Area officials: Obama’s health plan a step in right direction

With 46 million uninsured people in the United States, it’s easy to find folks who agree it’s past time to reform the present health care system, but agreeing on the details and how it is going to be funded, is another question.

Local health care professionals gave their opinions on the plan to overhaul American’s health care system that President Barack Obama presented before the American Medical Association on June 15.

“We’ve got to do something — it’s way past time,” said Kay Crane, executive director of Piedmont Access to Health Services, which is a federal qualified community health care center. About 40 percent of PATHS’ patients are uninsured.

Like other local health professionals contacted, Crane knows story after story of people who have died or come close to dying because of a lack of insurance. For Crane, one such story was that of her sister, who, lacking money for diagnosis and treatment, died of breast cancer, she said.

Crane admits that Obama’s plan may not be perfect, but says it’s better than what Americans have now.

“I would like people to keep an open mind and not to listen to liberals or conservatives,” she said. “This can’t be Democratic or Republican. If we don’t come up with a plan this administration, I think it’s time for people to take to the streets.”

Dr. Gary Miller, an alternate delegate to the AMA, was present at the convention where Obama presented his plan.

“I and many were pleased he took the time to talk to the medical profession,” Miller said. “Years ago under the Clinton administration, the medical profession got left out … Obama is trying to forge a bill with the backing of everybody. The idea is to help patients, and everybody might have to compromise.”

Bearing the burden

Jerel Humphrey, CEO of Danville Regional Medical Center, said that the “most critical issue facing hospitals is the growing number of uninsured patients, which puts pressure on everyone.”

Danville Regional spent more than $21 million in 2008 on charity care and bad debt, he said.

“Hospitals, like DRMC, face an increasing burden of uncompensated care every day,” he said. “Many of our residents are uninsured, poor or elderly. All Americans need affordable health insurance coverage, so they have access to quality, affordable health care.”

Humphrey said that most people would agree the basic principles of Obama’s health care reform are worthy: reducing health care cost increases, allowing Americans to choose their own doctor and health plan and enabling Americans to have quality affordable health care.

“The question is how we achieve them,” he said.

Denise Buckner, executive director of the Free Clinic of Danville, which bears much of the burden of the area’s uninsured said the clinic has had many discussions regarding the new health care proposals.

“We certainly hold to the belief that all citizens should have access to health care, and that is why so many free clinics have sprung up all over the nation,” she said. “The need is great, and with the declining economy, the numbers of uninsured are increasing. It is a concern for everyone.”

She said that the clinic doesn’t take a political stance on issues and can’t base any current decisions on “anything other than serving the current need of this community.”

Malpractice caps

Miller takes issue with Obama’s announcement that he did not support caps on medical malpractice awards — the only time Obama got booed at the convention.

“I personally think caps are beneficial because they lower benefits and keep physicians in business,” Miller said. “Premiums can be $600,000 to $700,000 for every physician in a practice — even those who haven’t been sued. We have a cap in Virginia at $2 million, which covers the vast majority of lawsuits.”

Crane also agrees that reform is needed with malpractice insurance.

“Our providers are covered under the Federal Tort Act, so when people sue, they are suing the federal government,” she said, “but if the plan could help other providers reduce their cost of malpractice insurance, doctors wouldn’t have to run every test in the book because they are afraid of getting sued.”

Miller said that it’s hard to measure how much malpractice torts cost everyone as physicians order more tests every day to cover themselves if sued for malpractice.

“Malpractice costs have gone up to eight times of what they were 15 years ago,” he said.

Another one of Obama’s proposals Miller supports is forbidding insurance companies from denying coverage because of pre-existing conditions.

“That is unpopular with doctors and patients, with everybody,” he said, “but the insurance companies will definitely fight that.”

Paying for it

While Humphrey said access to health insurance would be the most helpful of the proposed plan, he is also concerned about how the costs would be monitored as well as the plan’s effect on insurance companies.

“The public option presents concern in that it would compete with private insurance, under-pricing premiums such that no other plans could be competitive and likely result in payments to hospitals that are below costs,” he said. “The government could arbitrarily — because it could — decide how much to pay the hospital and doctors and leave only a government-run ‘single-payer’ system.”

Miller, however, said Obama clearly stated in his speech that he is against a single-payer, national health care plan.

Crane believes the resulting competition would be one of the advantages to a public insurance option.

“In our area, we have only Anthem and Gateway Health Alliance, but a national health plan would force competition,” she said.

Then there is the question of how to pay for a public insurance option, which is estimated to be close to a trillion dollars.

Obama pledged in his speech to the AMA that any health care reform must not add to the federal deficit and listed his ideas to fund about $950 billion through such ways as limiting tax deductions to wealthy Americans, enacting spending cuts, cutting waste and inefficiency and reducing payments to hospitals for treating uninsured patients.

“Paying for it is the issue,” Miller said. “If we had the money to pay for this, we wouldn’t have opposition. Of course, every hospital is required to see indigent patients and should, so if no one is uninsured, we could take that money.”

Crane sees Obama’s plan as “basic quality health care.”

“If you want Cadillac care, you can still get Anthem,” she said. “The government is putting aside money for this plan, and some will come from revamping Medicare and Medicaid.”

Miller worries about reducing Medicare and Medicaid payments, however, feeling that if reimbursements get any lower, even more doctors will opt out of participating in the programs.

“From what I understand,” Crane said, “this plan, if people will give it a chance, will provide quality, affordable health care with the choice of keeping your own doctor, and I see it as a uniquely American solution. It is not from Canada or Germany.”

Taking responsibility

Obama listed as the second step in his plan to “invest more in preventative care” and urged Americans to be more responsible for their own health and the health of their children.

Miller, who gets up at 5 every morning to exercise, agrees.

“The American public needs to take responsibility for their health and get up off the couch and exercise,” he said. “You need to exercise 30 minutes a day four to five times a day at a minimum, and people shouldn’t eat foods known to be unhealthy, such as fried and fast foods.

“If people were healthier, they wouldn’t get sick and enter the system. We should be putting money into preventative care and getting ourselves and children eating healthier and exercising.

“We’ve met the enemy, and it is us.”

• Contact Elzey at or (434) 791-7991.