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Published: Saturday, 8/31/2002

A daring health initiative

In a bold new program that could become a state and national model, Toledo's health care institutions have banded together with the city and county to devise a figurative safety net to assure quality care for up to 44,000 folks who don't have health insurance - public or private.

It's innovative, it's risky, and it's an unprecedented display of cooperation between hospital systems usually fighting each other tooth and nail.

Details are sketchy and issues like eligibility, compliance, and funding are still to be worked out, but the hospitals are impressed by the earnestness of Mayor Jack Ford, who proposed it, and seem determined to make it work.

Earlier this year the mayor proposed that the major health institutions find a way to assure health care for people who otherwise cannot afford it.

When this ambitious Toledo-Lucas County CareNet plan - to include prescription medicines and dental care - comes to fruition in January, the mayor jokingly suggested in a meeting with The Blade, he might as well resign. What bigger or better legacy could he leave the city than this, he wondered aloud.

What is evident in the development of this plan is the power of the Toledo strong-mayor's office as bully pulpit, without which our region's highly competitive health systems might never have joined together for the public good. Mercy Health Partners and ProMedica Health System announced the birth of their collaboration in March, two months after Mayor Ford proposed it. The base has since been expanded.

The city of Toledo also will be a partner in the enterprise, and other partners, including Medical College of Ohio, St. Luke's Hospital, Lucas County, and the city of Oregon will contribute to the $380,000 startup costs over two years.

The hospitals, as a buying consortium, expect to be in a better bargaining position with drug companies on price than any of them would be alone.

The rest of the costs for primary care, Mercy and ProMedica say, will be covered by the participating institutions' use of existing clinic spaces to deliver that care. Case records on computer will be available to doctors no matter which facility these patients use.

MCO, an educational institution as well as a medical facility, besides providing care as it now does, would likely play a significant role in the health education of patients in the program, according to its acting president, Dr. Amira Gohara.

The success of this program will depend upon its acceptance as a safety net that protects the health of the poor not eligible for other health programs, public or private. It will fall apart if it grows so big the local partners cannot manage it. And grow it might if employers without conscience drop their coverage in reliance on CareNet. Here, again, the mayoral bully pulpit would be persuasive, and strict eligibility requirements will help hold costs down.

The program will focus on primary care, whose cost is manageable. Organizers are in the process of figuring out the cost of drug and dental coverage, dental care, and specialist attention. Participants will even be able to get to doctor's appointments free on TARTA buses.

The two largest health providers' collegiality in this instance is as unique as it is intelligent and common-sensical. So is the planned focus on preventive care and the three-strikes-and-you're-out proviso for patients who don't follow doctor's orders.

In all, this proposal and the collaboration behind it will benefit both residents of Toledo and Lucas County and people in other cities who use it as a model.

It is also a testimony to Mayor Ford's social work approach to city government, which appears to involve seeing government as the servant of the people, identifying people problems - be they health care or trashy city lots - and devising workable solutions.

As Toledo-Lucas County Health Commissioner David Grossman said, “the devil is in the details.” But given the enthusiasm of this collaboration and the firm intent of solving problems to make it work, it's hard to believe the plan won't fly.



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