employees through their problems says an American expert.

Ms Susan Swan-Grainger, who is the executive director of the Employee Assistance of Central Virginia, spoke to just under 100 representatives of Bermudian companies in the Norwood room at the Stonington Hotel on Thursday under the auspices of the Employee Assistance Programme Bermuda.

The EAPB is an organisation made up of over 11,000 employees, providing counselling and other support services to persons experiencing financial, marital and psychological problems.

Ms Swan-Grainger explained why she thinks the EAPB is perfectly situated to help employees and their employers negotiate the health care hurdle.

"The biggest difference in how we are doing this (in Virginia) from the traditional managed care is that we do more face to face case management. We sit down with the employee and when possible with the (health care) provider.

"The Employee Assistance Programme is in a unique and enviable position of having the skills and understanding of the workplace's needs and a relationship with the employer that no other player in managed care has,'' she said.

Speaking about her experience with the managed care concept in Virginia, Ms Swan-Grainger said that many hospitals have closed in the past five years and those still around are struggling.

In those conditions she said many employers want to save money, but many do not understand what managed health care means and they worry about depriving their employees of necessary treatment.

However she says there have been improvements in the area of managed health care that make it attractive.

Gone are the days of using shorter in-patient stays as the way to reduce costs. Now network development, case management and residential programmes have been added for a more holistic approach to patient care.

Ms Swan-Grainger said the one of the biggest advantages of the managed health care system is that it "attempts to put the entire treatment endeavour on a more systematic basis.'' "The managed care movement requires us to be more specific about what we intend to accomplish and to measure whether we have accomplished it.'' Ms Swan-Grainger praised Bermuda's buoyant economy and said that the Island could become a leader in the managed health care arena.

"Bermuda is the perfect place to be the best. You've done it in tourism, you've done it in reinsurance, you've done it in monitoring travel to preserve the Island's beauty and you've done it with your first class EAP,'' she said.

HEALTH CARE EXPERT -- Ms Susan Swan-Grainger.