NH Outlook Talk Show , Friday, 9/25/2009
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script iconHello/Intro Profit vs. Non Profit Healthcare script iconKey: Health / Healthcare
script iconSquires Interview pkg script iconKey: Business / Industry
script iconConversation Profit  

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Return to index of stories... 		Soundup: LPA 206 0:41;55 "This is the prenatal folder we give to all our patients at Mathew Thornton."
Track: AS THE HEALTH CARE DEBATE RAGES, WHAT CAN WE LEARN FROM NEW HAMPSHIRE'S OWN MATHEW THORNTON HEALTH PLAN?
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Return to index of stories... 		Soundup: LPA 206 0:38:56 Baby getting shot
Track: LESSONS FOR THE HEALTH CARE DEBATE FROM NEW HAMPSHIRE''S HOMEGROWN HMO.
script iconHello/Intro Profit vs. Non Profit Healthcare
Return to index of stories... 		Squires Disk: 13:02:30 DO YOU BELIEVE THE MARKETPLACE IS A BAD PLACE FOR MEDICINE? It doesn't have to be but it's become so I think
Track: The doctor who started NH's first HMO - and its lessons for today's health care debate.
Track: From the Political Library at the State Library in Concord, welcome to NH Outlook.
Hello. I'm Richard Ager. More than 40 years ago, a young New Hampshire Doctor looked at the state of medicine and said we can do better. So he recruited other doctors and establish the Matthew Thornton Health Care Plan. It was the state's first HMO- and it's fate holds lessons for today's Health Care debate. We'll dicuss in a few moments but first, the story of Dr. Squires and his plan.
script iconSquires Interview pkg
Return to index of stories... 		Soundup: Squires Disk Squires chatting
Track: If there is one person who knows the price and perils of trying to reform health care, it is Dr. Jim Squires. As a young surgeon just out of the air force, he quickly became disillusioned about practices including unnecessary procedures.
Bite: Squires Interview Disk: 13:00:25 I remember as an intern helping the ENT person do 8 tonsolectomies in one day. You can't really look at that and not say what's really going on here? Do these need to come out? Not all of them, so what are we doing? And so forth. AND WHAT WAS YOUR CONCLUSION WHEN YOU ASKED WHY? I didn't think some of them needed to be done. SO IN OTHER WORDS, THERE'S SOME MONEY TO BE MADE. RIGHT? Right.
Track/Graphic: In a 1968 report, Squires reached other conclusions. Among them: Medical providers
Should be non-profit.
Should be governed by lay people representing the patients interests
Most important, Prepaid insurance should replace fee for service.
Track: Squires then recruited like-minded doctors and began the fight to establish Mathew Thornton Health care. _
Bite: LPA 206 39:32 Dr. Jim Squires. "There was some reluctance in 1971 to have us accepted onto the staff of the hospital. There was some hesitation about the members of this institution joining the county medical society and there was a considerable amount of emotionalism expressed over some of the issues that you touched on. The role of the federal govt., the role of a lay board of directors, the role of physicians accepting a salary. Indeed, the whole idea of prepayment in 1971 was fairly new.
Track: Today, he describes the fight with other doctors in starker terms.
Bite: Squires Interview Disk: 13:05:10 They didn't think this was such a great idea because we were talking about things at the heart of practice which is, for many of them, money. And the idea of taking a salary was socialism, communism, some people thought it was Naziism - I didn't quite get that but it was pointed out. And this was going to be the end of medicine. Medicine was rooted in fee for service
Bite: Squires Interview Disk: 13;07:00 SO YOU HAD OPPOSITION FROM DOCTORS. WHAT ABOUT THE HOSPITALS? That was another issue. I couldn't get into the hospitals. You needed somebody to sign your application who was already a staff member and no one would sign.
Bite: Squires Interview Disk: 13;08:37 I thought it was a little peculiar, and I did not anticipate that. I knew there would be some resistance but you know my wife had some threatening calls - it was pretty bizarre for a while.
Track: Squires persisted, found a consulting specialist in Boston who could sign his hospital applications, and Mathew Thornton opened for business in Nashua.
Soundup: LPA 206 0:38:56 Baby getting shot
Track: By 1978, a family could get all its medical services for a monthly fee of $84. The health plan expanded to several locations and at one point had 150,000 patients. But soon, for profit HMOs like Health Source began competing.
Bite: Squires Interview Disk: 13:10:30 Health Source began in 1984 - we had established a relation with the Hitchcock Clinic in Manchester and we wanted to expand to Concord to use the Concord Clinic. And the physicians responded by forming Health Source, which was a for-profit stock holding company and that introduced a totally new dynamic
Track: The for-profits could exclude some patients for pre-existing conditions, which the non-profits like Blue Cross and Mathew Thornton had avoided.
Bite: LPA 407 0:13:45 They've skimmed the cream of the crop and they've created a situation where companies like Blue Cross are being forced to say we are not all things to all people anymore. Those days unfortunately are over.
Track: By 1990, it was over for the Mathew Thornton plan. Sold to Blue Cross, which itself was sold in 1999 to the for-profit Anthem. But Jim Squires says the principles of non-profits hold lessons for today.
Squires Interview Disk: 13:20:00 LET'S L0OK AT THE PUBLIC DEBATE NOW - WHICH IS - WILL THERE BE A PUBLIC OPTION?
13:20:20 The public option is getting demonized. As I understand it, this would be a collection of commercial insurance carriers that one could choose from that would also offer subsidies for people who are unable to pay, and begin to delink, for many people, the relationship between health insurance and employment. WHAT ABOUT THOSE WHO OPPOSE THAT AS THE END OF PRIVATE INSURANCE? I don't understand that. THEY SAY IT'S UNFAIR COMPETITION. Unfair to whom? TO THEM AND THEIR PLANS. The idea is the person - the patient - is the number one priority here.
13:21:30 The fact is, there is something fundamentally wrong in the United States to not have health care insurance. IS THIS A MORAL ISSUE? Yes it is.
script iconConversation Profit
Return to index of stories... 		Joining us on Outlook to dicuss those - and related issues- Tom Bunnell, Direcotr of the Institute for Health, Law & Ethics at Franklin Pierce Law Center; Steve Norton, Executive Director of the NH Center for Public Policy Studies; and Charlie Arlinghaus, President of the Josiah Bartlett Center for Public Policy.
script iconThanks/Goodbye
Return to index of stories... 		That's all the time we have for this edition of NH Outlook. I'm Richard Ager, I'll see you next time.
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script iconKey: Health / Healthcare
Return to index of stories... 		NEW HAMPSHIRE OUTLOOK Air Date/Time: 9/25/2009
HOST: Richard Ager Length: 25:15
Hello. I'm Richard Ager. More than 40 years ago, a young New Hampshire Doctor looked at the state of medicine and said we can do better. So he recruited other doctors and establish the Matthew Thornton Health Care Plan. It was the state's first HMO- and it's fate holds lessons for today's Health Care debate. We'll dicuss in a few moments but first, the story of Dr. Squires and his plan.
PRODUCER/REPORTER: Richard Ager NAME OF PARTICIPANTS: Dr. James Squires\Founder of Matthew Thornton HMO, Clark Dumont\Blue Cross spokesman\1988, Steve Norton\Executive Director, NH Center Public Policy Studies,Charlie Arlinghaus\Pres., Josiah Bartlett Center for Public Policy, Tom Bunnell\Director, Institute Health, Law & Ethics.
script iconKey: Business / Industry
Return to index of stories... 		NEW HAMPSHIRE OUTLOOK Air Date/Time: 9/25/2009
HOST: Richard Ager Length: 25:15
Hello. I'm Richard Ager. More than 40 years ago, a young New Hampshire Doctor looked at the state of medicine and said we can do better. So he recruited other doctors and establish the Matthew Thornton Health Care Plan. It was the state's first HMO- and it's fate holds lessons for today's Health Care debate. We'll dicuss in a few moments but first, the story of Dr. Squires and his plan.
PRODUCER/REPORTER: Richard Ager NAME OF PARTICIPANTS: Dr. James Squires\Founder of Matthew Thornton HMO, Clark Dumont\Blue Cross spokesman\1988, Steve Norton\Executive Director, NH Center Public Policy Studies,Charlie Arlinghaus\Pres., Josiah Bartlett Center for Public Policy, Tom Bunnell\Director, Institute Health, Law & Ethics.
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