Thursday, September 10, 2009

Recent Column in The Journal Standard


The Great Health Care Debate

By

Roland Tolliver

Dan, a small business owner in the Chicago area, conscientiously paid his health insurance premium for over twenty years. Each month the bill would come and each month he would cut a check and forward it to the company. About two summers ago the company received the largest order it had ever had. The company was working almost around the clock and he was right alongside them. Thirty days lapsed and he was notified that his policy was cancelled. A couple of months earlier, he found out that his cholesterol was slightly elevated. He had gone in for a physical prior to running a marathon. Dan offered to send in his check, but the company wouldn’t reinstate him for, yes, you guessed it…a pre-existing condition. Dan cannot get health insurance without paying so much that it would create a major financial hardship for his family and his business. Dan favors the “Public Option” in the health care plan as proposed by the government.

Dan’s story is not unique. We, here in Northwest Illinois, are hearing this type of story almost daily. Businesses are downsizing. People are being “walked to the door” and the ranks of the uninsured or underinsured are growing with each lost job. The emergency rooms are becoming more crowded as people seek health care without the insurance or wherewithal to pay the medical costs. Medicaid ranks are growing, even though the state doesn’t have the money to pay existing bills. The number one reason for bankruptcy in our country is because of health care costs from a catastrophic illness or injury. What is our country to do? How will we be able to afford it? And what cost will there be as a nation becomes sicker, grows older and as the Baby Boomer Generation reaches Medicare age?

I had the opportunity to take part in a Health Care Forum in Chicago on September 1, 2009 at the WTTW studio in Chicago. There were only 24 guests invited to be a part of the audience and the panel included Senator Dick Durbin (D-IL), the Senate Majority Whip; Dr. Jeremy Lazarus of the AMA; Dr. Paul Handel of Health Care Service Corp, the parent company of Blue Cross/ Blue Shield Illinois; and Kevin Scanlan of Metropolitan Chicago Health Council, which represents 140 Chicago area hospitals. The hour long program, which was one of the most civilized I’ve seen, focused on some of the major issues which are currently (and will be) affecting Americans from all walks of life. Those of us in Stephenson County and throughout our region represent a microcosm of what is happening throughout the country and the health care issue is being rabidly debated, but goes much deeper than the rhetoric that is offered on the nightly cable news and on talk radio.

I presented a question to the panel about the problem that rural America faces in recruiting and maintaining physicians. There is currently a shortage of between 7,000-10,000 primary care physicians in America. This number is expected to grow to approximately 50,000 by the year 2020. Whether it is a preference for an urban lifestyle over a rural lifestyle, or whether it is the fact that the average medical student is graduating with a student loan debt load of over $155,000 even before they start in practice, fewer physicians are going into general practice. Another factor in the physician shortage is the cost of malpractice. This is another topic in the national debate, but was not addressed at the forum in Chicago. While the reform of tort laws is certainly an important issue, it is not the only factor for the escalating costs of health care.

The debate will continue to rage on, as it has for many years. Some feel that the current administration is forcing their plan onto the public. There is fear of so-called “death panels” and rationing of health care. In some ways, that is already going on in our country. From experience, however, it is not usually the public insurance, i.e. Medicare, which limits a physician’s ability to practice medicine. Their guidelines are straightforward. It is more often private insurance companies that are making the patients and their physicians “jump through hoops” when it comes to ordering necessary exams, prescribing the best medications for certain conditions as indicated, and being able to perform the procedures needed to allow a patient to live a pain-free or at the least, a more comfortable life.

No matter which side of the health care “debate” that one is on, we cannot deny that something has to be done for coverage of over 46,00,000 uninsured people in America. Neither can we afford to continue driving potential doctors away from the medical profession, because we will have an even greater divide in people receiving health care. We in rural America will suffer the consequences at an even greater percentage than in urban areas. We cannot afford this for our sakes, for the sake of our children and grandchildren and for the sake of our community’s overall well-being.

The questions are difficult and real answers about the cost of health insurance, prescription medications and the cost of poor lifestyle choices affect all of us. Let your voices be heard by writing our Senators and Congressmen. When the President speaks to the joint session of Congress this week, we must remember that it is ultimately up to each of us to make informed choices and take ownership in this issue and in our own health, whenever possible.

To view the Health Care forum, please visit WTTW’s Chicago Tonight website

or go to:http://www.wttw.com/main.taf?p=42,8,8&vid=090109a

Dr. Roland Tolliver is a podiatrist and freelance writer from Freeport.

Saturday, September 05, 2009

Health Care Forum WTTW

I had the fortune of being one of 24 guests invited to take part in a health care forum at WTTW in Chicago on September 1, 2009. The forum was one of the few that I've seen that has been civil, even though there were dissenting sides of the issue present. The forum's expert panel included Senator Dick Durbin (D-IL), the Senate Majority Whip; Dr. Jeremy Lazarus of the AMA; Dr. Paul Handel of BC/BS's parent company; and Kevin Scanlan of Metro Chicago Healthcare Council.
The questions/comments were relavent to the topic, though a couple of issues were either skirted over or weren't discussed in the 53 minute program. The host was Phil Ponce, longtime Chicago television newsman.

The most heated portion of the debate took place between Sen. Durbin and Dr. Handel. The Public Option, while favored by many, is being hotly contested and dissuaded by the Health Insurance companies. I had the most difficulty swallowing the "reason" why the CEO of Health Care Service Corp, the parent company of BC/BS of Illinois makes over 12 Million Dollars per year.

The consensus seems to be that those who have employer-based health care insurance are happy with it and those who are uninsured or underinsured (or like some of us are paying exorbitant amounts for less than optimal insurance with high deductibles) look at the public option as a way of being able to afford health insurance without going bankrupt or struggling to make ends meet.

There has been, and unfortunately always will be, some form of rationing of health care. It happens here in the USA and in countries with socialized or nationalized health programs. The underlying issue is that no matter what comes down through the House and the Senate, it will end up costing more than we can afford. We can't afford to do nothing, either, though.