Dr. Nanette Mickiewicz, Dominican Hospital president, says local healthcare reform needed

Mar 9, 2010 — Santa Cruz Sentinel

Jondi Gumz

Mar. 9, 2010 (McClatchy-Tribune Regional News delivered by Newstex) -- SANTA CRUZ -- When Dr. Nanette Mickiewicz looks into the future, she thinks about how local health care must change to serve a population that is older, if not grayer.

Mickiewicz, president of Dominican Hospital since 2007, shared her vision for health care reform with 160 people at the Santa Cruz Chamber of Commerce Women in Business luncheon Monday.

"Look at the 45-64 age group," Mickiewicz said, referring to statistics in her PowerPoint presentation. "We have more people of this generation in our community than most communities in California."

Statewide, children 0-17 and adults 45-64 each comprise about 25 percent of the population. In Santa Cruz County, the older group outnumbers the younger group, 29 percent to 22 percent.

The number of people 65 and up -- who qualify for federally funded health care through Medicare -- is expected to grow 23 percent by 2014 while the other age groups grow 1 percent or less.

Whether Congress reforms health care or not, health insurance is getting more expensive, and more people are uninsured.

As a result, people who have insurance pay more to cover those who don't.

Dominican Hospital provided $41 million in care to uninsured patients last year, according to Mickiewicz.

"We're not immune to the cost," she said, noting the hospital provides care to 95 percent of its 1,700 employees.

Doctors are nervous about a scheduled 21 percent cut in payments for treating patients

with Medicare. The cutback was supposed to take effect March 1; Congress postponed it until April 1. If doctors are paid less, fewer may be willing to see older patients.

"We have only one choice -- that's innovation," Mickiewicz said.

That means providing quality care in an efficient and cost-effective manner, and she admits it may not be a hospital.

In the fall, Dominican Hospital will put a new mobile van on the road to bring health care to people who need it. This builds upon the Rotary-supported free community clinic at the Live Oak Senior Center where volunteer doctors see 30 patients on Tuesday evenings.

Under her leadership, Dominican paid half the cost of a grant-writing specialist for Santa Cruz County's effort to land a federal grant worth $10 million to $20 million over three years for an electronic system linking hospitals with labs, clinics and pharmacies. Only 15 grants will be awarded.

"This is a big deal," Mickiewicz said, explaining that technology would allow innovations such as transmitting x-rays electronically rather than hand-carrying them from one location to another.

She advocates an ounce of prevention, recalling when her husband recently tore a calf muscle, their sons reminded him about the importance of stretching.

"We have to change our habits -- not being sick is not the same as being healthy," she said. "We are designing programs to keep you away from us, programs to keep people heart-healthy and exercising. Just taking a pill is not a solution."

Newstex ID: KRTB-1012-42706949