U.S. Congressman Jim Marshall does not support any of the five health reform proposals currently circulating through various levels of Congress, because none of them address what he sees as the major problem: America’s path toward bankruptcy.
Marshall shared his thoughts about the health care system and its reform with doctors and administrators from Newton Medical Center on Wednesday afternoon, but he was more interested in hearing their thoughts.
He said if healthcare was left the way it is, then in two to three decades the U.S. debt will balloon to $50 trillion, and $40 trillion of that would be health care related debt. If the debt continues to balloon, Marshall said experts predict that healthcare would take up the vast majority of our budget; there would be none for defense or transportation or most anything else. However, long before we reached that point, countries would simply stop buying our debt and subsidizing our spending.
According to Marshall, even though reform is clearly needed, the current proposals just throw more money at the problem. Care needs to be improved, but Marshall said he won’t support any bill that doesn’t also emphasize financial considerations.
As for the current proposals, he thinks the systems that offer both private and public options aren’t the right choice, because private insurers simply wouldn’t be able to compete. He said a public option should only be used, if the private insurance system cannot be reformed and remains dysfunctional.
"I think reform can be done with a private option, but only if significant insurance reform occurs, or real change in the way Americans access the system," he said. "We need to structure the system so that Americans are in control and managing our money and our relationships to hospitals. It would do a world of good, if we focused more attention on our health care and became more educated."
However, Marshall admitted he isn’t a health care expert, and he said he is seeking out the opinions of educated people in the health care system, like the administrators and doctors at NMC. He asked for feedback on the current system and the proposed systems.
James Weadick, NMC CEO, said everyone has problems with uninsured patients who simply can’t pay, as well as reimbursement issues with Medicare, Medicaid and private insurers. One of the problems is that if people need or want to get care, they’re going to be able to get some way, even if they don’t have insurance.
Marshall talked about more wellness initiatives, living healthier lives and receiving preventative care, but Weadick said that was a tough sell, because self-discipline is lacking in America and many people are more interested in finding a pill to solve their health problems, as opposed to eating right and exercising.
Marshall said he is interested in the Healthy Americans Act proposed by Oregon U.S. Sen. Ron Wyden, which has proposed to improve private health care while cutting costs. He asked Weadick and others to read up on the act and provide him with some feedback.
Weadick identified some other problems, including a lack of primary-care physicians, or general, non-specialized doctors. He said the number of doctors entering the medical field has plateaud at around 17,000 per year, while the population continues to grow. He said the absence causes problems in treating patients initially and in following up with parents, particularly those that don’t have a consistent doctor. Weadick said NMC is working on helping doctors open some more clinics to address the lack in Newton County.
The group also discussed end-of-life care, and said this is an example of rationing of care, something that already happens and needs to happen to keep down costs. Every day patients and doctors choose less expensive medicines and procedures, because the cost of the more expensive options isn’t worth the added benefit. End-of-life care requires patients, families and doctors to have a reasoned debate about what measures should be taken to keep someone alive. Marshall said it was important for every American to have a living will and consider many of these issues ahead of time.
Marshall and NMC officials also discussed the need to fix medical malpractice law, which doctors said forces them to do expensive procedures, which are unnecessary, just to protect them from lawsuits; the system promotes inefficiency. Dr. Steven Whitworth, NMC Chief of Staff, said he could cut costs by 25 percent if he didn’t have to worry about being sued.
What they settled on is that there are a lot of problems to fix and no perfect solution. However, Marshall reiterated that the cost has to come down one way or the other. He said he’s been having town hall meetings to hear from the public, and because he wanted to get in on the fun.
Marshall recommended that people go to the government committee’s Web sites where the bills are being considered and read those bills’ summaries. However, he said the bills are constantly changing and no one is sure yet how the final versions will read.