May 1997

Art Goshin’s Lofty Goal: Making Health Care Better

by Barbara COPLEY & Peter KATES

What’s the first thing that comes to mind when you hear the name HealthCarePlan? Perhaps the health insurance card in your wallet? Or maybe you recall reading that HealthCarePlan was rated the best HMO in New York State, and among the top ten HMOs in the country by U.S. News and World Report magazine.

What may not come to mind is that HealthCarePlan is the embodiment of an ideal whose basic tenets are that medical care should be easily accessible, comprehensive, of high quality and emphasize preventive care. Those were very lofty goals back in 1978 when HealthCarePlan became Western New York’s first HMO — and they remain lofty goals today as health care reform is so hotly debated. The person behind the HMO movement in Western New York — the man who founded HealthCarePlan 20 years ago and continues today as it’s first and only President and CEO is Arthur R. Goshin, M.D..

INHERITING A SENSE OF PURPOSE

Arthur Goshin was born in 1946 in Brooklyn, N.Y., the youngest child of Harry and Marion Goshin. Both parents were children of immigrants — his father’s family from Russia, his mother’s from Austria. The Goshins were a progressive, liberal democratic family. His mother was an elementary school teacher. His father ran a small neighborhood children’s clothing store. Harry was a dedicated New Dealer, who often discussed politics with his children — instilling the importance of social purpose, equality and compassion. “My sister and I were brought up knowing that we had a responsibility to serve other people. I always expected to fulfill that by becoming a physician,” says Dr. Goshin.

Arthur began helping out in the family store when he was seven. “My father placed great emphasis on paying attention to his customers,” Goshin recalls. “One of the most important things he told me was that a good manager selects the best staff, appreciates and recognizes them for skill and intelligence that may be superior to his own and trusts them implicitly. I’d like to think that the lessons I learned from my father still guide much of what I do.”

After graduating from high school at age 16, this self-described “average student” left New York City to attend college at the University at Buffalo. Once there he immersed himself in the pre-med program. His hard work paid off and in 1966 he was accepted into the UB School of Medicine.

TO BE OF USE

It was the summer of ‘66 and Arthur was to begin medical school the following fall. The family was now living in Springfield MA — his father now a district manager at Zayre’s. Home for the summer and looking for a job, Arthur was hired to work under the Commissioner of Health in Springfield in the State’s Commonwealth Service Corps.

“In that position I learned about the many aspects of public health,” says Dr. Goshin. “I inspected restaurants, made home visits with visiting nurses and worked in immunization clinics.” He also completed a research project assessing housing quality and safety for two hundred families living in a neighborhood transformed through urban renewal.

Most valued among his experiences of that summer was a project in which he was charged with coordinating the training for 90 Peace Corps volunteers who were being sent to southern India. “It was demanding work, but it was also exciting, and I learned that I had a knack for organization,” recalls Dr. Goshin.

At the end of the summer Arthur Goshin returned to Buffalo to begin medical school, intrigued with the idea of serving whole populations — wondering how he might not only be of service but also how he could “make a difference.” A year later an opportunity presented itself.

It was at the start of his second year of medical school when Arthur answered a poster soliciting “students interested in establishing a student health organization.” At the first meeting Arthur found other medical students and residents who were interested in setting up a health care facility for needy families in Lackawanna’s Old First Ward.

The next afternoon Goshin, along with a fellow medical student and three community leaders, took a walking tour of the First Ward. Togeth-er, these five people initiated the development of a clinic — the Lackawanna Community Health Center on Wilkesbarre Avenue. Arthur enlisted the aid of UB medical students and faculty; garnered the support of William E. Mosher, M.D., then Erie County’s Commissioner of Health; and organized a Board of Directors for the center. Arthur was elected head of that board and head of the Student Health Organization (SHO) at the medical school.

“It was the era of the civil rights movement and anti-war demonstrations and I was among the students who wanted to revolutionize medical education and medical care,” says Dr. Goshin.

He also gained mentors and life-long friends. Edward J. Marine, M.D. — who was to become HealthCarePlan’s medical director — was associate dean of the medical school. Both he and Health Commissioner Mosher supported Goshin in his work with the clinic. Public health was among the pressing issues in medical care in the late 60s and early 70s. “I went to Bill Mosher to get the Health Department to work with us in establishing and maintaining the Lackawanna Health Center, but I gained much more than the County’s commitment,” says Dr. Goshin. “Bill gave me a new perspective on public health and public service in general. I learned what it means to serve a community and insulate yourself from the shifting interests of politics.”

BUILDING WNY’S FIRST HMO

By the time he graduated from the UB School of Medicine in 1970 Dr. Goshin had begun to think that the organization of health care systems, not individual health care, might be his true calling. As an employee of the Erie County Health Department he became the full-time director of the Lackawanna Clinic. In 1972 he was named Assistant Commissioner of Health and was charged with developing additional community health centers. By 1974 he had been instrumental in establishing the Health Department’s Jesse Nash, Outer East Side and West Side community health centers. And while working he continued his studies: by 1975 he had earned a master’s degree in public health with a specialty in medical care organization from the University of Michigan.

With congressional passage of The HMO Act in 1973, Dr. Goshin’s public health activities began to take a specific focus. The HMO Act made seed money available to local organizations for the development of health maintenance organizations (HMOs). Government agencies recognized the growing need for improved health care throughout the U.S., and HMOs — with their emphases on preventing illness and ensuring the quality and appropriateness of care — were seen as important components of a solution.

Dr. Goshin saw the opportunity. “I had the idea that the HMO concept could be developed in Erie County,” he says.

Dr. Goshin and Dr. Mosher worked together on the initial planning grant for a local HMO. In 1976, with federal grant in hand, HealthCarePlan was born.
Dr. Goshin was its President and CEO, and Dr. Mosher its first Board Chair. At that time, there were only a few other HMOs in the nation — such as Kaiser—so the concept was somewhat hard to sell.

HealthCarePlan’s first medical center opened in September 1978 on Gardenville Parkway in West Seneca. By February of the following year the new HMO already had 7,000 members. Today HealthCarePlan has grown to include seven principal medical centers plus ChoiceCare, a network of more than 2,300 affiliated physicians. Approximately 155,000 members are enrolled in HCP’s various HMO programs.

Additionally — HealthCarePlan is the senior owner of Vytra HealthCare, a private not-for-profit HMO serving more than 200,000 people in Long Island and Queens, NY. Dr. Goshin serves as its CEO and Board Chair. Together HealthCarePlan and Vytra HealthCare employ about 2,000 statewide and will have revenues of about $600 million in 1997.

AWAY FROM THE OFFICE

Arthur Goshin has other interests, too. Over the years Dr. Goshin has been an active teacher in the UB Medical School, serving as a Clinical Associate Professor. He’s an avid reader, devouring one to two mysteries a week. He’s been a jogger for more than 20 years and he loves hiking in the great outdoors. But first and foremost in Arthur Goshin’s life is his family — wife Renee and sons Erik and Daniel and his sister Lois.

References to Renee occur often in Arthur Goshin’s description of his life and work. The couple celebrates 30 years of marriage next month. They met through friends during an undergraduate school break. And soon after her graduation from Queens College, 20-year-old Renee married 21-year-old Arthur, who was entering his second year of medical school. “Renee and I paid my way through medical school,” says Dr. Goshin.

Renee Goshin began teaching history at Bennett High School and went on to earn a master’s degree in guidance counseling from Canisius College and certification in secondary education from the State University at Buffalo. Today, with thirty years in education, she is the highly regarded principal of West Seneca East Senior High School and in 1995 was named West Seneca’s Educator Of The Year.

Erik, the older of Renee and Arthur’s two children, is twenty-five. He is a graduate of Hamilton College and now attends the Elliott School of International Affairs at George Washington University in Washington, D.C., where he expects in to receive a master’s degree in East Asian Studies in 1998. Erik speaks both Japanese and Chinese, having recently lived and worked in Tokyo for two years.

Arthur’s younger son Daniel is 17 years old and a senior at The Nichols School. Daniel was Junior Class President and has worked as a community summer volunteer on the Roswell Park Children’s Ward.

He will be a freshman at Babson College in Boston this fall. Daniel, an accomplished soccer player, has played for two years on the State Team and was selected as an Exceptional Senior in Western New York.

Arthur’s sister Lois lives outside New York City and is head of a multi-cultural private elementary school in Queens. He adds, “My sister is a teacher’s teacher — the kind everybody would want for their kids.”

“I’ve been tremendously fortunate in my life. I’ve always been given the opportunities and the support to do exactly what I wanted to do,” says Dr. Goshin.

Arthur Goshin, M.D. is a man who sets lofty goals — and he’s a man who achieves them.

Barbara Copley and Peter Kates work in the Marketing Department at HealthCarePlan. Barbara is Director of Publications. Peter is Coordinator of
Advertising and Public Relations.

Photos courtesy of HealthCarePlan.

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