With 47 million Americans lacking health insurance, many would agree the current system needs a major overhaul.

The problem lies in how best to facilitate that change.

The American’s Affordable Health Choice Act is arguably the most divisive piece of legislation currently being debated in Congress, with lines being drawn definitively down party lines between Democrats and Republicans.

Thursday evening, Oklahoma Sen. Jim Wilson, D-Tahlequah, introduced a health care expert to a crowd of local residents seeking answers and explanations about how the proposed health care system would work, providing legislation is passed.

Dr. Katherine Scheirman is the Oklahoma director of Doctors for America, a group working to convey the ideas and experiences of physicians to achieve health care reform based on four key ideas: affordable coverage, expanded access to care, high quality care and practice environments that allow physicians to focus on patient care.

Schierman has spent the past 20 years in the Department of Defense medical system, and retired from the U.S. Air Force in 2006 with the rank of colonel. Her final assignment was a s chief of medical operations for the U.S. Air Forces in Europe at Ramstein Air Force Base in Germany.

“I attend the Veterans Administration hospital, and can say it has improved a lot over the last 10-15 years and the been following this model and it seems to work,” said Wilson. “Dr. Scheirman is going to try to explain how the new system might work.”

Scheirman said when she became a doctor over 20 years ago and went into practice it was when managed care was being introduced.

“Well, you had to call the insurance companies for approval for this and approval for that, and this was also about the time prescription drug prices started climbing,” said Scheirman. “I decided right then I wanted to be a doctor, not a businessman or a marketer, so I joined the Air Force, where I could practice medicine.”

Scheirman said she signed up initially for three years, thinking in that time the health care system would be fixed.

“Not so,” she said. “I’ve been fortunate enough, however, to experience health care systems in other countries where all citizens are covered and they don’t pay near what the U.S. does for health care.”

Scheirman told the group that trying to understand the U.S. health care system is “not easy stuff.”

“First of all, it encompasses 1/6 of the U.S. economy, which is nothing to sneeze at,” she said.

“I’m going to talk about what’s wrong, the myths versus the facts, and what we can do to fix it.”

According to Scheirman, the incentives to the system are wrong in virtually all areas, as insurance will pay $40,000 to $60,000 for a stint, but won’t pay for preventive care for diabetes.

“This is sick care, not health care,” she said. “We’ve had a competition in this country to have the most expensive health care without utilizing proper technology.”

For instance, hospitals compete to have the state-of-the-art MRI machines, cardiac wards and other specialty items, but they refuse to have a comprehensive medical database functioning across the board to prevent medication errors. Mostly, she said, because that technology doesn’t provide revenue.

“Also, health care is too expensive for middle-class Americans,” she said. “The poor are covered under government programs, and the rich can afford insurance. Middle America is being squeezed.”

According to Scheirman’s research, a person working 40 hours a week at minimum wage will spend their entire salary just to pay for health insurance.

What Congress is reviewing now is a public health option which would create a health insurance exchange.

“This would strengthen primary care, invest in preventive and wellness care, as well as health information technology,” said Scheirman. “While it’s the best option to control costs, the public option seems to be where people are drawing a line in the sand.”

The public option, according to Scheirman, would give people a device to purchase government sponsored insurance if they choose, it would be subsidized to make it affordable, would be similar to the Medicare system, and would cut costs to patients by approximately 23 percent.

“Who opposes this plan?” asked Scheirman.

“The Republican leadership, insurance companies, the Chamber of Commerce and some Democrats. These people believe the health care system should work in a free market. Well, I can tell you why the free market system won’t work. First of all, you don’t know when you’re going to get sick and need care. When you do need care, it’s extremely expensive. Few, if any, can pay cash for care, and you can’t sell health care like cars or bread.”

Scheirman said groups supporting the proposed legislation include the American Medical Association, AARP, and Walmart, just to name a few.

“So, where are we now as far as legislation is concerned? Well, despite what you hear on the news, the House of Representatives has already worked out its bill,” she said. “The Senate is still working on it, and agree on about 80 percent of the content. The last 20 percent, the hard part, is how to cover the cost of the subsidies.”

A couple of solutions include capping itemized deduction at $500,000, and taxing insurance companies for providing “Cadillac care plans.”

According to Scheirman’s research, America’s Affordable Health Choices Act would provide significant benefits in the 2nd Congressional District of Oklahoma. Up to 11,600 small businesses could receive tax credits to provide coverage to their employees; 10,300 seniors would avoid the doughnut hole in Medicare Part D; 910 families could escape bankruptcy each year due to unaffordable health care costs; health care providers would receive payment for $173 million in uncompensated care each year; and 165,000 uninsured individuals would gain access to affordable health insurance.

“When it comes down to it, this is a fight between the American people and the insurance companies,” said Scheirman. “Rep. Dan Boren is eager to hear from you on this issue, regardless of where you stand. This is not a left or right issue, it’s a health issue.”