Health Care

By Kenneth J. Thomas

The power of Health Maintenance Organization administrators to dictate individual health care treatments, even when HMO physicians and patients seek other treatments, is not acceptable. Also, Arizona's behavioral health care system is simply not working. The Board of Medical Examiners needs to monitor and discipline more effectively.

Q. What can we do about the behavioral health care situation in Arizona?

A. Many of the homeless people we see on the streets are there, not because of poverty, but because of mental illness and lack of treatment. Most of these folks are harmless to others, but we must face the fact that the behavioral health care situation in our state is deplorable. Even for families that have health insurance, behavioral heath care is usually not covered. There is no simple answer. We need a thorough overhaul of Arizona policy on mental illness and behavioral healthcare. The legislature should devote a special session on working out the policy, programs, staffing and funding of behavioral health care. The laws should be proposed only after extensive citizen input, presentations by mental health experts, and testimony of social workers who must deal daily with this problem. In the meantime, one thing we can concentrate on immediately is improving the poor state of affairs at the Arizona State Hospital. We need to appoint a new director, repair the dilapidated structures, hire more qualified staffers, and restore certification of the hospital.

Q. What can we do about Health Maintenance Organizations (HMOs) which are more concerned about profits than quality health care?

A. Doctors should prescribe your course of health care, not HMO or insurance company accountants. Individuals should control their own choices of treatment, in order to obtain the quality health care they deserve and need. The state can require that medical care be based on the needs of the patient instead of cost containment tactics pushed by management of HMOs.

Q. Do you think Health Maintenance Organizations (HMOs) should be held to the same standards of liability as licensed individual physicians or hospitals?

A. Yes. In addition to liability in a court of law, HMOs should be better supervised by existing state boards, which currently lack the staff and motivation to oversee these medical organizations.

Q. How about other clinics, like abortion clinics?

A. Yes. Standards of liability should be the same, no different. These clinics, like HMOs, need more monitoring than they receive currently. This requires adequate staffing by the State Board of medical Examiners, which already has the power to yank licenses of poorly performing or dangerously incompentent physicians and clinics.

Q. Do you support public policy that protects the confidentiality of persons living with HIV/AIDS?

A. Yes. Public health records concerning individuals with other disabling diseases are generally confidential. Persons living with HIV/AIDS are no different.

Q. Do you support providing adequate health care to all Arizona citizens regardless of income or health status?

A. Yes. In many cases, employer-provided or individual health insurance, HMOs, Medicare, military health care or AHCCCS will provide the health care. State leaders can influence corporate leaders to provide adequate coverage for medical or behavioral treatment of employees and their family members. But we must take action to make sure those who are not eligible for such company-sponsored benefits are also covered. There are still many working families and individuals with disabling diseases or injuries who are near the poverty level and need coverage. Poverty or pre-existing conditions should not doom them to suffering, illness or death. One study ranked Arizona 48th out of the 50 states in two disturbing categories: the percentage of children without health insurance (20%), and in the percentage of two year olds who were not immunized (28%).