Be more specific

Published 12:00 am Saturday, September 19, 2009

As the health care debate continues, local doctors agree the bill is lacking in one key thing – specifics.

But, just how do they think it will affect Pike County residents?

“A lot of it depends on what kind of financial situation you are in,” said Dr. Wilson McRae, a local ear, nose and throat doctor and vice chief of staff at Troy Regional Medical Center. “The majority (of Pike County) would end up in the public option. The public option is big on generalities, not on specifics.”

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In fact, doctors agree there is a lot left for interpretation.

“The only concern I have when you read the health care reform there is a lot left to interpretation of the administrator,” said Dr. Chuck Wood, chairman of the doctors board at TRMC. “It would be nice to know who the administrator is. Will it be left to one person?”

Dr. Mickey DiChiara agrees.

“Is one person going to be charge?,” he said. “With Blue Cross we have to check with them before we do anything big. How’s that going to work?”

But President Barack Obama insists his administration would require insurance companies to cover preventative care like mammograms and colonoscopies because it “makes sense, it saves money and it saves lives.”

Still, studies have shown that much preventative care – particularly tests like the ones Obama mentions – actually costs money instead of saving it.

That’s because detecting acute diseases like breast cancer in their

early stages involves testing many people who would never end up developing the disease.

The costs of a large number of tests, even if they’re relatively cheap, will outweigh the costs of caring for the minority of people who would have ended up getting sick without the testing.

In August, the Congressional Budget Office wrote, “The evidence suggests that for most preventative services, expanded utilization leads to higher, not lower, medical spending overall.”

That doesn’t mean preventative health care doesn’t make sense or save lives. It just doesn’t save money.

Wood said the bill is costly, large and complicated. It leaves interpretations that could harm overall health care.

While the doctors agree it will be good for everyone to have health insurance, they all have concerns about how it will affect the overall quality of health care and exactly who is going to fund this.

“There are not specifics on how much the government would pay,” McRae said. “Right now the hospital would not stay afloat if it was like Medicare or Medicaid.”

Obama told the Associated Press, “I will not sign a plan that adds one dime to our deficits either now or in the future. Period.”

Still, There is no final plan. So far, House Democrats offered a bill that the Congressional Budget Office said would add $220 billion to the federal deficit over a 10-year span, the AP reported

But, Democrats and the Obama administration officially claimed the bill actually was deficit-neutral. They said they simply didn’t have to count $245 billion of it – the cost of adjusting Medicare reimbursement rates so physicians don’t face big annual pay cuts.

McRae and Dichiara both raised the issue of how will the doctors be able to treat everyone if they have health coverage.

“The care would be the same, but it would cost less,” McRae said. “It could overwhelm the doctors office. We already have a shortage of doctors in Troy. With everyone adding people to the coverage, doctors could get overwhelmed.”

“My one concern is it would be great if everyone would be covered. It would really help the hospital not having to do anything for free, but my concern is if we have enough doctors,” Dichiara said. “If all of a sudden, we have 10,000 people in this county with health insurance, how are we going to treat all of them?” Doctors also wondered exactly who is going to pay for health care.

“The thing I’m concerned about is how they are going to pay for it,” Dichiara said. “We have a small business and insurance is already expensive.”

McRae said it could make it difficult more doctors to make a living.

“Older doctors could retire,” McRae said. “And younger ones would not go to med school since all the doctors would be paid the same.”

McRae said he thinks it would eventually drive down the overall quality of health care, older experienced doctors would probably get out of the business and potential doctors wouldn’t want to take the time to go to school for significantly less salaries.

U.S. Rep. Bobby Bright, who represents the second district, which includes Pike County, is avidly opposed to the health care plan as it is now.

According to Bright’s Web site, he is opposed to the current House draft health care legislation.

“I continue to believe that the current direction of health care reform relies too heavily on taxes on individuals and small businesses, and the overall cost of health care legislation remain too high,” Bright said. “Moreover, though changes have been made to how the public option will work, the overall bill does not represent my belief in a free-market approach to health care reform.”

As it stands now, the House bill contains a public option that would be a government subsidized plan that competes with current private health care plans.

With that, McRae said about 90 percent of individuals in this county with private health care have Blue Cross Blue Shield insurance.

The United States is the only industrialized democracy that lacks a comprehensive national health care system.

Most Americans rely on health insurance partially subsidized by their employer and can lose their family’s coverage if they lose their job.

“Nothing in this plan will require you or your employer to change the coverage or the doctor you have,” Obama told the AP.

That’s correct, as far as it goes. But neither can the plan guarantee that people can keep their current coverage.

Employers sponsor coverage for most families, and they’d be free to change their health plan in ways that employees may not like, or drop insurance altogether. The Congressional Budget Office analyzed the health care bill written by House Democrats and said that by 2016 some 3 million people who now have employer-based care would lose it because their employers would decide to stop offering it.

Earlier this week, Senate Finance Committee Chairman Max Baucus, a Democrat, unveiled his much-anticipated bill, and senators who have been waiting for months lined up to offer a bevy of contentious changes. One senator said the bill “needs more than just a few tweaks.”

Democrats are concerned about affordability. Republicans almost uniformly oppose the measure and may be loathe to hand the President a victory on his biggest domestic priority, legislation to rein in skyrocketing health care costs and extend coverage to many of the 50 million uninsured.

*The AP contributed to this story