On Dec. 1, 1993, Alan Snell, M.D., Barbara Wheeler and Mark Chambers meet at Memorial with representatives from Michiana Medical Associates, a physician provider network. A member of the hospital board is also at the meeting to support the proposed program.

Phil Newbold speaks about the uninsured: "Nobody sees the uninsured as their problem. Forty two million people and nobody feels responsible because nobody can stand to think about the cost of bringing them into the system, but the thing is they are already in the system. They're using the ER and they're showing up at clinics with acute medical problems. So we spend huge amounts of money on expensive band-aids, quick fixes, temporary solutions to permanent problems. What we don't do is get upstream to solve environmental problems like abuse. Instead we impose a hidden tax on our patients or we pass the cost along to the government. What we're talking about with the Phoenix Program is another way of doing things, a way that's about partnering in the community to help people find their own resources to solve problems before those problems show up in the ER."

The 23 physicians at the Dec. 1 meeting are offered an alternative to the uncompensated care that they are, in most cases, already providing. In the Phoenix program they won't have to pick and choose between the charity cases that come in their door. Instead the physicians will be sent patients screened and enrolled by PARTNERS. The patient will pay a $5 co-payment and PARTNERS will pay the remainder of the cost of the office visit.

Physicians began to sign up: 238 will be involved by the end of 1994.