Health Care Reform: A Summit County perspective
Summit Daily News
Turn on your television any given day of the week and you’ll probably catch news pundits arguing over health care reform. It’s always been a hot-button issue, but the recent implementation of pieces of the Affordable Care Act – which started Jan. 1 – along with the Republicans in Congress launching a repeal effort has put “Obamacare” in the spotlight again. So what are these changes, and how do local practitioners feel about them?
Unless the law – or parts of it – are repealed, the Affordable Care Act is scheduled to continually take effect through 2015. Healthcare.gov, the federal government’s website promoting the changes, says the act will “increase access to affordable health care for individuals, families, seniors, and businesses.” Among the changes made so far: Extended coverage for young adults – up to the age of 26 – under their parents’ plans, and access to insurance for individuals with pre-existing conditions. Among the changes to be made: Increasing the small business tax credit so more employers can provide insurance, tax credits for middle class families, and eliminating annual limits on insurance coverage.
“New reforms under the Affordable Care Act begin to bring to an end some of the worst abuses of the insurance industry,” Healthcare.gov says. “These reforms will give Americans new rights and benefits, including helping more children get health coverage, ending lifetime and most annual limits on care, and giving patients access to recommended preventive services without cost-sharing.”
So what do local doctors say?
Dr. Norman Numerof – an internal medicine practitioner in Avon – said the less government intrusion, the better.
“Everyone should be leery of government intervention,” he said. “I don’t know of any government bureaucrat who knows better than I do how to practice medicine.”
Numerof lists three changes he sees as essential for health reform: bringing the patient into the financial equation, tort reform, and the ability for Americans to be able to shop across state lines for health insurance. Numerof uses a buffet analogy to explain bringing patients “back into the financial equation.” He said many patients will take whatever they can get – unnecessary blood tests, catscans, etc. – when they don’t realize how much procedures cost.
“When people think everything is free, they take everything,” he said.
Numerof said unnecessary tests only drive up the cost of health care. He said patients should know how much everything costs, and be able to shop around for affordability and quality. He said this, and the ability for Americans to shop across state lines for health insurance, would increase competition between insurance companies and drive cost down.
“This is one country,” he said. “Why can we only buy insurance in one state?”
Numerof also lists tort reform as essential to health care. He said too many doctors practice “defensive medicine” for fear of being sued. He said this drives the cost of healthcare up, for both the patient and the insurance company.
Numerof said the current changes to the system – pre-existing condition coverage and more coverage for young adults – only drive up the cost of premiums.
Dr. David Gray of Breckenridge now works as a mobile physician, but practiced for years in a Texas emergency room. He said he is “all in favor” of pre-existing coverage and young adults staying on parents’ insurance “while they get their lives figured out.” Gray said to really reform the health care system, it must be given back to the doctors. He said insurance companies and lawyers are currently running the show. He said insurance companies are “abusive;” constantly trying to raise premiums, and lawyers are too willing to sue. Gray and Numerof both said patients have a right to sue for “gross negligence,” but the practice of defensive medicine is driving up costs.
“60 percent of what I saw in the emergency room, I could’ve handled over the phone,” Gray said.
Gray said a national physicians health association should be formed, so doctors who understand the system can control it.
Dr. Don Parsons of Dillon is a retired general surgeon and Kaiser Permanente executive, a health policy and public health expert, serves on the Boards of Saint Anthony Summit Medical Center and the Community Care Clinic, and is executive director of the Colorado Patient Safety Coalition. He said the current act is “a good first step,” and that the more people learn about the benefits, the more they seem to like it.
“The fact is, polls suggest only 20 percent (of citizens) are in favor of repealing it,” he said. “Things will only get better as time goes on.”
Parsons said 50 million Americans are uninsured, and 170 million are underinsured. He said he is in favor of universal healthcare, as it would broaden access for all citizens. He suggests a system, like Medicare, with a small bureaucratic overhead. He said Medicare’s overhead is around 3 percent, while companies like United Healthcare operate with a 25 to 30 percent overhead.
“In my view, if we have health insurance, it ought to be nonprofit,” he said. “It ought to be administered at a minimal administrative expense.”
Parsons said he disagrees with the notion of buying insurance across state lines. He said it would lower the price, but erode “the quality of insurance.” He said different regulations in different states only open patients up to seedy insurance companies.
“I think it’s a bad idea,” he said.
Dr. Louis Perrinjaquet – Doc PJ – who has worked as a family physician in Breckenridge for over 20 years, also said he thinks there should be a universal health care policy, which should be built into our taxes. He said the idea of “pre-existing conditions” wouldn’t exist under that plan, since everyone would be participating since birth.
“Even lower income people could afford it,” he said.
Brittany Carroll is a 30-year old Breckenridge resident who works in the restaurant industry. She said she thinks Obama’s ideas “are great.”
“There needs to be reform,” she said. “People can’t afford it.”
Carroll said she had surgery for a broken ankle eight years ago under her parents’ insurance. The pins holding her ankle together are now working their way out, and she can’t afford the $5,000 deductible her health insurance company will charge her to get it fixed.
Carroll said in a community like Summit County, a lot of people work in the restaurant industry and don’t have the opportunity to get insurance through employers because of insufficient hours.
“People can’t even find jobs,” she said. “How can they afford health insurance?”
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