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closeWhen members of Congress return to Washington next month from their summer break, it’s unlikely that they will have extinguished the firestorm that’s been raging over proposed health-care reform.
Representatives and senators have been getting an earful at town hall meetings about President Obama’s push for a government-run insurance program that would guarantee coverage for all Americans. And the public opinion voiced over the next few weeks could very well sway the vote one way or another.
The Telegraph polled a sampling of area residents — from doctors to patients and working folks — about their concerns, hopes and thoughts about health-care reform. Here’s what they had to say:
NAME: Dr. Michael Greene AGE: 52 RESIDENCE: Macon OCCUPATION: Family medicine physician
Dr. Michael Greene was at the American Medical Association meeting in Chicago in June when President Obama outlined his plan for health-care reform. He’s read most of the 1,000-page reform bill proposed by House Democrats.
Greene, a family doctor and past president of the Medical Association of Georgia, is not a fan of what he’s heard or read.
“I’m not in favor of socialism, and this is going high-speed down the road to a single-payer system and to socialism.”
A single-payer system is one in which a single entity — in this case the federal government — would collect and pay all health-care fees and costs. Under proposals from House Democrats, the government would offer a public insurance program and determine costs and coverage of all private insurance.
Greene’s biggest issue with the plans? “From a physician’s standpoint, the interference in the physician-patient relationship.”
The House bill would create a health benefits advisory committee that would recommend benefits standards and cost sharing. Under the bill, the 26-member committee is required to include just one physician or health-care professional.
“We’re handing over a tremendous amount of power to an appointed branch of government,” Greene said. “It creates a monstrous level of bureaucracy.”
Some people, including Greene, dispute estimates that 48 million Americans are uninsured. About 10 million of that number, he said, are legal alien residents who choose not to buy insurance. Many more are people who have access to Medicare or Medicaid and have not enrolled, he said.
“There are about 12 million to 18 million truly uninsured. I’m not sure we should upset a system taking care of 350 million to take care of 18 million.”
Greene agrees that there are “numerous improvements that need to be made,” including an increase in primary care, the elimination of pre-existing-condition exclusions and a movement away from employer-based insurance.
Any legislation, however, needs to include insurance and tort reform, efficiency reform and more competition in the marketplace, he said, and patients should remain in charge of their health care.
The overseas models of socialized health care, he said, are not the solution. Despite its faults, health care in America’s is “head and shoulders” better, Greene said.
“There’s nothing in that bill that expands the way care is given. This bill controls the cost of that care. ... If you want to wait 12 months to get an MRI, go to Britain. It’s free, but it’s not fast.”
NAME: Dr. Thekkepat G. Sekhar AGE: 45 RESIDENCE: Perry OCCUPATION: Obstetrics and gynecology physician
America may have the best health-care system in the world, but what good does it do, Dr. Thekkepat Sekhar asks, if few people can afford it?
“People who can’t afford it don’t get health care,” said Sekhar, chief of staff at Houston Medical Center. Or, they get health care and put themselves into debt, possibly risking bankruptcy, he said.
That’s why Sekhar would like to see a health-care system in which everyone has some form of adequate coverage, whether it’s through an employer, a private company or a government-run program.
Sekhar rebuts the idea that a private health-care system fosters competition and allows choice. Insurance companies all have the same basic pricing, he said. His practice, Physicians for Women P.C. in Warner Robins, faces the same high premiums and challenges as other small businesses, Sekhar said.
“We’re slowly getting squeezed for what we keep paying.”
And when it comes to making choices about a patient’s treatment, it’s the insurance company that ultimately makes the call, he said. It’s “ludicrous” to pay so much in premiums and not have a choice, he said.
Sekhar said he would like to see more emphasis on primary care and prevention rather than having to “put out fires.”
When an uninsured person comes to the hospital for emergency treatment, doctors cannot turn that person away. Rather, the cost is passed on to paying patients through a higher cost of service.
“That (debt) ultimately gets transferred somewhere. Nobody’s doing it for free,” he said.
When it comes to the current health-care reform debate, Sekhar is concerned there is too much misinformation and demagogy. At the same time, there is not enough knowledge about the issues, he said.
People on both sides need to actually read the proposals, rather than listening to sound bites, Sekhar said. One of the biggest hurdles will be finding a way to fund the system, he said.
NAME: Dr. David Parish AGE: 60 RESIDENCE: Macon OCCUPATION: Professor, interim chairman of Mercer University School of Medicine’s Internal Medicine Department
Dr. David Parish, a faculty member at Mercer University’s School of Medicine for 26 years, has a problem with the proposed health-care reform: “It doesn’t go far enough.”
“Might it go as far as you can get in the United States today?” he asked. “Maybe.”
President Obama has proposed reform that calls for government-sponsored public health insurance available to all Americans. Parish would prefer true “universal access” in which health care is simply made available to all patients and all medical providers are paid equally.
“People know they’re not being well-served by the system in our country and that there’s got to be a better way to do this. Why should we be bankrupting people because of medical bills?”
Our current health care, he said, is “pushing people into chronic states of ill health” by not covering treatments for conditions such as diabetes before they lead to more major health problems, such as stroke.
“It’s like you pay to change out the old motor in that 18-wheeler that you would not change the oil in.”
Parish said the reform bill comes close enough to universal access to close big holes in coverage — such as people getting written out of coverage for pre-existing conditions — and bring relative transparency to insurance coverage.
“What is on the table is really insurance reform and, to an extent, it’s insurance regulation. ... The intent of health-care reform is maintenance. The simplest way to do it is one system — cover everybody.”
Universal access has worked in countries such as Britain, France, Germany and Canada, Parish said, and it can work here.
“You’re not seeing drug companies going out of business in those countries. They’re just not making the oh-my-God profits they’re making in this country. ... The things that insurance companies get away with over here don’t happen over there. The system won’t allow it.”
“This is not a radical proposal to say that with a country as developed and sophisticated, we should have universal access. There should be a U.S.-designed system. It’s got to be one that we design and one we can live with.”
NAME: Jeanette Miller AGE: 22 RESIDENCE: Macon OCCUPATION: Department store worker
Government-sponsored health insurance sounds like a good idea to Miller, whose part-time job does not provide insurance benefits.
“I feel the government should pay the doctors to see us. Everybody doesn’t have the money,” Jeanette Miller said. “They don’t give you the same care if you don’t have insurance.”
Miller said she was in school, studying to be a radiology technician, but had to drop out. She hopes to return to school soon.
Miller said she has attention deficit hyperactivity disorder and is on four prescription medications for the condition. The medicines cost about $40 each time she gets a refill.
That might not seem like much, except, Miller said, she works just one day a week.
“I just don’t have that kind of money.”
NAME: Mike Sanford AGE: 44 RESIDENCE: Warner Robins OCCUPATION: Financial service representative for MetLife
Warner Robins resident Mike Sanford says he’s happy with his health insurance.
Like many Americans, Sanford receives insurance through an employer-sponsored plan, in which both he and his employer, MetLife, contribute. (MetLife does not offer health insurance.)
While “there needs to be some corrections made to the health-care system, I don’t believe it needs to be run by the government,” Sanford said.
Sanford said he’s concerned that a government overhaul of the health-care system will lead toward a “one-payer system,” with that one payer being the government.
He fears employers will drop private insurance for cheaper, government-sponsored insurance.
One change in the system he would like to see, though, is more transparency.
“I’d like to be able to walk in (to a doctor’s office), and (they) tell me how much it’s going to cost,” he said.
Knowing the cost of service up front would make the market more competitive and, he said, ultimately lower the cost of health care as people begin to shop around for services.
NAME: Carl Caesar AGE: 49 RESIDENCE: Warner Robins OCCUPATION: Owner of ITC Data Access
Small-business owner Carl Caesar used to offer health benefits to his employees.
But about three years ago, the cost of providing those benefits got to be too much, and Caesar, who owns a telecommunications company, dropped the coverage.
“All employees want benefits. When I dropped the benefits, I lost a lot of employees,” he said.
Now, he said, he contracts out all his work.
The cost of health insurance is crippling, Caesar said. Premiums are high — his own individual policy almost doubled when he renewed it this year, he said.
As it is, the health-care system needs to be reformed, Caesar said. While he has not closely followed the recent health-care reform debates, he said, he had his own ideas about what would be a step in the right direction.
One, small-business owners should get some sort of break on health care, Caesar said.
“If you’re a small-business owner, you should come under an umbrella so you can benefit from a discount as if you were a larger institution,” he said.
Two, premiums are too high and should be lowered, he said. Three, patients should have the right to choose what doctor they see.
Finally, preventive care should be encouraged and should cost less, so health problems are taken care of before they arise.
“Preventative is definitely the way to go,” he said.
NAME: Charles Jackson AGE: 61 RESIDENCE: Macon OCCUPATION: Retired state employee
Charles Jackson says lawmakers are moving way too fast and too far on health-care reform.
“They need to scrap what they have right now. Go back to the drawing board and just go line by line, correct what’s wrong,” he said.
“You don’t burn down the house to fix up the kitchen. Something that quick can’t be all good.”
Jackson has health coverage under the state merit system and pays about half the monthly premium. He fears that the Obama proposal to provide government-run insurance to people who can’t afford private coverage will only drive up costs.
“If you think it’s expensive now, wait until it’s free.”
He’s also skeptical of any plan that would put the government in charge of determining benefits, coverage and other decisions,
“There’s too much in this bill that’s going to take our freedoms away,” he said.
NAME: Daryl Morton AGE: 48 RESIDENCE: Macon OCCUPATION: Attorney
Daryl Morton, an attorney who handles Social Security disability cases, sees a lot of uninsured clients, the people who fall through the health-care cracks.
Access to health care for patients who can’t afford health insurance or who are denied because of pre-existing conditions should be as basic a right as public education, he said.
“You’re more likely to be productive if you’re healthy, or as healthy as possible,” Morton said. “You’re going to have to have something to help people who don’t have access. We have to have a meaningful public option for those who cannot reasonably access health care.
“We know we need it,” he said. “We know it lowers costs in the long run.”
Health-care reform, Morton said, is “more about the philosophy than the program.” He understands concerns about the government dictating coverage and benefits, but he believes that’s the lesser of two evils.
“The problem now is we have insurance companies dictating the decision-making process.”
Morton said regulation is needed to dictate the basic care and benefits that people need.
And a government-run insurance program might encourage insurance companies to lower their rates, he said.
“Anything that increases competition is a good thing.”
As it stands now, he said, the uninsured head to emergency rooms for their basic care needs, which only drives up costs. Universal access to basic care might cost taxpayers, but much of the increased cost would be offset by long-term savings through preventive care, he said.
“It’s an important commitment that we need to make.”
NAME: Keith Meredith AGE: 63 RESIDENCE: Macon OCCUPATION: Retired from military
Keith Meredith already has government health insurance. He retired after 20 years in the Air Force, so he and his wife are covered through Tricare, the military’s health insurance.
The coverage is not free. He pays $115 a month. His two sons who live at home have no insurance.
Meredith said his biggest concern about proposed health-care reform, which could offer government-run insurance to those who can’t afford it, is the cost. The plan is estimated to cost $1 trillion over 10 years, according to the Congressional Budget Office. The plan is to cut that cost through Medicare savings and tax increases, but those measures will still leave an estimated $239 billion deficit, the budget office said.
“All I know is they don’t know where the money is coming from,” Meredith said. “Everybody needs insurance, but I don’t know whether we can afford it.”
NAME: Brittany Johnson AGE: 22 RESIDENCE: Macon OCCUPATION: Student
As a student at an area technical college, Brittany Johnson does not have health insurance. So, instead of the Nexium that doctors had prescribed for her acid reflux, she takes a cheaper, over-the-counter medication.
She’s also stopped taking vaccines for human papilloma virus. The shots had been free at the health department, but now they cost $150, she said.
Johnson said she hopes Congress will pass President Obama’s health-care reform proposal.
“Everybody should at least get some health care, especially the poor,” she said.
As an alternative to government-run insurance, some Democrats has tossed around the idea of nonprofit cooperatives to provide care for the uninsured. Whatever legislation passes should focus on providing preventive care, Johnson said.
“That’s why people go back and forth to the hospital. Go ahead and solve the problem and take of it.”
NAME: Latoyo Robinson AGE: 27 RESIDENCE: Macon OCCUPATION: Geico employee
Latoyo Robinson couldn’t be happier with her health insurance.
The mother of two girls and two boys said her premium costs are only $35 and deductibles are low.
“My insurance is great,” Robinson said.
She knows, however, that not everyone is so fortunate. She has friends who have no insurance coverage.
Robinson admits she’s not all that familiar with the health reform legislation, but she has some ideas of her own. She would like to see lawmakers focus on lowering costs and rates.
“I think the prescription costs could be lowered a whole lot,” she said.
NAME: Katrina McMahan AGE: 48 RESIDENCE: Warner Robins OCCUPATION: Disabled
“I live on a heating pad,” Katrina McMahan said.
On the couch. In her bed. She even has one that plugs into the car while driving.
McMahan has arachnoiditis, a disease caused by inflammation of a membrane that surrounds the brain and spinal cord. There is no cure. The only real treatment is managing the often debilitating pain.
The condition has a number of causes, but McMahan blames a myelogram injection to examine her spine 20 years ago. She was diagnosed in 1994 and had been on narcotic painkillers and patches until April. That’s when her doctor gave her a drug test that showed what she says was a “false negative,” a result not uncommon with patients who take certain kinds of opioid medications.
McMahan said she’s been unable to find a doctor who will treat her. She’s been “branded a drug dealer.” And she’s on Medicaid.
“I cannot find a doctor now that will treat me, and you certainly can’t find one that takes Medicaid because the state has lowered payments so much that doctors say it’s not cost-effective.”
McMahan is hoping for some sort of health-care reform that might open up access and address the Medicaid payment issue. Doctors and insurance companies are more focused on treatments than cures — and on “making money,” she said.
“If it will help people, I’m for it. I don’t like our current system.”
NAME: Bill Hervey AGE: 50 RESIDENCE: Macon OCCUPATION: Associate professor of health services administration, Macon State College
When it comes to making changes to America’s health-care system, associate professor Bill Hervey is more like the tortoise than the hare.
“I believe in gradual change. Think it out, especially when you’re dealing with such large amounts of money,” said Hervey, who teaches health service administration at Macon State College.
Change should be made incrementally, he said. Make a small change. See if it works. If it doesn’t, take a step back. If it does, make another change. Repeat.
“With big changes, you can’t go back,” he said.
The current proposal for health-care reform goes too far and does so too quickly, Hervey said.
While there are holes in the system, there also are parts that run well, he said.
Hervey said he would like to see consumer choice stay a part of the health-care system. He said he has a “hard time” with government-run insurance if it’s going to compete with private insurance.
“The government’s always going to win in the end,” he said.
As a result, many private insurers could drop out of the market, with only the most expensive remaining, he said.
“I’m not sure the private insurance system is that broken,” he said. “Maybe you tweak it and maybe you look at some of the regulations between catastrophic and primary care. ... But to throw out an entire industry, that’s hard to do.”
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