STATE OF GEORGIA COUNTY OF COWETTA AFFIDAVIT My name is Annie Dodge, and I live in Newnan, Georgia. I am a 55 year old widow and my sole income is my dead husband's V.A. pension. As I am disabled and cannot work, I am having a great deal of trouble paying my medical bills. My doctors in Newnan will not see me unless my account is paid up. So far I have been able to make my payments because I know I have to, but I am very fearful that one day I will not be able to, because of my limited income. If I have to see a doctor, and I don't have the money to pay, I don't know what I will do. STATE OF GEORGIA COUNTY OF COWETTA AFFIDAVIT My name is Ossie Jean Ragland, I am 37 years old, a resident of Newnan, Georgia, and the mother of 4 children. My general assistance checks are the sole support of my family. We have a very difficult time getting medical attention for my children. In Newnan, the very few pediatricians work at a clinic, which demands payment before treatment. Occasionally, my children can be seen if I have talked at length with the clinic's office manager and made arrangements for payment. Most often, however, I do not bother to go to the olinic, because I know that I do not have the money to pay for the visit. In addition, if I should need a doctor, and he prescribes a drug, I often do not have the money to buy it. Therefore, if I do not have money in advance to both see the doctor and buy whatever he prescribes, I might as well stay home, and usually do. STATE OF GEORGIA COUNTY OF COWETTA AFFIDAVIT My name is Leona Black. I am 42 years old, and I live in Newnan, Georgia, with my son and my aged father. I get AFDC, which means we get Medicaid; and my father receives disability payments, which means he gets Medicare. We still have health care problems. For instance, there are no dentists in Newnan who take Medicaid or Medicare. Also, my father had trouble getting out of the hospital when he couldn't pay the difference between the hospital bill and what Medicare paid. The doctor ordered a private room, but Medicare only pays for semi-private rooms. They didn't want to release my father because he couldn't pay that medical bill. I had to talk to three different people before I could get him out of the hospital. I was scared that the hospital wouldn't let him go home, and would just keep running up the bill even higher. STATE OF GEORGIA COUNTY OF COWETTA AFFIDAVIT My name is Sylvia Cleveland. I am 20 years old, a resident of Newnan, Georgia, the mother of two, and I am expecting a third child in May. The inability to see a doctor is a continuing problem. In emergency, I can be run up to Cowetta County General Hospital, but routine medical care, or anything short of emergency, is almost unattainable. There are very few obstetricians or gynecologists in Newnan, and those that do practice here work in a clinic that demands payment in advance, or a session with the office manager to discuss payment before I could be seen. Because I have so little money, I know I will not be able to get seen, and have been with a doctor only once since becoming pregnant. In spring 1977, in the last stage of my second pregnancy, I became ill. Family and friends called my obstetrician, who would not see me; when my condition worsened, friends drove me to the emergency room at Cowetta County General Hospital. I was treated overnight and finally saw my doctor as he made rounds the following morning. This was only the third time I saw my doctor throughout the entire pregnancy. Senator KENNEDY. I think that is a very helpful-the whole panel has been excellent in covering the human aspects with Mr. Mitchell and the practical aspects of what is happening out in the field, and Mr. Suitts' comments about the general survey of some of the particular problems, and your wrapping this up together. I think you get a sense, both from Senator Schweiker and my own questions, there is substantial agreement. The real question is how it is going to be done. Hopefully, the first thing will be the regulations in terms of carrying it forward along the lines that you have outlined here. We will follow those very closely and work closely with you on that, and beyond that, in terms of the legislation itself and how we can do it in a way that doesn't create all kinds of problems which you indicate is obviously not the purpose, and yet, have meaningful progress in those areas of balanced representation. I am personally strongly committed toward achieving that goal and we would like to work with you on that. I don't know whether Barry Checkoway would like to say a word. Do you want to say a word? We have about 8 or 10 more minutes. Is there anything that you would like to add and then maybe I would ask Anne Fenerty if she would just like to say a word. Is there anything you would like to add? We have your testimony and I understand it is excellent. I will get a chance to read it. STATEMENT OF BARRY CHECKOWAY, ASSISTANT PROFESSOR OF URBAN AND REGIONAL PLANNING, UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN; CHAMPAIGN COUNTY HEALTH CARE CONSUMERS Professor CHECKOWAY. I can give about a four or five summary statement since you already have my testimony. Senator KENNEDY. You may proceed. Professor CHECKOWAY. Thank you, Mr. Chairman. My name is Barry Checkoway, and I am an assistant professor of urban and regional planning at the University of Illinois, at Champaign-Urbana and a leader of the Champaign County, Illinois Health Care Consumers. Senator KENNEDY. Were you up at our dinner the other night in Chicago of our consumer Professor CHECKOWAY. No: but I am an elected board member of the Illinois Public Action Council, and I would like to take this opportunity to thank you for Senator KENNEDY. I am sorry, I didn't mean that. It was such a stormy night I was wondering. Professor CHECKOWAY. I am pleased that you made it back to Washington. My statement describes the local constraints on public involvement in health care planning under the Federal law. These are not the only local constraints with which we in our area are concerned but they are among the most important. The first constraint is the failure of consumer majorities on HSA governing and supporting bodies to approximate their area population. A recent report of a 3-month study of the East Central Illinois Health Systems Agency found this to be the case. This HSA comprises |