Health care’s future focus of meeting
Posted: Wednesday, October 3, 2012 6:17 am
By GLENDA CAUDLE
Special to The Press
“... you and I are going to spend our sunset years telling our children, and our children’s children, what it was once like in America when men were free.” — Ronald Reagan in 1961, warning that unless citizens let their voices be heard by those representing them in government, socialism would take control. At the time, Reagan was a Democrat. He changed party affiliation a year later, saying his party had left him, and went on to become governor of California and then a two-term president on the Republican ticket.
Why should it make a difference to you if physicians and other medical professionals will soon see their salaries decrease by six cents on the dollar? Why should it concern you if students in medical schools know they will need to earn at least $190,000 a year to be able to repay the cost of their medical education — training that comes with a price tag of around $540,000 — but also know the average doctor’s salary is below that rate and falling? Is it your problem if your employer is faced with mounting business expenses because he is required to provide you with more costly insurance to satisfy government mandates? Why should you lose sleep just because the local hospital is going to be receiving fewer funds from the Medicare program, beginning next week? Private insurance companies are going to become a thing of the past — so what?
These issues and more were at the forefront of the discussion at a recent standing-room-only crowd concerned about health care. A panel of physicians and representatives from a local insurance company, business and hospital shared information and tried to respond to questions from the crowd at Union City Second Baptist Church during the event labeled “Healthcare 2013 and Beyond.” Union City attorney and mediator John Miles was the moderator.
Before the evening was over, it became clear that changes already being seen under the mandates flowing from the plan known as “Obamacare” are not confined in their negative impact to health care professionals, insurance companies, small business owners or hospital managers. Every change that affects one of these entities with a stake in the health care debate will ultimately affect the health care consumer in a negative way. These changes will be seen not only in taxpayers’ pocketbooks, but also in their quality of care and their relationships with their health care providers, according to members of the panel.
The testimony of those who are already dealing with the fallout, as well as evaluations by financial and business experts who have reviewed the program that is coming under increasing criticism as the date for full implementation draws near, spells out the escalating cost of health care for the taxpayer, the uncertainty inherent in a program American citizens were told by Congressman Nancy Pelosi had to be passed before its contents could be made known and the dismal health futures of the elderly and those who require highly specialized and expensive treatment who will have to deal with “medicine by committee” under the program’s guidelines, it was noted.
None of the news was good news for the average citizen at the meeting.
Miles opened the program with a brief review of the methods used to secure the passage of the bill, including congressional “bribes” to representatives from Louisiana and Nebraska, which earned the names “Louisiana Purchase” and “Cornhusker Kickback” when news of the paybacks involved in securing votes for passage became public knowledge. He noted that in that instance, politics prevailed over conscience for Democratic legislators who had previously said they could not support the Obama health care plan if it did not contain language ensuring that abortions would not be funded with public money.
He noted that the bill finally landed on the president’s desk, not through an above-board process with the support of the electorate, but by means of legislative sleight of hand. He explained that all bills aimed at raising revenue must originiate in the House of Representatives. In order to secure passage of the bill that Democrats wanted in the Senate, Sen. Harry Reid took an inocuous bill related to military service personnel and their homeowners’ taxes which had been introduced by Congressman Charlie Rangel and had received unanimous support in the House earlier. Reid changed the name of the bill and replaced all but the first sentence with the Affordable Care Act provisions. This was a trick to satisfy the Origination Clause, Miles pointed out. Then the Democratic leadership used the process of reconciliation between the bill they wanted in the House and the one that had been thus approved in the Senate and sent it to the president for his approval.
Orma Smith, representing First State Insurance, provided estimates of the cost to businesses that will be forced either to supply policies that meet government approval — not employee satisfaction — or risk heavy fines. He added that citizens who then find themselves without insurance because their employers cannot afford it will be required to provide it for themselves or face fines of $95. He pointed out, however, that this aspect of the program will have to be changed — and not to the employee’s benefit — because it is neither enforceable nor sufficient to cover costs the government will then have to pick up. Either the uninsured individual fine will have to increase dramatically or taxpayers will have to make up the difference.
Smith said the state’s insurance commissioner expects a triple-digit increase in the cost of premiums for small business in 2014 as the rating structure changes because of provisions in Obamacare. As the astronomical rises come into play, Smith said owners of businesses will be forced to opt out of providing coverage for their employees. In Tennessee, about 900,000 citizens are not covered by insurance. It is expected another 300,000 people will be added to the Tenn-Care rolls in Tennessee.
Once insurance companies face their own ruin under the new system, Smith added, the government will be forced to bail them out, just as it did several banks when the current debt crises escalated. When that happens, he added, there will not be enough funding to pay hospitals the rates government currently adheres to, and this, in turn, will impact the health care available and affordable for the average citizen in an intensely negative way.
Joe Wilson, a risk management authority with E.W. James & Sons Groceries, focused attention on the impact Obamacare will have on local businesses’ hiring practices. “It’s pretty simple. You wonder why there are no jobs out there. If I add a new employee (under the new healthcare program), it will cost me an extra $2,000 to $3,000. This affects the growth of jobs. So when you go to the polling booths, you need to think about which button to push.”
Dr. Robert Cameron from The Woman’s Clinic in Union City pointed out that when proposed cuts in Medicare and Medicaid take place (a 2 percent reduction is scheduled to go into effect Jan. 1 and a 27 percent decrease has been threatened for the past two years and could occur at any time), it will be impossible for him to pay his employees. He also noted that a new tax on all brand name drugs is about to go into effect and said Medicare will not cover this charge, according to the information currently available.
Dr. Paul Nieves, who is in the local Ob/Gyn practice with Cameron, said there is a shortage of physicians, and that shortage is estimated to increase to around 63,000 by 2015. The actual number may be even greater, however, as the reality of Obamacare impacts the decision of young people to enter the field. He also provided specifics for Cameron’s concerns, saying implementation of Obamacare will mean the loss of 500,000 medical jobs of all kinds, not counting indirect losses.
Family practice physician Dr. John Hale from Doctors’ Clinic of BMMG in Union City talked about the changes that have come about recently in the physician-patient relationship. He said the Clinton administration’s insistence on implementing an electronic medical records system has not only placed a huge financial burden on doctors but has also been directly responsible for the reduction in the amount of time doctors are able to spend in actually examining and evaluating the needs of their patients, since more time must be committed to typing details into the records system about the patient than in securing that information.
“We’re all going to have to change with the times, but it’s up to the American people to decide how the times are going. I feel sorry for our country right now. We have a great country, but we need to go out there and say a prayer for our country,” he said.
Dr. James Hall, a cardiologist, added, “I don’t want the federal government between me and my patient.” He also discussed problems that are developing in being able to secure needed medical devices for patients. Some of these, he said, must first be approved by nameless and faceless entities whose own medical backgrounds and abilities to assess health care needs and situations are unknown. Not only is the patient at risk of not receiving help he needs, he pointed out, but the physician must devote time to trying to deal with red tape surrounding the issue rather than being involved with treating the patient.
Nieves agreed, adding that conformity of medical practice is being enforced by the government at an alarming rate and this approach has taken the “art of medicine” out of the equation. “It’s now cookbook medicine,” he said, “but that’s not the human mind and that represents a danger.”
Miles said the new 2.3 percent excise tax on medical devices being implemented under Obamacare will almost certainly push many manufacturers of such equipment into moving their businesses overseas to cut costs, resulting in the loss of an estimated 43,000 jobs in this country. He provided information from hearings before the House Budget Committee that showed at least 800,000 jobs will be lost as a result of Obamacare. He added that estimates of the cost of the program for the first 10 years have increased from $0.9 trillion in 2009 to $2.6 trillion for the 10-year period beginning in 2014, when all spending measures are in effect. These figures are from the Congressional Budget Office.
Dr. Ron Kirkland of Jackson said most of the money spent in the health care system is delivered at the end of life. “Most of it goes to patients in intensive care. How do you control these costs? Well, if doctors make the decisions, it can be managed. But if the government does it, they will ration care. If you don’t pull the right lever Nov. 6, we will be in deep trouble.”
Union City surgeon Dr. Wright Jernigan added, “All of us believe that health care should be available to all. What we are trying to say is, there has to be a better way than what has been presented. Basically, Obamacare expands who is available for Medicare and Medicaid. More and more will be eligible. If we can’t afford those things now, how will we afford it later?”
Miles also noted that changes mandated in insurance coverage under Obamacare that appear to be positive on first reading, such as forbidding insurance companies from refusing to cover new customers who have pre-existing conditions, will instead have negative effects for the health care consumer. A report based on information requested by Sen. Michael Enzi and quoted by the Galen Institute shows that insurance companies in at least 17 states — including Tennessee — have already stopped issuing new child-only policies because they cannot mitigate the risk of accepting those with pre-existing conditions.
“How will all this affect you?” Hale asked the crowd. “Well, many patients will have a hard time seeing another doctor, beginning in January. It won’t be up to me, or to you, then. So we as American people need to stand up and say we’re not going to do this.”
Nieves called attention to the changes he says are coming to areas like this one that have enjoyed the services of community hospitals. “There is an attack (from this administration) at the level of the community hospital. We are taking care not just of patients there, but our neighbors. The tertiary centers have a different mindset. This new act and the proposed cuts may force community hospitals no longer to exist.” He pointed out that in Iowa, where he practiced until fairly recently, 100 community hospitals closed in the space of a few years. “It is important not just to vote but to communicate to our families and others the real need. We need to fight to keep our hospital.”
Miles welcomed state Reps. Bill Sanderson and Andy Holt to the session and said citizens must make sure all their elected representatives know of their concerns over the health care issue.
Sanderson noted, after the program was over, that Obamacare will cost the State of Tennessee almost $300 million a year. He said Tennesseans simply cannot afford the program and there is great concern in Nashville over the issue.
“I don’t want us to have any part of it,” he said. “I want to opt out of the current plan. The Republican caucus is united on that, as well. There is talk of a special legislative session between Nov. 6 and Jan. 1. There will have to be a legislative decision and it will have to be made before Jan. 1.”
Miles closed the program by playing a speech President Ronald Reagan made in 1961 as a private citizen. In it Reagan pointed out the dangers of having the government involved in health care and said the determination of some to do that sprang from the certainty that once health care became socialized — as it would certainly do at that point — it would be easy to spread that political doctrine to every aspect of the lives of the people. Reagan closed that speech by pointing out in dramatic fashion how freedom might then become nothing more than a story related by old men to their sons.
“President George Washington said government was a dangerous servant, but it was a terrifying master. Do we want to be a bunch of sheep? Our Founding Fathers thought we could govern ourselves, but Progressives want to control it all. Then they exempt themselves from so much. We all should be doing a lot of praying,” Miles added.
Glenda Caudle is special features editor at The Messenger in Union City. She may be contacted by email at glendacaudle @ucmessenger.com. Published in The WCP 10.2.12