Maintaining Health on Puget Sound

Abstract

Experience with the Group Health Cooperative, a health maintenance organization, of Puget Sound is described. The Cooperative provides health care to 195,000 members (6 out of 10 of them of childbearing age) in western Washington State through 7 neighborhood outpatient medical centers and a 301-bed hospital. Until September 1973, only a few group contracts, paid for by the government, included complete contraceptive services. At a membership meeting in September 1973, coop members led by the organization's Women's Caucus, voted by narrow margins for the inclusion of contraceptive care and male and female contraceptive sterilizations in all private contracts to take effect in July. Opponents of extended coverage insisted that it be put to a vote at the coop's annual meeting in April, at which time contraceptive coverage won by 10 votes. Group Health's coverage of fertility related services had been minimal. People were opposed to complete coverage on moral and cost grounds. Even now, Group Health's coverage of fertility-related services is still far from complete. Only counseling is really covered. Abortion to terminate unwanted pregnancy is not covered, but it is available at cost, up to the amount of the regular $200 maternity fee ($250 for group members).