The Register-Herald, Beckley, West Virginia

August 3, 2013

Mont. model on state employee care is worth a look

By Nerissa Young

— Montana is a great place to go for history and sightseeing. But health care? Just maybe.

National Public Radio reported this week the success of Montana’s first free clinic for state employees after one year of operation.

The Helena clinic provides services to the 11,000 employees and their dependents who work in the capital city. The numbers, as they say, do not lie.

 The clinic is credited with identifying 600 cases of diabetes. Add to that 1,300 cases of high cholesterol, another 1,600 cases of high blood pressure and 2,600 cases of obesity.

People delay going to the doctor for a lot of reasons. Cost is a major one. Even if a person is insured, the co-pay is assessed at the office and any remainder not covered by insurance is assessed later. Sometimes affording a co-pay is a challenge, let alone the 20 percent the insurance company doesn’t cover.

Ultimately, delays cause many health conditions to worsen, which means treatment is more expensive. That was the rationale behind starting the Montana free clinic a year ago.

Patients have no co-pays or deductibles. They still get their regular state insurance benefits; patronizing the free clinic is a choice.

State library technician Pamela Weitz told Montana Public Radio she first thought the idea was goofy. But in the past year, she has visited the clinic for checkups, blood tests and flu shots. There, providers discovered a lump in her breast. They persisted in scheduling follow-up visits for that and her high blood pressure.

She gave high marks for the care she’s received. “Yeah, they’ve been very good, very good.”

The state pays for the clinic, which means it gets discounts on supplies. Physicians are paid by the hour, not by the number of procedures as in private clinics. It contracts with a private firm to operate the clinic.

While all these expenses are a new line item in the state budget, division manager Russ Hill said the state saved $1.5 million since the clinic opened. Montana Public Radio said an employee’s visit to the free clinic costs about half the price of a visit to a private physician.

Patients and providers like this model. Weitz got the personal attention to resolve the lump that appeared on her mammogram. Physician’s assistant Jimmie Barnwell said providers have more time to interact with patients.

This model is what modern health care should be — allowing providers to perform at their best and giving patients the attention they deserve to remain healthy and vital. It puts the “care” back in health care. The bonus is cost savings.

Some would call this socialized medicine, but that’s not accurate. The Montana model lets patients choose whether to patronize the free clinic or their private providers. It allows the state government to be one of the companies competing in the health care market. Choice is what a free-market economy is supposed to provide.

While West Virginia is recognized as a leader in rounding up its resources to join the Affordable Care Act, perhaps her leaders should spend a little time in Montana. The clinic model came from former Democratic Gov. Brian Schweitzer.

Montana has opened a second free clinic in Billings, NPR reported. Others are being planned.

— Young is a Register-Herald columnist. E-mail:

© 2013 by Nerissa Young