Left of College Station

Central Texans Discuss Health Care Ideas for Obama Administration

By Cindy V. Culp (Tribune-Herald Staff Writer)

From the Waco Tribune-Herald

Central Texans have plenty of suggestions for how President-elect Barack Obama should reform the nation’s health care system. The problem is, their ideas often are in direct conflict with each other.

At a forum hosted by the Scott & White Center for Healthcare Policy, area residents got the chance to sound off to the president-elect. The meeting was one of more than 8,500 held across the country in the past few weeks at the request of Obama’s transition team. The purpose is to gather grass-roots input to shape the new administration’s health care policy.

Dr. Jim Rohack, who heads up the center and also is president-elect of the American Medical Association, said last week’s meeting at Scott & White’s Temple campus was the only one of its kind in Central Texas. About 100 people attended, most of whom were Scott & White staff. About 20 community members were present.

Rohack led the group through a series of eight questions formulated by Obama’s transition team. They focused on the cost of health care, health insurance and how to promote prevention efforts and healthy lifestyles.

A couple of the simple questions generated consensus. For example, almost everyone in the room raised a hand when asked if they or a family member had ever had difficulty paying medical bills.

But questions that asked for solutions yielded widely varied responses. When the group was asked what the role of employers should be in a reformed health care system, one woman said all of them should be required to offer coverage. Another woman said employers should be taken out of the equation in favor of a system in which the government would provide coverage for everyone.

Similarly, one staff member in the audience suggested that restaurants be required to publish nutritional information for all dishes to help people maintain a healthy lifestyle. A colleague later called the idea “silly.”

Much of the debate centered on the question of government regulation vs. personal responsibility. Audience members floated ideas, such as charging people more for health insurance if they don’t get preventive care or penalizing the parents of children who are enrolled in publicly funded programs and don’t get all their vaccinations.

Specific suggestions for improvement offered by participants included:

* Better educating people about what is covered by their health plan and what is not so they can avoid unexpected out-of-pocket expenses.

* Standardizing bills to make it easier for patients to understand for what they are being charged.

* Allowing more tax deductions for medical expenses.

* Increasing physical activity opportunities for students who aren’t athletic or aren’t interested in team sports.

Toward the end of the discussion, Dr. Fernando Elijovich, an internal medicine physician at Scott & White, said he thought the country will continue to be divided until there is a consensus about whether health care is a right or a commodity.

“We have not defined as a society what health care is for us. And until we make that decision, it is going to be very hard (to bring about reform),” Elijovich said.

In addition to the meeting, Scott & White also solicited input through a questionnaire on its Web site.

A summary of the ideas from the Web entries and the meeting will be sent to Obama’s transition team, along with a video recording of the meeting.

Brad Simcik said he appreciated the opportunity to be heard. The 38-year-old Hewlett Packard employee and Houston resident was at Scott & White because his father was receiving care there. When he saw the meeting advertised in a newspaper, he decided to attend.

“I think this is a great forum,” Simcik said. “When you take community input, you don’t come up with a pat answer. But there were a lot of smart people in this room sharing their views.”

Published on Wednesday, January 07, 2009

According to an article in the Dallas Morning News the privatization of Texas health care has “failed needy Texans and taxpayers,” while Evercare of Texas has attributed its problems to “normal start-up issues.” The state has fined Evercare, $1 million in fines last year, $400,000 in fines due to the recent North Texas complants, and was ordered it to increase staff and fix other problems. However, a $1 million dollar fine represents about 1.3% of UnitedHealth Group profits from 2007; UnitedHealth Group owns and operates health care companies such as AmeriChoice, PacifiCare, and Evercare.

“Since 2003, the state has paid the company's Evercare and United Healthcare units more than $1.2 billion to provide managed care to more than 255,000 Texans under four programs… It enjoyed record profits in 2007 – $7.8 billion in earnings on $75.4 billion in revenue.”

The problem is that when large corporations are fined relatively small amounts of money it does not have the desired effect. Companies that make billions of dollars in profits are not affected in the same way that smaller businesses are by regulations. It is the cost of doing business.

“UnitedHealth has amassed fines around the country. In September 2007, the company's UnitedHealthcare unit agreed to pay $12 million to 36 states and the District of Columbia to settle complaints that it applied incorrect fee schedules and deductibles, was slow to pay claims and failed to correct problems identified by state regulators.”

The article then posed the following question: So how can a company repeatedly violate regulations around the country and still win big contracts?

Like any company UnitedHealth lobbies state legislatures and donates to the political campaigns of politicians that will support favorable legislation. In Washington UnitedHealth spent $4.9 million on lobbyist in 2007, and $485,000 to $924,999 on lobbyist in Austin. According to the Texas State Ethics Commission UnitedHealth has contributed $16,250 to political campaigns since 2004, including a $5,000 donation to Lieutenant Governor David Dewhurst and $2,000 to Texas Senator Stephen Ogden (Senate District 5).

“In the 2006 election, it contributed $20,000 to Perry's re-election campaign….Since 2000, it has contributed more than $180,000 to political causes and candidates in Texas, according to a Dallas Morning News review of campaign finance reports and court records.”

This after a year in which Texas dropped from 37^th in the nation in health care to 46^th.

Texas is near the bottom among the 50 states in per-capita spending on health and human services, but it is a leader in outsourcing these functions to private contractors. Since taking office in 2000, Perry has pushed some of the nation's most ambitious outsourcing endeavors, going well beyond his predecessor, George W. Bush.

However, those who are affected the most by all of this are those that are still waiting for the heath care they need.

“Willis Stewart, a 61-year-old carpet layer who had his teeth pulled during treatment for mouth cancer, said he has waited three months for Evercare to approve the dentures that will allow him to eat solid food again. Steven McGee, a 55-year-old truck driver disabled by multiple sclerosis, said he phoned the company for seven months without reaching a medical coordinator. And Mary Hunt, a 72-year-old widow, said she has waited months for dental care. “They ought to call them 'Nevercare,' " said Hunt, among the hundreds of people who have complained about denied or delayed medical care.”