Health forum decries current care methods

By Jill Coley
The Post and Courier
Sunday, January 4, 2009



photo

The Post and Courier

'They send patients to us who can't pay. That's not a system,' said Ronald A. Ravenell, executive director of the Franklin C. Fetter Family Health Center, at the community health forum in McClellanville on Dec. 30.

McClellanville — More than 30 consumers and health care professionals gathered last week to tackle a daunting question: What is the biggest problem with the nation's health care system?

Their answer was succinct: There is no system.

Fragmentation and inefficiency are endemic, the group said. One participant described a revolving door of medical clinics, hospitals and private physicians. And no one knows what the others are doing.

They also indicted the insurance industry for placing a barrier between consumers and providers that is based on making a profit.

Those were the messages participants wanted to send to President-elect Barack Obama. The Dec. 30 meeting was one of thousands held across the country at Obama's behest, a grassroots experiment in policy-making.

Two main schools of thought

formed inside Greater St. Peter's

AME Church, tucked in the woods, down a country road.

One group advocated education as the answer to health care disparity. About 10 years ago, Florene Linnen, director of the Georgetown County Diabetes CORE, was diagnosed with diabetes. At the time, she thought, "It's just a little sugar, nothing to worry about."

When she learned that 75 people in her church were diabetic, and the nearest doctor was half an hour away, she took matters into her own hands. "People needed help. People were dying. People were having amputations," she said.

Through grit and dedication, a health center was born to educate diabetics about diet and exercise.

Physicians and administrators at the forum had no hope for making do with the current system.

Ronald A. Ravenell, executive director of the Franklin C. Fetter Family Health Center, said, "They send patients to us who can't pay. That's not a system." When clinics try to refer patients for specialty treatment, they're blockaded, Ravenell said.

Alfred Daniels, medical director of the St. James-Santee Family Health Center, likened the system to people running around in a field of tall rye grass, unable to see the edge. "What about those who fall off and show up in my office with chest pain and they're not sick enough to refer," he said. "There's no system here."

To qualify for Medicaid, which covers care for the poor and disabled, some have to sell off everything they own. "Poor folks are being forced to get rid of all their property to maintain their health," said Fred Lincoln of Cainhoy. "You shouldn't have to become indigent to get health care."

Even those better off suffer from fragmented care. Daniels shared a story of his 100-year-old mother, who recently suffered acute back pain. Getting the emergency room physician, a specialist and her primary doctor on the same page was a Herculean task, he said.

Daniels advocated a single-payer system, similar to those used in Canada, excising the insurance industry. He scoffed at a criticism often leveled against universal health care, that people must wait for non-emergency care.

"Let me tell you about my waiting list, and it's age 65," he said. Daniels has patients in their 40s who need hip replacements, but have no hope of getting the surgery until they age into Medicare.

Juanita Middleton, former educator and consultant for a mental health partnership with Charleston County School District, was baffled by what she's paying her private insurer for, when they shift most of her costs onto Medicare.

"Medicare pays so much for me. What am I paying Blue Cross Blue Shield for?"

Insurance companies wield massive political power, and toppling them would be revolutionary, participants agreed. Obama has proposed a new public plan, similar to Medicare, that would compete against private insurers.

"Medical care is a right, not a privilege," said Daniels, an idea considered as radical today as when he was in school decades ago. "We haven't got there yet. In fact, I think we're getting worse."

Reach Jill Coley at 937-5719 or jcoley@postandcourier.com.

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majorjohnson (anonymous) says...

he reason your health care is so expensive is that the government mandates your employer insure you for everything from a lung transplant to a splinter. The doctor who does nothing more than give checkups and prescribe medication for the flu and pull splinters has to maintain a full staff of people whose only duty is to understand and file insurance paperwork. That staff has to be paid for. On top of that the government only pays X dollars for procedures for medicare/medicaid patients, and that requires not only staff to keep up with those rules and file that paperwork, but because it doesn't actually cover the cost of those procedures that staff has to also figure out how to spread the amount that those set payments don't cover to the insured and uninsured payees, because that money has to be made up somewhere. You people who think government is the answer to the cost of health care are hiring foxes to guard your chicken coops.

It was within my own lifetime that we were able to afford routine healthcare, even childbirth out of pocket and we had catastrophic insurance for the big stuff...now thanks to government no one can afford to have a splinter pulled unless they have insurance or medicare/medicaid. And every time there is an audit of the medicare/medicaid system they find that it's littered with improper payments and fraud. The last audit carried out found that 35% of the payments made were fraudulent or improper and unretrievable. And you people can't wait until health care is free, and think the medical care system is the problem.

Further, the most affordable and competitive health care in this country is cosmetic health care. Cosmetic surgery is not covered by insurance or government. You'd better think long and hard before you let the government take over your health care.

January 4, 2009 at 8:30 a.m. ( | suggest removal )

gencon1 (anonymous) says...

The federal government cannot afford to bankroll another health care program. Federal government revenues in 2006 totaled $2.4 trillion. The present value of long-term liabilities for the Medicare, Medicaid, and Social Security programs currently stands at $39 trillion, according to the U.S. Government Accountability Office. The liability has increased 147 percent in the past six years alone. Clearly, the federal government cannot afford to increase its health care liabilities even more.
State governments are in no better position to fund a single-payer program for their residents. Last year, Medicaid eclipsed education as the largest expenditure for state governments. States spent $336 billion, accounting for 22 percent of their budgets.
Even if the federal government or states could afford to cover everyone"s health care needs, such a government-run program would fail. Proponents of government-run health care often point to Canada and Britain as models that work. But the two countries offer better examples of how government-run programs fail to improve access to care. At any given time, 800,000 Canadians and more than one million Britons are waiting for health care. In 2005, the Supreme Court of Canada ruled that "delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care.

The average Canadian family pays 47 percent of its income in taxes, and most of that goes to pay for the single-payer system.
Single-payer programs chase away health care providers. Canada ranks 24th of 28 countries in the number of doctors per thousand people, according to the Organization for Economic Cooperation and Development. In the U.S. a growing number of doctors are dropping their current Medicaid patients or refusing to accept new Medicaid patients into their practices, because the program reimburses them less than it costs to care for those patients and payments are often delayed by weeks or even months. If you want more taxes, less doctors and worse care, vote for universal health insurance.

January 4, 2009 at 9 a.m. ( | suggest removal )

gencon1 (anonymous) says...

I can't wit to see the liberals give us health care as efficient as public education.

January 4, 2009 at 9:01 a.m. ( | suggest removal )

oldglory (anonymous) says...

I think of my friend and her husband, a childless couple, who have owned their home for many, many years. They have the very best Blue Cross/Blue Shield policy available to them which now costs them over $2,000/month. She was diagnosed with colon cancer. There were three (3) chemo treatments: (1) Blue Cross/Blue Shield paid $18,000.00 for the first one; (2) She and her husband paid $18,000 out-of-pocket for the second one; and (3) She did not get the third treatment, because they could not afford another $18,000.

I have been very frugal my entire life and able to take care of myself (at least to this point, although I've lost part of my savings). But who among us can pony up $18,000 for that first treatment? Who among us want to sell our home (now not worth nearly what we paid for it) in order to provide our next breath? I tell my doctors straight out that if (more like when) I have a catastrophic illness, then that is the point I choose to allow nature to take it's course. I have a feeling I'm not alone in this position.

If the foregiong sounds morbid, please understand that it's not meant to be. We all need to learn and understand this reality of life.

January 4, 2009 at 9:52 a.m. ( | suggest removal )

majorjohnson (anonymous) says...

The big problem glory is that they have insurance that covers everything from having a boil lanced to a lung transplant. And with premiums that high those people have serious health issues. No way does insurance run that high for two healthy people. As far as letting nature take its course, look at the cost of her care. That's $54,000 just for the 3 chemos JUST IN HER COST. Add in the cost her insurer is paying out, rest of the care, and the expenses after, and her end of life care is going to run into the many hundreds of thousands, if not millions.

The vast majority of health care dollars go to end of life care. Lung transplants for 70 year old diabetics, hip replacements for people with only a few years left, the very most expensive procedures go to people with very little time left to begin with. How can you justify spending hundreds of thousands or even millions to keep someone alive for another year? In order for that enormous expense to be paid for, we have to pay increased rates for simple everyday health care. There is something to be said for letting nature take its course.

January 4, 2009 at 10:28 a.m. ( | suggest removal )

Tides (anonymous) says...

The entire health care system has turned into a cesspool of greedy doctors and hospital administrators. No matter how you try to slice it and dice it, that is the plain truth.

Greed people wanting to get rich have destroyed the US economy. We are going into a depression. That is a reality.

South Carolina is broke. The State is almost #1 in the nation with it's high unemployment rate. State government has been horribly run. Not because of Mark Sanford. Mr. Sanford has fought hard to control the OUT of control spending habits of Senator Glenn McConnell and Representative Bobby Harrell.

McConnell and Harrell are RESPONSIBLE for SC being BROKE - PERIOD! Other states have surplus. But these lame brain corrupt Senators and Representatives are worthless to us all. Yet SC voters are dumb enough to keep elected them. Now look at the mess they helped get us into. LOST JOBS AND NO GOVERNMENT MONEY.

South Carolina is Bankrupt. And McConnell and Harrell most certainly played a Major role in causing it.

January 4, 2009 at 3:05 p.m. ( | suggest removal )

majorjohnson (anonymous) says...

Tides is a money hating socialist. The real truth is that his envy is far greater and more destructive than any greed.

January 4, 2009 at 5:12 p.m. ( | suggest removal )

yird (anonymous) says...

Until I signed onto medicare part B BCBS paid nearly all medial procedures with a "reasonable" copay.

Now socialized medicare pays 80% and BCBS pays the remainder.

Here's the rub. Now that BCBS only has to pay 20% why are premiums not reduced instead of increasing?

This is more government screwing up big time.

As people age they require more medical care and at the break point for medicare B,(65)all of a sudden the insurance company has reduced liability and the taxpayers shoulder the burden leaving the insurance companies a greater degree of profit.

Wouldn't have anything to do with the huge lobbies of the AMA and the insurance industry would it?

If the government got out of the medical field with the exception of monitoring drug production it's a given that health care costs would decrease dramatically.

Doctors and hospitals would have to compete.

What a novel idea!

January 4, 2009 at 8:02 p.m. ( | suggest removal )

YankeeLady (anonymous) says...

Healthcare providers are not "greedy" - figure in the years of education, the cost and time of keeping skills current, and the mountain of redundant, ridiculous paperwork necessary to retrieve ever-dwindling reimbursements, AND the supreme responsibility of rendering healthcare - medical providers deserve to be well paid. It may be difficult to find a family doc to take care of cost-saving preventative issues, as primary care salaries are no longer worth it to many; look at the trend towards fewer and fewer primary care providers, as new graduates decide to become specialists for the bigger bucks and insurance reimbursements. The only folks getting rich in this healthcare system are the ones who control it - the insurance companies and the pharmaceutical industry.

January 4, 2009 at 8:48 p.m. ( | suggest removal )

YankeeLady (anonymous) says...

P.S., Oh, by the way, we'd have so much more available for health care if we stopped spending every last dime on endless wars and the defense industry.

January 4, 2009 at 8:50 p.m. ( | suggest removal )

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