By BETTY RIDGE
Few people disagree that something needs to be done about the escalating cost of health care, and the increasing number of people who don’t have access to it because of that cost.
An uninsured, or underinsured, person is just one major health problem away from losing everything – including his house and most of his possessions, not to mention his peace of mind.
Congress is considering various options for health care reform and has held committee hearings on the proposals, with the goal to reducing costs and improving access to health care., according to the National Conference of State Legislatures.
Government statistics show national health care expenses of $2.2 trillion in 2007, a figure projected to double by 2018. More than 43 million Americans had no health insurance last year.
Congress is looking at plans that would create a public health insurance system as a competitor for private insurance. Other people favor a single-payer system, which would eliminate the insurance bureaucracy and ensure access to health care for all. People who oppose this say Americans would be forced to accept substandard care, no longer have choices, and would have to wait long periods for some types of treatment.
State Sen. Jim Wilson, D-Tahlequah, and State Rep. Mike Brown, D-Tahlequah, have advocated reform of the health care system in Oklahoma and nationwide.
Wilson said reform efforts have been hobbled by the powerful insurance industry, which not only resists any effort to cut into its profits, but works to deny those who have insurance and need to use it.
“What we can’t do [in national health care reform] is to get the insurance people to play,” he said. “The Obama administration has been holding tough on the public insurance policy, which is the only way to hold back the insurance companies, if there is competition.”
He is “somewhat optimistic” that the current proposals will bring about meaningful health care reforms.
Dr. Sharon Zang, CEO of NEOHealth, agrees reform is needed, and she is optimistic something will happen soon.
“I think there are a lot of Americans who are uninsured or underinsured. The cost of health insurance for consumers is getting more and more prohibitive,” she said. “There has to be, at some point, some sort of reform.”
Zang said regardless of whether an individual is insured, everyone pays for the cost of care through Medicaid and other programs.
“The whole system’s paying the cost, in one way or another,” she said.
She believes in preventive care, which is provided at the NEOHealth clinics, including the newest one in Westville. But uninsured people do not normally receive this regular, preventive care.
“Their conditions deteriorate until they become emergencies,” she said.
People seek treatment in the emergency room, an expensive method of treatment. They’re released from the ER with chronic medical conditions and no way to get the continuing care they need.
“Keeping people out of the hospital is the most cost-effective way,” she said, adding that hospitals would benefit from health care reform as well.
NEOHealth sees people with and without insurance, with charges on a sliding scale based on the patient’s income.
Zang believes lawmakers will create a package similar to Insure Oklahoma, which provides affordable insurance to employers and employees. Not everyone is available for this program because of income limitations. A solution would be to raise the level of allowable income, with corresponding premiums.
Zang said NEOHealth provides much-needed services in obstetrics and gynecology, a field where options are limited for pregnant women because of the high cost of malpractice insurance for physicians in that specialty. The agency shelters the doctors and enables them to practice, she said.
Dr. Wallace Champlain, who practices the at NEOHealth OB/Gyn Associates clinic, sees patients from across northeastern Oklahoma, some from as far away as Poteau. Many are women who seek care later in pregnancy, or who have high-risk conditions others won’t accept.
“Recently we had a patient who was severely diabetic, and she just couldn’t get in anywhere else,” he said. “I’m thankful NEO is able to provide a lot of services. Quite honestly, the private doctors around just aren’t able to do it.”
He hopes federally qualified agencies such as NEOHealth will be part of the health care reform solution.
Wayne Rohde has worked for years to ensure proper treatment for autistic children in Oklahoma. Nick’s Law, which would mandate insurance companies to cover autism treatment, is named for his son who has autism. Now Rohde’s involved with the Oklahomans for Health Care Reform, which seeks to address a wide variety of health care issues statewide.
He said most people don’t feel they have much power or influence on what’s going on in Washington, D.C., so the group focuses on what it can do in this state.
“Most people do not have a voice in regard to policy-making,” he said.
Oklahomans for Health Care Reform plans nine or 10 town hall meetings. The first is tonight in Noble, which Wilson plans to attend. Rohde hopes to schedule a meeting in Tahlequah or this area, with the date to be announced later.
Among his group’s goals are taking back the state Legislature from the insurance companies; stopping insurance companies from “cherry-picking” or discrimination based on pre-existing conditions; stopping insurance companies from telling doctors how to practice medicine; and stopping insurance companies from treating small businesses unfairly.
Wilson recently issued a policy statement on health care reform, which is available by contacting his office.
Among other things, he discusses myths and facts about health care reform, and the way health care is handled in other countries.
“When the data shows virtually every other industrialized country delivers a better health care product for half the cost, it is incumbent on us to at least hypothesize that there may already be plenty of money in the system, and it is just not properly managed,” he said.
Wilson said insurance companies that testified at hearings in Washington. D.C., resisted any increased exposure to their industry, at the cost of reduced profits to their companies.
“There’s too much greed out there,” he said.
His report states other countries provide universal care, at far less cost than the United States, with an increase in the positive outcome for patients – despite the fact that America spends more on health care than the other countries.
“A comparison of 13 countries in a 1998 study showed the United States ranked 12th – second from the bottom – for 16 available health indicators,” Wilson said.
The U.S. came in last in low birth weight percentages, neonatal and infant mortality, and years of potential life lost. It came in low for life expectancy for people of ages ranging from 1 to 65.
Wilson said opponents of health care reform have played on citizens’ fears, saying the system may be broke, but fixing it will make things worse. He believes fixing it is essential, if people will speak out and let lawmakers know the problems with the system.
“When I had public hearings on this a couple of years ago, I had lots of calls from people who had been beaten up by the insurance companies or the hospitals,” he said.
But when he called them and asked them to testify at the hearings, they were afraid to do so.
“And for those who are uninsured, it’s hopeless,” he said.
Zang hopes some solution will be found soon to ease the burden on hard-working people who can’t afford to pay the ballooning costs of health care. She thinks the decision isn’t about people making the choice between luxuries and health insurance; it comes down to people making the choice between paying their basic expenses such as food and housing, or purchasing insurance. Millions of Americans are one crisis away from losing everything.
“These are hard-working Americans who can’t afford health insurance. It’s a choice between food and health insurance. They aren’t lazy or slackers,” she said. “I’m beyond optimistic — I think something will be done; it must. Something has to happen.”
You’re invited
Dr. Katherine Scheirman, who has had experience with health care systems in the United States and abroad, will discuss public and private solutions to health care during a town hall meeting at 6 p.m. July 30 at the Armory Municipal Center. State Sen. Jim Wilson, D-Tahlequah, is sponsoring the event.
