June 29, 2012

Mixed feelings on health care ruling

MARK NEWMAN Courier Staff Writer

OTTUMWA — Right now, there are uninsured Iowans who will find health coverage — or pay a hefty fine.

U.S. Supreme Court Chief Justice John Roberts announced the judgment that allows the controversial “affordable care act,” sometimes called “Obamacare,” to move toward its stated goal of covering 30 million uninsured Americans.

“Because the Constitution permits such a tax, it is not our role to forbid it,” Roberts said.

Good, said Ottumwa Democrat Steve Siegel, the current head of the Southern Iowa Labor Council.

“This will bring us closer to having universal health care,” he said. “In the richest country in the world, there’s no reason someone should have to go without health care or go bankrupt [paying] for it.”

That doesn’t mean the program, set to start in 2014, will be without cost.

Phil Dionne, CEO at Ottumwa Regional Health Center, has questions about the bill, but hasn’t been impressed with what he’s seen so far.

“This [appears to be] an additional expense placed on an already overburdened public, and that is not going to be a positive thing,” he said Thursday.

He is concerned that if insurance companies are forced to cover everyone for everything, premium costs will go up to the point that some Iowans will just have to go without any insurance.

“When people don’t have insurance, the condition [can] worsen [because] people defer medication or avoid going to the doctor for office visits,” he said.

By the time they have to get treated, they often wind up in the emergency room, the most expensive way to be treated.

But if everyone has insurance, wouldn’t that allow patients to go to the doctor or visit Dionne’s hospital.

Maybe, he said, but at what cost — and do we end up making it impossible for some people to buy insurance?

Wellmark Blue Cross Blue Shield covers many families in southeast Iowa. They sent some answers to the Courier on Thursday. They tend to agree with Dionne that insurance providers say they’ll pass increased costs to consumers.

Wellmark will do what the law requires, they wrote, but even as they do that, they plan to lobby politicians to address the parts of that law “that will increase costs [and] will result in driving up premiums for young people and the health insurance tax that will add hundreds of dollars to families’ premiums each year.”

Professional campaign strategist Terry Holt told the Associated Press that there is justification for Republicans to call this “the largest tax increase in American history.”

This isn’t just about money, said a local doctor.

“I am extremely concerned,” said Michael Shaeffer, M.D. “Bureaucrats will  be making decisions overriding the doctor’s order. They’re going to tell doctors you can’t get this test, go to this one, it’s cheaper.”

He sees it with other government-run health care, like at the VA. He just experienced it again Thursday. He had prescribed a modern  medicine for a patient, something he believed would really help. The patient came back without as much improvement as the doctor expected — and then the doctor sees that the VA gave the patient a cheaper medication, one developed 15 years ago.

“The American health system has major problems and needs to be changed,” Dr. Shaeffer acknowledged. “Obamacare is not the solution. Quality will diminish noticeably. People will die unnecessarily.”

A Courier reader opined it’s politics as usual.

“Republicans crying, Democrats gloating [and] neither … have a clue what us real Americans want,” said John Essary.

It’s unfortunate that an issue like providing health care has become so political, said a nurse working in Ottumwa on Thursday.

Cheryll Jones, a pediatric nurse practitioner, said she’s paid close attention to this issue but thinks some people have made their decisions based on whether they like or dislike President Barack Obama.

While researching the issue, she read a study by a medical company where they asked if people were for or against many of the things listed in the new law — being denied insurance coverage for pre-existing conditions or having lifetime maximums on benefits.

“People said they didn’t want those things. Then the survey [asked] how they felt about Obamacare, and those same people said they hated it,” she said.

As a nurse who works with children, she said she likes a lot of what she’s read about the ACA, including requiring that patients can be insured even if there is a pre-existing condition. Lifetime maximums can be ruinous to families.

In general, she said, for 30 years she’s been upset by big companies telling children, “Oh, you’re sick, you’ve got problems, we’re not going to cover you.”

The ACA is a start toward helping both the young and the old, she said. For example, that “donut hole, which made no sense” in Medicare requiring senior citizens to pay full price for their medication, is now closed, she said.

“As a country, we have to really look at health care,” Jones said. “No matter which side you’re on, the way we were going with health care, something had to be done. This isn’t perfect, but it’s a start.”

“This is not my dream legislation,” said Siegel. “Does this bill need improvement and tweaking as we go along? Absolutely. Do we need to go back to the way things were? Absolutely not.”

But isn’t it accurate that society will end up footing the bill to care for  uninsured poor people?

“Who pays for that now?” Siegel asked rhetorically, pointing out that all taxpayers or people with insurance end up paying for those who can’t afford to pay for care. “If it had been declared unconstitutional, it’d be especially hard on children.”

Dr. Shaeffer disagrees  and worries that the law as written could actually limit care for the very young.

“Government control of anything is rarely the answer,” he said.