Panelists share views on health care reform at hospital meeting in Glenwood Springs
GLENWOOD SPRINGS, Colorado – Opinions may vary widely in the current health care reform debate, but few can deny that the existing patchwork system of public and private health insurance is not sustainable, a panel of medical industry experts tended to agree Monday.
“We as a country will go bankrupt if we don’t solve this problem,” Neil Waldron, chief marketing officer and vice president of strategic initiatives at Rocky Mountain Health Plans, said during a panel discussion at Valley View Hospital sponsored by the VVH Foundation’s Business Relationships Committee.
However, change is likely to come incrementally rather than in one sweeping reform effort, said Waldron, who has also held executive positions with Sloans Lake Health Plan, Great West Healthcare and Aetna.
“While much of the current debate is on how to assure all Americans have access to affordable health care, it is ultimately the cost of care and its impact on the national debt that will shape reform,” he offered.
Waldron was one of four panelists invited to the luncheon meeting to discuss and field questions from local business people about health care reform.
Joining him were Dr. Irene Aguilar, a primary care physician in Denver and current president of Health Care for All Colorado; Dr. Mike Barnes, a local anesthesiologist and medical director of the Community Health Plan; and Larry Dupper, chief financial officer for Valley View.
Health Care for All Colorado (HCAC) advocates for comprehensive reform utilizing a single payer financing mechanism to provide basic health care for all. Such a system would allow everyone to contribute to and benefit equally from health care, said Aguilar.
“Insurance was designed for a model that no longer exists; one in which the need for health care was a possibility,” she said. “Due to the advances in medical science and the increased life expectancy of Americans, everyone needs health care.”
Aguilar pointed out that it wasn’t until for-profit health insurance companies entered the market following WW II that the practice of “cherry picking” desirable insurance clients, namely the young, healthy and wealthy, and “lemon dropping” more risky clients, namely the elderly, disabled and poor, became commonplace.
That resulted in the 1965 passage of the federal Medicare and Medicaid programs to cover those under-served and un-covered populations.
That has led to the current situation where those who have private insurance now bear much of the health care cost for those who don’t.
“This distorted ‘system’ of health care financing and service delivery has led to unsustainable cost increases and unaffordable health care,” Aguilar wrote in a recent HCAC article, which she distributed at Monday’s event.
That “hidden tax” on the insured is one of the main reasons the current system is unsustainable, Barnes said.
“As the ‘hidden tax’ gets larger, insurance gets more expensive, more people then can’t afford insurance and so on in a vicious cycle,” he said.
But the main reason the system is failing is because neither physicians nor legislators are willing to ration care, Barnes said.
“At some point society does have to determine what is reasonable and necessary care,” he said. “Instead, we have decided to do everything possible, regardless of cost.”
Barnes also agreed that any government paid public option should include a standard benefit for all.
“This standard benefit should be provided to all citizens regardless of their ability to pay,” he said. “This does not relieve anyone from the responsibility of paying what they can. Most people can pay something.”
Furthermore, “Insurance companies should continue to provide a variety of products to those who wish to purchase a higher standard of care,” Barnes added.
Education about healthy habits and personal responsibility is also key to any reform efforts, he said.
The current health care reform debate represents a paradigm shift, Valley View CFO Dupper said. And for VVH there could be impacts, from increasing demand to affecting reimbursement rates, he said.
Dupper added that individual states should play a greater role in shaping health care reform on a national level.
“I would like to see more experimentation on the state level, instead of throwing the whole country in one direction or another,” he said.
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