Hillary Clinton, still an undeclared candidate for the United States Senate seat that will be vacated when Senator Daniel Patrick Moynihan's term ends in 2000, brought her campaign of "listening to New Yorkers" to North Shore Hospital on Thursday, July 15. Earlier in the day Mrs. Clinton had met with teachers, parents and children at a middle school in Syosset.

As usual, the First Lady was accompanied by a busload of reporters from around the state. At North Shore local reporters and television crews joined in the media coverage.

The meeting at the hospital brought memories of Mrs. Clinton's proposed health plan of a few years ago because former Surgeon General Everett Koop came to North Shore to give the details of that plan which was doomed to failure. Ironically Mrs. Clinton's visit coincided with the debate on the floor of the Senate on the so-called "Patient's Bill of Rights," which resulted in the adoption of a Republican plan that fell short of the Democrats' proposal and which President Clinton is expected to veto.

Aside from reporters and Democratic politicians, the North Shore meeting was attended by invited guests, many of whom were on the staff at North Shore. Mrs. Clinton's visit took the form of a panel discussion with members of the north shore community followed by a lively question-and-answer session. The First Lady herself gave introductory remarks and responded to questions but did not give a speech. As she says, on this trip, she's listening to New Yorkers.

In her opening remarks, Mrs. Clinton praised the North Shore Long Island Jewish Network for the high quality care delivered here and in its related network. She said that it was fitting that the meeting should be held as the Senate debated the Patient's Bill of Rights because of the importance of the patient-physician relationship.

Dr. Vicki Seltzer, an OBGYN at North Shore and vice president of Women's Health Services, stressed the importance of pre-natal care for all women. "We have a generous plan in New York State," she said, "but 8 percent of women without health insurance don't meet the need requirement. Our system doesn't turn anyone away," she said, "but the problem exists."

Dr. Selzer was followed by Maureen White, RN, vice president and chief nurse executive at North Shore. Ms. White told the audience that "the health care climate has changed dramatically." In a moving statement she said that managed care has affected the time nurses can give patients. "We went into health care because we wanted to care for patients," she said. "Nurses want to be with patients, not behind a desk. Case management structures are labor intensive and the RNs do the work. Accounts receivable departments are larger than ever. Time should be spent on care. The bottom line has to be redefined. Dollars and cents were never meant to be the chief concern of health care professionals."

Mrs. Clinton agreed saying that she has been hearing the same concerns expressed all over the United States. "Obviously arguing with insurance companies is not what you went to nursing school for."

North Shore-LIJ President Dr. David Dantzker spoke next and said that "we are at a funny point in American medicine. We were never before able to do what we can do now. This community is used to getting the best care and I'm not sure we're going to be able to give it to them. We're being squeezed by the federal government, the state government and managed care companies." Dr. Dantzker cited the case of breast care in which a new drug has been developed that costs $40,000 annually for a single patient, adding that there are 180,000 new patients annually. "This means $150 million in un-reimbursed care. Is the government willing to pay?" he queried.

Mrs. Clinton's response was that it's not a question of being willing to pay or not. "It's a question of maximizing the use of available funds."

Dr. Dantzger agreed. "Medicare," he said, "is a wonderful system and should be extended. We're excited about your coming into New York because of your interest in health care."

Frances Bell, a systems analyst from Suffolk County deplored the fact that the United States is ranked number 50 in delivering health care. "Medicare benefits are great but they fall short for the elderly." She gave the example of one patient who needs care that Medicare would provide but she can't effort a taxi to take her to the clinic. She urged more spending on preventive care.

Mrs. Clinton agreed, saying that some problems, such as transportation are not just medical. "United States has the best care in the world and New York the best in the United States but it's not necessarily available."

After a lively question and answer session Mrs. Clinton thanked those in attendance and said she is "confident we can come up with some thoughtful proposals that will work."