‘Hot’ conversation cordial

Register Editor

Register/Susan Lynn
Tuesday’s Community Conversation on Health Care drew a myriad of opinions. The forum was in the basement of Community National Bank. From left are Paul Sorenson, Bill LaPorte and Vivian Michael.

Register/Susan Lynn
Citizens from throughout the county attended Tuesday’s conversation on health care.

Suggest that the government programs Medicare and Medicaid be abolished, and “a riot” would likely ensue, ventured Janice Rake.
But propose that a similar health-care program be established for all Americans, and all of a sudden, government has become “too big,” “all-controlling,” and “inefficient.”
Such were many of the sentiments expressed Tuesday at a Community Conversation on Health Care hosted by Thrive Allen County.
Fifteen area people attended the two-hour conference led by Allison Green of the Topeka-based Kansas Health Consumer Coalition. The coalition is a three-person non-profit whose mission is to educate and listen to Kansans about health care issues.
Tuesday’s group included those who favored health care reform, those who support the status quo, and those on the fence.
All agreed to criticize the current system. Common complaints about health care today included:
* Insurance, health care and prescription drugs are too expensive;
* Insurance isn’t available to everyone;
* Pre-existing conditions can bar insurance coverage; and
Bringing those topics closer to home, many gave examples of the inadequacies of the current system.
“My two daughters, both in their 30s, do not have insurance,” said Sunny Shreeve, Humboldt. “Their children can get coverage by the state under HealthWave. It’s the working poor — the middle class — who are the hardest hit.”
Karen Gilpin echoed that fact. Her son, Stephen, lacked health insurance for him and his four children until he was 31 and remarried.
“They couldn’t afford it,” Gilpin said of her son’s situation as a self-employed illustrator who then must be self-insured.
A medical situation, such as when her grandson, Nemo, suffered an asthma attack, necessitated a trip to a hospital’s emergency room rather than to a physician’s office.
That particularly irritated Gilpin both as a nurse and as a former director of nursing at the hospital.
From the medical perspective, preventive care such as proper medications and lifestyle changes can reduce emergency situations. From the administrative position, emergency room visits are costly and overwhelm those without insurance.
Nonpayment for services is a big burden to Allen County Hospital, said Joyce Heismeyer, its chief executive officer.
For 2008, the hospital was out $1.6 million due to bad debts, charity cases and a 35 percent automatic discount the hospital gives to the uninsured.
That is a debt absorbed not only by the hospital but by those who pay their bills, Heismeyer said.
“You hope that Medicare and commercial entities will make up the difference in reimbursements,” she said of the lost income, “but in reality, it’s the ‘good’ people — those who pay in full — who are carrying the debts of those without insurance or the underinsured.”
Heismeyer said predictions for 2009 show the hospital incurring $2.3 million of lost income.
Citing another example of poor health coverage, David Toland, Iola, said that when he and his wife, Beth, had their baby at ACH in June, “hospital administrators congratulated us for being the first ‘new baby’ family of the year to have health insurance.”
The previous 14 families lacked coverage to help pay for the births of their children.
“It’s especially the younger generations who lack adequate coverage to meet health care expenses,” said Gilpin.

VIVIAN MICHAEL chimed in that it’s the elderly who suffer because of expensive prescription drugs.
“People are having to decide between buying medicines or food,” she said. The infamous “doughnut hole” in the Medicare Plan D program — where consumers must pay full fare for drug expenses incurred past $2,250 and up to $3,600 — is especially a burden.
Covering all citizens is essential, maintained Chuck Platt. But Bill LaPorte, Moran, said he favored a “catastrophic” plan where the government would assume expenses beyond a certain limit. First he proposed all citizens incur the first $250,000 in annual expenses, but said a $100,000 limit would be more amenable.
LaPorte said he feared a comprehensive system would be fraught with waste and susceptible to abuse.
“No more than any other entity — private or public,” countered Rake, a native of Allen County visiting from her home in Redfield.
But some were suspicious that they would be forced to pay for health care services beyond their own if a plan were devised to cover all.
“That’s happening now,” Platt said of the Medicare and Medicaid programs and those that cover veterans.
Also, Platt said, “Every time someone without insurance uses a hospital’s emergency room — the taxpayer picks up the tab. It’s those not covered by insurance who are costing society the most.”
Donna Houser, Iola, had only praise for the Medicare program. “It’s the best health care I’ve ever had,” she said. Houser also said the recruitment of Dr. Kelly Richardson, an Iola dentist who treats primarily low-income patients, “is the best thing to happen to Iola in my 43 years here.”
As a former dental hygienist, Houser is big on dental care and how disease-free teeth and gums can contribute to overall health.
Levelling the field — where at least a minimum plan would be available to all — would be the most equitable, said Barbara Chalker, Iola.
It was a hard sell to many.
“I don’t want the government getting any bigger,” said Michael.
Kathy Ward, Moran, voiced suspicion that all taxpayers — not just the upper brackets — would see their income taxes raised if a universal health care system were adopted.
“They may start with the rich, but it’ll trickle down,” she warned.
Under a current bill in the House of Representatives, individuals who earn $250,000 and higher would see an increase in their taxes to help pay for increased health coverage.
But Rake countered, “I don’t have a problem with higher taxes for two things: Better health care and better education. These are things that will make our country better. We’re too short-term in our thinking. I can only see things getting worse if we do nothing.”
Platt agreed. “We need to think outside of the box about health care. We can take the examples of France, England and Canada and come up with our own plan that will suit our needs.
“I’m a lifelong Republican and former insurance agent,” said Platt, “And I’ve never seen a business make such a mess of things. We need to take the incentive for profit by insurance companies out of health care. They are doing less of what people need and focusing more on marketing — which only makes insurance more expensive.”
Despite premonitions of socialism, no proposals are on the table to take the insurance business out of health care. Rumors of the United States adopting a single payer system, are just that, the facilitator Green said. Such a system, also referred to as universal health care, would have one fund to which all citizens contribute and from which everyone’s medical expenses would get paid.
“It’s a common misconception that that’s the direction we’re headed,” Green said. So far, all major versions of legislation rely on a combination of private health plans, offered by employers and by insurance companies, subject to sweeping new federal regulations.
Paul Sorenson, quiet for most of the meeting, offered, “Things can’t stay the same, or we’ll bankrupt our society.”