Association (NMA) and associate professor at Duke University Medical Center, said, "In HMO's, you have to be very careful that someone, the gatekeeper, is not saving money at the cost and expense of your health. I know for a fact that there are some doctors who are being paid not to see patients. Their interest is in profit, not your health."

According to Ellis J. Bonner, president and chief executive officer of Comprehensive Health Services, Inc. of Detroit, "We have thousands of dedicated physicians in this country who will counsel patients and send them to the health educator within that HMO framework. We do use physicians as our gatekeepers. Without physicians, an HMO is nothing."

But, accessing health care goes beyond the delivery system," Bonner says. "The patient has to have enough money to buy the proper food for nutrition and the medicine prescribed by the doctor."

Panelist Dr. Fred McQueen, Jr., president of the Old North State Medical Society and a family practitioner in Richmond County said the black community could receive the best health care through one-to-one contact with the physician without a middle man. "The doctor is the patient advocate. He cannot serve two masters. No one needs to manage between the patient and the physician."

However, according to Al Washington, vice president and regional manager of Kaiser Foundation Health Plan of North Carolina, the idea that HMO's have a middle-man between the doctor and patient "is the furthest thing from the truth. Managed care includes business aspects, but our physicians definitely make the decisions of what is best for the patient."

McQueen agreed with Bonner, saying, "I find that the Physician is not the real problem here, The real problem is pharmaceuticals, because that is the true cost. The medicine is continuous, whereas she may see me once every four to six months, if she does not have money to buy her medicine, she goes to the emergency room in a coma. And, the costs go up because she could not afford the medicine in the first place."

Other topics addressed include the need for more minority physicians and the high cost of Medicare and Medicaid.

PANELISTS:

Ellis Bonner, president of Comprehensive Health Services, Inc., of Detroit, MI.

Dr. Fred McQueen, president of the Old North State Medical Society.

Dr. Charles Johnson, president-elect National Medical Association.

Al Washington, Vice President of Kaiser Permanente.

The panel discussion was moderated by Valeria L. Lee, Chair of the University of North Carolina Center for Public Television and Program Development Officer for the Z. Smith Reynolds Foundation.