Crisis in healthcare: Does Vic Wood have the answer?

Vic Wood of Wheeling, WV, is one tough hombre.

As a football player at West Liberty State College, Wood took his licks returning punts and kickoffs, and dished them out as a defensive back.

As a former state trooper, he wrestled more drunks into his squad car than he cares to remember.

To Wood, it's all about removing the financial middlemen between doctor and patient, at least when it comes to primary care. "There are answers to the healthcare crisis that don't involve insurance companies," he says.

Prepaid primary care is by no means a complete answer, since it leaves out hospitalization, medications, and specialist care. But combine it with a health savings account and a high-deductible insurance policy, as Wood suggests, and his capitation-like proposal looks a little more interesting. Not surprisingly, doctors in other states are thinking the same way-and at least one has encountered the same sort of opposition from the insurance industry.

The uninsured have fear in their eyes

A classic Rust Belt state, West Virginia needs a healthcare system fix more than most. Nearly 18 percent of its citizens had no health insurance in 2005, ninth from the bottom among the 50 states. They don't have much money for out-of-pocket payments to a doctor, either. In 2004, West Virginia ranked dead last in household median income at $31,504. Yet its unemployment rate that year was below the national average, indicative of a state flush with the working poor.

West Virginians enjoyed better times when its coal mining and steel industries operated at full throttle, providing union jobs with benefits, according to state Sen. Jeff Kessler, a legislative ally of Wood. Now the steel mills are either closed or operating at reduced capacity, while mechanization and hard times have drastically shrunk the ranks of coal miners.

Hugging the Ohio River in the state's northern panhandle, Wheeling epitomizes the state's economic depression, evidenced by its many boarded-up stores and vacant lots where buildings were razed. The city's population dwindled from almost 60,000 in 1950 to 30,000 in 2005, inspiring a black-humor bumper sticker: "Will the last one out of the valley please turn off the lights?"

It's here that Wood, associate FP Doug Midcap, two physician assistants, and a nurse practitioner log 20,000 patient visits a year. Wood's clinic, called Doctors Urgent Care, takes patients strictly on a walk-in basis six days a week, and up to 7 p.m. Monday through Friday. Besides providing the preventive and chronic-disease care at the core of family practice, Wood treats patients whose cuts, broken bones, and fevers might otherwise send them to the emergency department. "We generate 92 percent of the CPT codes you find in an ED," says Wood. A broad array of ancillary services such as X-rays, lab work, cryotherapy, and ECGs equips Wood for urgent and primary care alike.