74^th Arizona Town Hall

Future Directions for Arizona's Health Care

May 16 - 19, 1999

Health care is an issue that tremendously affects every Arizonan -- every American. Three decades ago in January of 1970, Fortune Magazine wrote: "American medicine, the pride of the nation for many years, stands now on the brink of chaos. To be sure, our medical practitioners have their great moments of drama and triumph. But much of U. S. medical care, particularly the everyday business of preventing and treating routine illnesses, is inferior in quality, wastefully dispensed, and inequitably financed. Thus, ...the time has come for radical change."

The issues within health care affect every American -- every Arizonan. Debates on health care issues have been with us for decades and will continue long into the future. The reason -- contradictory goals. We want unlimited medical care, but with limited spending. These contradictory goals help to generate continuous complaints about our health care system. The 74th Arizona town Hall took on the controversial topic of health care reform for the fifth time in its thirty-eight year history and for the second time since 1993.

• Arizona faces a number of unique challenges in the delivery of health care: a sharp split between urban and rural communities; a large Native American population; a growing, aging and seasonal population base; border health care issues arising from the influx of immigrants; an underfunded behavioral health care system; the largest percentage of uninsured children in the country; a large homeless population; and a service based economy with al large number of uninsured part-time employees. Each of these issues requires prompt and careful attention. Each was discussed in more detail within the full report.
• Access to some basic level of health care should be provided to all Arizonans. Defining a "basic Level" is difficult and should be determined by the Legislature, working together with a newly appointed Governor's Task Force consisting of consumers, providers, insurers, employers and educators.
• Expanding AHCCCS to meet the needs of the working poor for basic health coverage was considered a critical need. Applying tobacco settlement and tobacco tax monies exclusively to address health care issues, particularly the problems of the uninsured and underinsured.
• To help alleviate the strains of Arizona's aging population, we need to: educate and train more health care professionals; encourage retired health care providers to volunteer; educate baby boomers on ways they can reduce the risk that may require extensive elder care and about planning for the financial consequences of elder health care costs; and encourage the use of in-home care and hospice.
• Managed care has been relatively successful in urban areas, but needs to do a better job of educating their clients and the general public, to standardize and simplify their terms, administrative processes and the manner in which information is collected and shared. Managed care has not been successful in rural areas and new models need to be developed for use in those areas, such as purchasing cooperatives to improve the collective buying power of rural residents or tax incentives to encourage managed care entities to operate in rural areas.
• The 74th Town Hall supports increased funding for mental and behavioral health care and believes that such increases can be partially offset in the long run by a reduction in the need to fund care that often is required as a result of subsequent physical health problems experienced by the untreated mentally ill.

The 74th Arizona Town Hall was made possible in part by contributions from Bank One and Mayo Clinic Arizona.