Tahlequah Daily Press

Features

November 24, 2009

State of health

The Senate is moving forward with a health care bill, winning a victory Saturday to bring the issue to full debate.

Senate Majority Leader Harry Reid may have gotten enough votes Saturday to prevent a Republican filibuster against the health care bill, but the debate is far from over.

The Senate voted to advance the bill that would cost $959 billion over 10 years, but according to the Associated Press, it could still leave 12 million Americans uninsured.

The bill would require all U.S. citizens to carry health insurance, with government aid available to help pay premiums for those in lower-income brackets.

But even with the federal help, many middle-class families would still struggle to pay premiums.

All insurance companies would be prevented from denying coverage or charging more for people with health problems, and new markets would be created for those who have trouble acquiring, and keeping, insurance.

To pay for the bill, the Senate is suggesting a tax on high-cost insurance plans, a Medicare payroll hike on the wealthy, and fees on medical industries. The House’s bill would rely primarily on an income tax hike for higher earners to pay for expanded coverage.

Republican Sens. Jim Inhofe and Tom Coburn, both of Oklahoma, voted against Saturday’s measure.

Inhofe had a number of concerns with the bill.

“We need reforms, but this bill is not a good product and its substance is questionable,” said Inhofe in statement to the press Monday. “Republicans want to ensure that a Washington bureaucrat does not get between patients and their doctors, denying you the medical care you need. This bill includes the public option, otherwise known as a government-run option. Government-run, universal health care, or socialized health care, is not the answer, as evidenced by the state of health care in other nations that use this model, like Canada, or Great Britain.”

Coburn, also a medical doctor, has recently drawn fire for his opposition to the measure, but he claims the bill is “reckless, irresponsible and dishonest.”

“The bill’s mandate that all Americans must buy insurance is an unconstitutional and unworkable assault on individual liberty and personal responsibility,” said Coburn on Saturday.

“If this passes, millions of younger, healthy Americans will save thousands of dollars every year by dropping coverage until they get sick. The low penalties of not buying coverage in the bill, combined with assurances that no one can be denied coverage, will push younger and healthier Americans out of the system, leaving older Americans to endure sky-rocketing costs.”

The Daily Press posted an online, unscientific poll, asking readers what they thought the biggest problem is with health care, from a number of choices.

Of 38 respondents, 31.58 percent indicated they believe the problem is that insurance premiums are too high, and so are deductibles and co-pays.

Another 13.16 percent said health management organizations – HMOs – have restricted doctor and procedure choices, and overpaid hospital CEOs and others are in it for profit more than to help other people.

A little over 10 percent believe too many people are “on the dole” and not paying for their own health care, thereby driving up the costs for those who carry insurance.

A little less than 8 percent believe either doctors and hospitals overcharge patients for services, or that too many people are filing lawsuits, forcing the doctors and insurance companies to raise rates.

Five percent of respondents believe people’s bad habits – smoking, obesity, lack of exercise – are causing them to be unhealthy, thus driving up the costs for everyone.

Another 5 percent indicated the problem lies in lack of regulation to maintain quality and fair pricing, and that Congress is “too spineless to do anything about it.”

Regardless, one opinion shared by many locals is that the American health care system is broken, but few agree on how to fix it.

Local resident Diane Weston has a family of five, wishes the Congress would drop its habit of playing party politics with such an important issue.

“No one will agree on everything, but doing nothing is worse,” she said. “Other countries have government-funded medical coverage; some work, some don’t. Look at what has worked, or not worked, for these countries and create a more viable model.

Dr. Shannon Grimes, local chiropractor, disagrees with the bill currently before the Senate because of the mandatory coverage it would require.

“The government intends to force everyone to have healthcare coverage of the type its special interests favor,” he said.

“The intent is that those who don’t need as much care end up paying the difference for those that do. By what morality is it OK to force someone to buy something they don’t want or need in order to cover someone else’s costs?

Grimes said he also disagreed with forcing companies to extend coverage to people with pre-existing conditions.

“Forcing companies to cover them is like forcing a car insurance agent to sell me a policy to cover a wreck I had the day before,” he said. Weston said she sometimes hesitates to go to the doctor, due to the cost.

“People with Medicaid often abuse their benefits by going to the emergency room for minor ailments that should be treated by the primary care practitioner,” she said.

“People with no coverage also go to the emergency room which, in turn, causes a huge increase in medical costs,” she said. “The emphasis should be more on prevention and keeping costs down. Insurance companies play too big of a role in determining what fees and services are acceptable.”

Weston’s son had open-heart surgery several years ago, and was only approved by their insurance company to stay three days in the hospital.

“I had to get his surgeon to write a letter to the insurance company to get approval for him to stay longer than the ‘approved’ three-day stay,” she said. “I feel one of the biggest problems in our current medical system is insurance companies.

Local attorney Denise Deason-Toyne agrees, and adds big pharmaceutical companies to that mix.

“Why can I, as an individual, purchase medication for $36 cash, but if it’s billed to my insurance company, it costs $200? Same meds, same number of pills,” she said.

“This is theft, and it happens every day in this country. Drug companies have one of the highest advertising budgets of any company in the world. Seriously. They pay for the advertising by charging exorbitant amounts to insurance companies.”

Deason-Toyne said insurance companies have no business making medical decisions.

“Talk about death panels,” she said.

“Insurance companies have limited regulation and can get away with a lot, all to the disadvantage of the insured.”

Both Deason-Toyne and Weston believe personal responsibility is also key to having a health care system that works.

“If the government provides insurance benefits to the public, these consumers would be required to see their physician for well-care visits on a regular basis,” said Weston.

“If they refuse to attend well-care visits, then they should be responsible for a higher portion of their co-pay or other government-funded benefits could be reduced.”

Deason-Toyne said Americans love their excesses, but also want the best in health care.

“We don’t want to be responsible for our own health,” she said.

“We may smoke, drink to excess, self-medicate, we are fat and lazy and hate to exercise, and we want the very best in health care. Give me the latest and greatest test, whether my symptoms call for it or not, because I heard about it on ‘Oprah.’”

Grimes believes the best solution may be old-fashioned competition among doctors.

“If doctors were competing for money out of your pocket instead of insurance payments, prices would come down, as people tend to look for quality and a good price. As it is no, most do not even know the cost charged for a visit to the doctor,” he said. “Get insurance be for the big, bad events, not the little stuff, and fix the problems with lawsuits that doctors face so they can actually work on helping people instead of avoiding lawsuits by running extra costly tests.”

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