With the Health Care Initiatives in the works, medical checkups will focus on illness prevention rather than treatment. That means better care for people like eight-month old James Harrison III here seen by Physician Assistant Anita Louison.

"You can't download health care from the Internet. You can't get it from a mail order catalog," says UAW Local 249 member Cathy Davis, a registered nurse and co-director of the UAW-Ford Community Health Care Initiative (CHCI) in Kansas City.

"Health care is delivered locally, and if you're going to improve quality, that's where you have to start."

A new report by the UAW-Ford Community Health Care Initiative on the state of health care in the Kansas City metropolitan area is sparking discussions among unions, health care purchasers and providers, and political leaders about how to provide community-wide access to high quality, cost-effective care.

The study offered an unsettling overview of racial disparities in health care in the five county area, which straddles the Kansas-Missouri border.

It showed, for example, that African-Americans have a higher mortality rate for heart disease, cancer, chronic obstructive pulmonary disease, and cerebrovascular disease than white residents," says Davis.

"In all, African-Americans lose 2.5 times as many years of life due to all causes as their white counterparts."

The Community Health Care Initiative also found that while Kansas City area residents enjoy slightly higher incomes, lower poverty rates, lower unemployment, and are more likely to have health insurance, they also suffer more respiratory disease, cardiovascular disease, and mental health problems than people in comparable cities such as St. Louis, Wichita, Indianapolis, Seattle and Minneapolis.

In addition, Kansas City area residents spend more on health care than those in comparable cities.

One reason cited by the study is the length of time spent in the hospital. On average, area residents stayed one day longer in the hospital each time they were admitted than people in other cities.

Commonly overutilized surgical procedures such as gall bladder surgery, hysterectomies, cardiac catheterization, and back surgery were performed more often in the area than elsewhere, the study found. Likewise, such factors as an excess of 963 hospital beds and duplication of high tech medical equipment also contribute to higher area costs.

"The U.S. spends a higher portion of its gross domestic product than any other country but ranks just 37th in terms of the performance of its health care system," says Dr. Rex Archer of the Kansas City Health Department.

"Our model is wrong. We fix problems in this country instead of preventing them."

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