To ignore health care reform is not good economic sense

I have been a medical administrator for over 30 years in both nonprofit and for-profit practices. Currently I am administrator for an office with 21 physicians and over 100 staff. Every staff member is required to consider how a patient's bill will be paid. Up to 30 percent of our time and resources go to making sure we get enough money to continue to provide services. With Medicare, the rules are defined and if you follow them you get paid. With the multiple insurance plans, there are negotiations required to ensure that you get fair payment. Some will pay as promised and others take hours of follow-up to collect for a clearly reasonable charge.

All employees are not secure in their coverage. Many companies have self-funded plans. When the company hits economic hard times they drop coverage. People lose coverage when they lose their jobs. Health care is as important as water and roads. I have listened to the arguments against health care payment reform and wish to respond to what I see as clear reasons to support it.

Health care reform opponents claim that we should not depend on our government to provide health care. Over 60 percent of the dollars collected by many physicians' offices and other health facilities are from government related health coverage already. This includes: Medicare, Medicaid, Veterans Benefits, TriCare, federal government employees, state employees, county employees, city employees, government retirees, prisoners, etc. The spouses and children of the various government employees and retirees are frequently covered as well. It is often the most reasonable and stable coverage available. Medicare is our most dependable payer. Their time lines and requirements for reimbursement are clear and consistent. Is there any one person receiving these government benefits who wishes to discard them?

Health care reform opponents claim that reform would ration treatment options. Already both government and private insurance companies limit which procedures they will pay for and how much they will pay. That's nothing new. Approximately 80 percent of the people with commercial insurance in South Carolina have Blue Cross/Blue Shield. Their executives make coverage decisions on a regular basis.

Health care reform opponents claim that reform would restrict access to physicians. Traditional Medicare (Part B) is a national system with access to more physicians than most if not all health plans, including private insurers. You can access care throughout the country so that if you move to another state you still have coverage. It is a good example of the public option proposed by the Obama Administration. It does not restrict a choice in providers any more than they are already restricted in today's world. It has the lowest administrative cost; an estimated 4 percent compared to as high as 17 percent for private health plans. We would be fortunate to have this as one public option. Keep in mind that the Medicare dollar that goes to doctors is only 17 percent of the entire Medicare budget. The remainder of the budget goes to hospitals, nursing homes, pharmaceutical companies, and durable medical equipment companies. Again, doctors are not the problem.

Health care reform opponents say the Obama Administration is moving too fast. For over 60 years the U.S. has debated reform to the health payment system. Medicare was a major milestone in that effort. Everyone over 65 understands the importance of Medicare. Each Medicare recipient has an option to buy supplemental insurance to enhance that plan if they wish increased coverage. This is not different from what is being proposed. In 2003, a Republican Congress and a Republican president pushed through the Medicare Modernization Act in an after-midnight move that limited debate. We ended up with the Medicare Part D bill for prescription drugs. It was flawed and the price tag was all but ignored. Nonetheless, people over 65 now have prescription coverage they did not have before, and efforts are being made to work out some of the problems; i.e. the famous donut hole. Delay is often used to kill an idea. We can't afford to delay and thus kill the effort to fix our current payment system.

Health care reform opponents say that we're getting mired in too many unknown problems. Of course there will be problems, but once a plan is in place the government and private insurers will continue to make changes just as they continue to do right now. We make adjustments in our billing on a monthly basis as new rules and regulations come in from both the government and private insurers. I don't expect that to change. I hope that what will change, however, is that everyone will have access to health care without being threatened with personal bankruptcy. Sen. Jim DeMint's recommendation of $2,000 - $5,000 subsidies per family falls far below the average $1400 monthly bill for family insurance coverage. It is little wonder that small businesses and many families simply can't afford it. As it stands now there are government funded programs in place for seniors, children, the military, veterans, federal and state employees and their families and the very poor. Yet still those unemployed, those working Americans whose employer doesn't offer health care or has stopped funding the company plan, and those who have pre-existing conditions frequently have no coverage. When they get sick they go to the emergency room and who pays for the bill? You and I do through our taxes and increased insurance premiums. We are already paying the bill for the uninsured in the least cost-effective option available. To ignore it just doesn't make good economic sense. The time has come for health care payment reform.

WILLIAM D. REMMES
Health Care Administrator
Mayesville