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txncerpt from

Area IT, Vol. Ll, Mo. 10, May 5,

“RTMELIMES" California Regional
1971.

Modical Programs

[di torial: “ERE WE GO AGAIN:

Moil C. Andrews, HAD.
Area TL Coordinator

As some of you will remauber from the eavly REP
Days, the lepistation inigially known as the
Heart Disease, Cancer, and Stroke Program usder~
went an early name change to Regional Medical
Yrograms. ‘This uncertainty about the name of
the program, the lack of dixeetion from the
federal goverment as Co specific guals and ob-
jeetives to be achieved by this nev program,
and the miniinal amount, of monvy nade available
resulced in a considerable deyree of confusion.
Gradually, the cateh phrases of: the legislation
were examined and “cooperative arrangements”
were defined as working agrcements between med-
ieal schools, houpitals, and clinics. “Bring-
ing the latest scientific Finding from the lab-
oratory to the practitioner" was defined as
continuing education of health professionals
and has, unquestionably, upgraded medical care
throughout the United States during the inier-
vening five years. Much of this improvcinent
was accomplished in the areas of Heart Disease,
Cancer, and Stroke, as might be expected. Al-
though these "killer" diseases account for 70%
of the causes of death in the United States, a
definite impact upon care of patients with other
diseases has occurred.

 

During the past several years we have heard more
and more about the inadequacies of health care
delivery throughout the United States. The
atement is made that vast niunbers of our citi-
vens cannot or do not know how to obtain medi-
cal-care. Weare told that. the private practi-
tioner of aedicine is similar to the proprtetor
of the corner grocery: store who cannot compete
adequately with the superancket,. that the de-
livery system must be changed. ‘There is little
doubt that some change is jotny CoO “ccur since
the. administration is recommending health care

   

 

through Health Matatainance Organizations, Sen-
ator: Edvard Kennedy is Advocating Barioual
Health Insurance, the rican Hospital Assucia-

   

tien is. recounsending its recently developed
"Ameriplan", and oven the American Medical Asso-
ciation is advocating a progran known as "Medi-
credit.”

At the same time that the various persons and
organizations are recommending changes in the
methods of financing health care, Regional Med-
jeal Programs finds itself somewhat at odds with
the declared health goajs of the Nixon adui nis-
tration. As. one of the prograns within -the
Health ‘Setvices and Mental Health Administra
tion, it seems appropriate fo many coordinators
that Regional Medical Programs should review
these stated objectives and see which are appro7
priate to it. During Tate 1970, those conecarned
wiehthe Regional Medical Programs in California
determined that the areas of health manpower ond
the delivery of personal. health services te those
alin mn atétenne donvived of health care or to

ponent. aoney recently granted to the California
Region was specifically set aside for the plan-
ning of small projects related to those two
subjects.

Since this decision was reached, it has become
apparent that at the national level there is a
further de-cuphagis of a categorical approach
to health care delivery. One self-evident. re~-
sult of this de-eaphasis is the reduction in
the Regional. Medical Program budget, both dur-
ing the current year and for the coming year.
Thus, ongoing projects with categorical capha-
sis will be continued for thetr lifetime, but
when they expire in 1972 and 1973, competition
for the money thus released will be intense,
since it ig anticipated that no new money will
be available for categorical disease activi-
ties. This, despite the fact that the law
passed by the Congress of the United States
Still defines the activities of Regional Medi-
cal Programs to be in the area of Heart. Disease,
Cancer, Stroke, Kidney Disease, and Related
Conditions.

Thus, once again, Regional Medical Programs, in
a five-year instant replay, finds itself.in a
state of flux with minimal divection as to its
activities for the coming few months or years.
The administration suggests one course of ac-
tion, the law under which the program continues
states another. It would seem that the only
logical course to follow is to continue those
activities that have made Regional Medical Pro-
grams a viable entity in the past. In Area II
this will be reflected in the continuation of
those educational activities which have become
the halln of this program. At the same time,
in view of the new national priorities, we must
be aware of those areas in which we. can have -4
meaningful impact in improving heakch care de~
livery. With the minted budget available, we
must recognise probleas; than through eaceful
study and javolvement of iany people dnd organ-
izations, Find solutions. te those problems.

Tn the future, Regioual Medical. Programs must
continue: to be the proponent of quality in the
delivery of health care. The RMP must investi-
gate innovative approaches to health care prob-
lems, whither categorical or related to the de-
livery of care. Regional Medical Programs have
demonstrated their ability to bring together the
universities, medical schools, hospitals, medi-
cal societies, and the practitioners, These
accomp}ishmnents must noe be Allowed. to fade
away. During its short life, the Regtonal Hed-
joeal Propram has attracted a mmber. of highly
qualified people to yts vanks, both at. the core
staff leve) and as volunteers. For -the good, of
medicine in the future, these relatiouships
most be maintainec.

  

  

 

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