Clinton Plan Targets Uninsured Patients

WASHINGTON —  The Clinton administration will propose a $1-billion initiative aimed at improving medical care for many of the nation’s 32 million uninsured by encouraging community clinics and hospitals to collaborate in keeping track of patients and making sure they get the treatment they need.

Health and Human Services Secretary Donna Shalala said the initiative, part of the fiscal 2000 budget President Clinton will recommend to Congress in two weeks, eventually would provide 100 U.S. communities with grants aimed at helping the nation’s growing cadre of low-income workers who lack health insurance.

The grants are intended to help clinics and hospitals set up systems to share patients and monitor their care, according to Shalala and other administration officials. They also would help communities acquire more dentists, mental-health workers, drug counselors and providers of other basic services that often are in short supply for adults who have trouble paying medical bills.

The proposal revealed Sunday is intended to motivate communities to overcome the inefficiency, delays and fragmentation that often characterize medical care for the uninsured. It would encourage new collaborations among local health department clinics, independent community health centers, public hospitals and sophisticated hospitals affiliated with medical schools.

“We are working to get [people] health care while we are working to get everybody health insurance,” Shalala said in an interview. People without insurance often do not obtain routine medical services, postponing care until health problems worsen and overusing expensive hospital emergency rooms, studies have shown.

Administration officials were vague about how they would find money to pay for this initiative, as they have been about funding for other initiatives unveiled in recent weeks. They merely said the budget Clinton proposes would be in balance.