Abe Kauvar, M.D., doesn't want this article to be about him.
The focus, says the Denver gastroenterologist, should be on the efforts to bring universal healthcare to Colorado residents and the entire country.
In Colorado, and especially in Denver, it's impossible to separate 86-year-old Kauvar from the issue of insurance for all. Providing healthcare to everyone is "one of the most important things we have to do," Kauvar says. "We have to have everyone covered."
The founder of the model Denver community clinic system officially retired from his practice this fall--a fact he does not mention when he answers his office phone. But he's heading a campaign to get an initiative that would provide universal healthcare to all Colorado residents on the ballot.
He also has a proposal before the state's legislature to reform Medicaid.
Kauvar sees the states as laboratories to test universal coverage. "The states experimented with various welfare reforms," he says. "It worked well enough that . . . (the federal government) decided they should do something about it. I think the same thing can happen in healthcare. Our goal is to eventually have everyone covered by insurance."
Kauvar graduated from the University of Denver in 1935. He served in the Army Medical Corps during World War II, and in 1946 he began teaching at the University of Colorado School of Medicine.
In 1965, Denver's mayor told Kauvar, his physician, that he wanted to spend $6 million to help the city's poor. Kauvar used that money to create neighborhood health clinics. The idea was to keep people out of the emergency room by taking preventive measures.
"The neighborhood health program is the greatest thing I ever did," Kauvar says. "I said it took people from always being horizontal and going to the hospital and keeping them vertical and doing preventive medicine."
Beginning in 1972, Kauvar spent six years reorganizing the clinic system as manager of health and hospitals for Denver, today's equivalent of a CEO. The tax-supported, integrated system has grown to include 13 school-based clinics, 11 community health centers and an HMO. Denver Health operates a public hospital that was founded in 1860.
Denver Health CEO Patricia Gabow, M.D., says when Kauvar founded the clinics, he put his reputation on the line.
"He came from a large private practice, and he brought his patients here for their care," she says. "That was a wonderful statement for the community."
In 1980, New York City Mayor Ed Koch invited Kauvar to start a community clinic program. Kauvar spent a year there getting it started.
Woven throughout these efforts was a passion for universal healthcare, a topic that made its way into conversations, including those in the exam room.
Fee-for-service was "not very good at all," Kauvar says. "Then managed care came in. I'm much more in favor of managed care than unmanaged care."
Managed care was good because it cut the fat out of the system, he says. The bad part, he says, was the creation of stockholders in the healthcare system.
"Medicine is not a business. It shouldn't be subject to the whims of the people who buy stock."
A lot of healthcare is "underused. A lot is overused. And a lot is misused," Kauvar says.
His Medicaid proposal before the state legislature, and one that he hopes to get on the ballot, would automatically cover 544 conditions and treatments, he says. The H.A. Kauvar Foundation is sponsoring the project.
He also works with another foundation to find 1,000 students who never thought about pursuing a career in medicine or pharmacy and pay for their education.
"It's not diversity in color, it's diversity in people," he says.
Kauvar has a way of getting people's attention and getting them to care about his passion, says James Regan, M.D., former president of the Denver Medical Society.
Kauvar's idea to set up community health clinics was a "no brainer" but novel at the time, Regan says.
"He's a vibrant source of ideas. I don't know of anybody else like him. He's sought out because he has novel and cutting-edge ideas. He's not just someone who's patted on the back. He's still a main cog in the wheel here."
Kauvar's advice to frustrated physician executives: persist.
"My motto is 'I care and I try,' and my second motto is 'Seize the opportunity, whether it be with career, family or friends."'