Reforming the nation’s health insurance system has been a topic of discussion since Theodore Roosevelt’s Progressive Party included a national health care plank in its campaign platform in 1912, according to www.pubmedcentral.nih.gov.From a Web article for the Indianapolis Examiner, in 1934, President Franklin Roosevelt considered proposing universal health coverage as part of the Social Security Act but decided against it.The Truman Library Web site notes that in 1945, President Harry Truman asked Congress to enact a national insurance program “to assure the right to adequate medical care and protection from the economic fears of sickness.”In 1993, President Bill Clinton attempted health insurance reform, and warned, “All of our efforts to strengthen the economy will fail unless we take bold steps to reform our health care system.” (www.washingtonpost.com)Health insurance reform has once again taken center stage. Congress is considering a federal government-sponsored health care insurance plan, much like Medicare, that will compete with private health care insurance. People who choose the public option will pay premiums and have deductibles and co-pays, like private insurance.Here are some local thoughts on the proposed health insurance plan and health care in general.PRO REFORMSen. Michael BennetSen. Michael Bennet visited Colorado Springs in July and spoke about health care at the East Library. Points from his speech include the following:
- 47 million people in this country do not have health care insurance.
- 250 million people in this country have some form of insurance but are getting crushed by rising premiums.
- Health care costs have increased 80 percent in the past eight years while median family income decreased by $300.
“Is it any wonder that people went into credit card and home mortgage debt to pay for that kind of a gap?” Bennet asked. “Our families and small businesses can’t sustain this for another five or 10 years.”Bennet said reform must control run-away medical costs, must cover everyone and must be paid for.”We can’t borrow from our kids to reform our health care system,” he said.Bennet identified Medicare cost increases as “the biggest driver of our budget deficits. We can’t solve the federal budget problem without reforming our health care system.”We’ve got to restructure the incentives under Medicare so that we stop paying by the test and start paying people to keep folks well. That’s where we’re going to see extraordinary cost savings.”Bennet cited Colorado’s Mesa County as an example.In Mesa County, the hospital readmission rate for Medicare patients is three out of 100 patients, compared with a nationwide rate of 20 Medicare patients out of 100. (Readmission is defined as readmission less than one month after discharge.)”That nationwide 20 percent readmission rate costs the country $17 billion a year,” he said.Mesa County’s readmission rate is low because they’ve created a system where a coach follows up with the patient to make sure the patient is taking the right medications properly and is being seen by a primary care physician.Bennet has introduced a bill, the “Medicare Transitions Act of 2009,” to fund the adoption of Mesa County’s coach system nationwide.He also addressed the cost of private health care insurance.”When I talk to small business people around the state, these double-digit insurance premium increases are choking off small businesses,” Bennet said. “This week, I talked with a florist in Montrose who has given up his family’s health insurance in order to keep his kid in college.”Bennet said he supports the public option if it meets his criteria for reform.
Tom Davis, M.D.Dr. Tom Davis is a medical doctor who recently retired as chief medical officer for Penrose-St. Francis Health Services in Colorado Springs.Now that he’s covered by Medicare, Davis said, “It’s the best insurance I’ve had in the last 15 years and far superior to managed care.”Health care reform is an absolute necessity.”As an example, Davis referred to an article in The New Yorker magazine entitled “The Cost Conundrum” by Atul Gawande.The article describes Gawande’s efforts to understand why, in 2006, Medicare spent an average $15,000 per patient in McAllen, Texas, but spent just $7,504 dollars on Medicare patients in El Paso, Texas – with similar results.After analyzing the data and talking with McAllen’s doctors, Gawande concluded that “compared with patients in El Paso and nationwide, patients in McAllen got more of pretty much everything-more diagnostic testing, more hospital treatment, more surgery, more home care” in a state that has enacted tort reform by capping medical malpractice jury awards.A physician-owned hospital was responsible for the extras. “The doctors receive not only their fee for whatever service they provide but also a percentage of the hospital’s profits from the tests, surgery, or other care patients are given.”Davis is also concerned that a crisis is approaching, especially in primary care, because the United States produces 17,000 new doctors a year, and many opt for specialties.A neurosurgeon earns 15 to 20 times more than primary care or pediatric physicians earn, he said. The gap also pressures generalists to see more patients and spend less time with them, which compromises their ability to provide the preventive care that is necessary to bring down health care costs, Davis added.
Mike MadayMike Maday is a professional mediator and owner of Resolution Resources of Colorado in Colorado Springs. His clients include people in bankruptcy and couples in divorce situations.”I’ve been doing mediation for 24 years and the last two years, I’ve seen a huge increase in the number of people going through bankruptcy because of enormous medical costs and inadequate insurance,” said Maday, who estimates the cost of his own medical insurance premiums at about $10,000 a year – and that doesn’t count deductibles and co-pays.”Some are insured, but their coverage is not good. If it’s the insured person who is sick, they often lose their job. Once they lose their job, then they lose their coverage.”People are entitled to COBRA coverage, but it’s so expensive. They lose their job, they lose their income, plus they have to pay $700 to $1,000 a month for COBRA. There’s no way they can pay it.”For most American families, health care is the biggest expense they have – more expensive than housing and food, and often, it’s not very good health care, he said.Maday added, “Everybody in this country is one serious illness away from bankruptcy or losing their house.”
AGAINST H.R. 3200Rep. Doug LambornU.S. Rep. Doug Lamborn held a town hall meeting Aug. 18 in Woodland Park, Colo. Lamborn presented some of the reasons why he opposes H.R. 3200, the House bill that has received the most attention in the health insurance reform debate.First, it’s the “cost of it,” Lamborn said. “It’s going to make taxes and the deficit go up tremendously.” He said of the 47 million people that don’t have coverage, only 6 million people – 2 percent of our population – actually want health insurance coverage and can’t get it. “I don’t think we should revamp our nation’s health care for 2 percent of the country,” he said.”I’m concerned that we will inevitably have rationed care, which means lower care and discrimination, if we enact H.R. 3200.”Lamborn also opposes H.R. 3200 because “private plans will be crowded out” and “those who are young and healthy or who for whatever reason don’t want to have to buy health insurance and be self-insured, will no longer have that option,” because “a government run plan is less efficient,” and “unelected bureaucrats will be given immense power.”The bill will impair the ability of pharmaceutical companies and medical device makers to fund new research, Lamborn said.”These companies, whether you like them or not, have made a lot of life-saving discoveries that have made our lives better over the years. We’re basically carrying the world on our shoulders when it comes to medicine,” he said.He is also against the bill because it does not contain litigation reform. “Malpractice premiums go up and those high costs are passed on to the consumers,” he said.”Tax payer funding of abortion is not prohibited under this bill,” Lamborn said.With regard to the bill’s provisions for advanced care planning, Lamborn said, “Some of that is legitimate. However, I have a concern that in the context of a bill that’s trying to set up a system that’s saving money, that we will have an unfortunate connection in some people’s minds, and they will feel pressure to maybe forego treatment they would otherwise be able to have, to save the country money, and that would be unfortunate if that ever happened.”An audience member asked Lamborn about other reform ideas in Congress. Lamborn said he favors more favorable tax treatment for individuals who buy private health insurance.”If we go out and buy insurance as individuals, we don’t get the same favorable tax treatment that a corporation does for its employees, so it costs you more than it really should,” he said.Lamborn also favors the ability to buy insurance across state lines, which would enable organizations, such as the National Association of Realtors, “to use their economies of scale and negotiating power” to create nationwide pools, he said.A woman in the audience, who said her husband’s health and life insurance had been canceled when he was diagnosed with cancer, asked, “Why can’t you guys do a little legislation that stops that kind of thing, and that won’t cost us anything.””My understanding of the law is that they cannot do that,” Lamborn said. “As an attorney, when I practiced small business law, I sued a few insurance companies and got them to pay more to the people they had underpaid.”
John CalderaJohn Caldera is president of the Independence Institute in Golden, Colo., and also hosts a radio talk show. He spoke at the rally in Acacia Park in August.”There is something that has changed fundamentally in the last few years in politics. This is no longer an “R” versus “D” issue. This is not a liberal versus Republican issue, conservative versus socialist, this is now ‘us’ versus ‘them.'”This is not about policy, this is about our bodies, this is about our children, our loved ones,” Caldera said.Caldera listed past bills, such as the Patriot Act and TARP that Congress passed without reading.”If there is one message I want to get across from here to there, don’t you dare vote on this until you’ve read every word yourself,” he said.Caldera pointed out Medicare, Medicaid, the Veterans Administration and Indian reservation health care as examples of government-run health care.”Are they running [them] well?” he asked the audience, which shouted, “No!””Don’t worry, this time they’re going to get it right,” he said.Caldera compared his recent experience of getting an MRI within one day of the doctor ordering it as opposed to his friend in Canada who was told it would take four months to get an MRI for a brain tumor and another four months to have the tumor removed.Rather than wait, Caldera’s Canadian friend got the MRI and had surgery in the United States.”Coverage does not equal care. Coverage does not equal treatment and that’s the fallacy of this plan,” Caldera said.”Seven years ago, I lost my daughter to cancer. She was a year old. It was a rapid, vicious, hideous cancer. I didn’t know what was wrong. I didn’t know what was happening. That day, we got a CAT scan. Two days later, she was in surgery to have a biopsy. She died a week later.”If I had lived someplace else, if we lived under Obama care, she would have died [undiagnosed]. She could not wait three months.
Ellen WadmanAt the anti-health care reform rally at Acacia Park in Colorado Springs July 29, Ellen Wadman said, “I think they’re doing the wrong thing by trying to socialize medicine. They should change other things first, like tort reform.”Health insurance should be like car insurance and people should be able to purchase it across state lines, she said.”Don’t make [coverage] through your employer. Just have it sold by a private insurance company; just like car insurance and then you could buy it from any company you want.Wadman said she worries that her doctor, who does not take Medicaid patients, might stop taking Medicare patients.”One of the arguments Obama gives is that if you don’t want socialized medicine, you don’t want Medicare. I’d rather have private insurance and have control over my own health care,” she said.”I think the government’s going to start controlling health care. They’re going to say ‘you better not eat this, or you better not eat that … you’re not going to get the coverage because you’re not taking good care of yourself.’ It’s all about control.”
