| Held
on September 25th, 2000 in Louisville, Kentucky at the Hyatt
Regency, Congresswoman Anne Northup chaired a healthcare forum
entitled americans discuss health: Conversations in
Kentucky. Part of a national healthcare dialogue series,
local Louisville health affiliates met to discuss both regional
and national healthcare initiatives. Two discussion panels
and one brainstorming session, each led by a moderator and
multiple speakers, initiated dialogue among various healthcare
experts. Keynote speaker Ms. Deborah Steelman, president
of Steelman Health Strategies, concluded the forum.
Pointing out the bipartisan
format of the conference, Congresswoman Northup stressed the
importance, concern, and need for solutions in the healthcare
field. She anticipated an enjoyable, yet educational day
due to the cross-section of opinions represented in the room.
Throughout the forum, participants used electronic keypads to
register their own opinions regarding particular issues.
These eForums helped tally the opinions present in a statistical
format.
PANEL ONE: Challenge of
the Uninsured
The first panel focused on the varied problems of the uninsured.
Coverage matters and the inevitability of increased problems
without action comprised two key issues of the panel. Cost
also became central to the uninsured discussion. Common
sense, the need to be patient, and affordability appeared
crucial to revamping healthcare as well. Mr. Jonathan
Ortmans, president of the Public Forum Institute, moderated the
panel. Mr. Dean Rosen, from the Health Insurance
Association of America, provided an overview. Mr. Rosen
advocated the need for flexibility and choice obtained through
private, as opposed to government, groups.
Panelists:
Panelist Mark McGuire focused on healthier consumers having to
decrease their health coverage due to rising costs. He
also criticized a lack of authority to check costs. Mr.
McGuire serves as an Actuary for the Kentucky Department of
Insurance and pointed out a seeming lack of control by providers
to set coverage costs. On average, 84% of money spent on
insurance pays for prescriptions or the actual doctors visit.
Insurance companies, then, possess little control over what they
can charge consumers.
Manager of the Health and
Insurance Practice Group for the law firm Greenebaum, Doll &
McDonald, Ms. Vicki Yates Brown discussed healthcare costs.
She noted that while pressure to keep prices low for coverage
exists, Kentucky has done little to remedy the situation.
Ms. Brown described a “death spiral” whereby as rates
increase, young males, for example, drop their coverage.
In turn, with the decrease in those paying for health insurance,
prices increase.
Ms. Heidi Margulis, Senior Vice
President for Government Affairs at Humana, Inc., perceived the
cost of healthcare and accessibility as directly interrelated.
With less government funding costs are increasing, which then
forces people to decrease their coverage. She also
criticized a discrimination against two-parent working families
and a need to solve problems without necessarily creating
legislation.
Mr. John Morse, on the other
hand, perceived progress for the uninsured. As a Senior
Fellow in Health Policy at the University of Louisville School
of Medicine, he pointed out a decrease in the uninsured rate
from 17% down to 14%. Morse contributed this decrease to a
strong economy and an extension of outreach programs. He
did note, however, that Kentucky suffers from a regional amount
of uninsured ranging from a low 9% to as high as 25% in other
areas. Where a high unemployment rate is directly
connected with the uninsured, he commented that no one who is
eligible to work could receive Medicaid benefits.
Congresswoman Anne Northup felt
options for parents are crucial to make health coverage
appealing. To coerce this sector to use private health
insurance companies, Northup felt subsidizing co-payments would
ease the transition. Cost, she maintained, was the
overwhelming constituent complaint as well as a desire for
personal control over one’s own health insurance.
BRAINSTORMING SESSION:
Kentucky Values in Health Care
Talking among one another, participants brainstormed changes for
the healthcare system. Each group provided a different
issue to the rest of the participants, and their ideas were
posted electronically. Varied topics of importance were
listed and ranged from a lack of focus on mental healthcare, a
need for more healthcare education, and even a desire to run
healthcare like a public utility. Results were tallied
and, using the electronic keypads, participants voted on eight
ideas to decide their importance. Affordability ranked #1
at 43%, choice came in second with 33% of the vote, and
individual responsibility ended third tallying 11%.
PANEL TWO: Medicare and
Seniors’ Health
Mr. Jonathan Ortmans moderated the second panel on Medicare and
Seniors’ Health. Ms. Nancy Galvagni of the Kentucky
Hospital Association provided an overview. She felt that
with the Balanced Budget Act, the financial state of healthcare
has actually improved. Ms. Galvagni noted, however, that
seniors spend three times more than anyone else on healthcare.
Although they only account for 13% of the population, they pay
for 1/3 of the costs. This group does not merely include
those who are sick and without coverage, but also includes those
right above the Medicaid cutoff line.
Panelists:
Mr. Edward Ries perceived choice as crucial for every senior to
gain access to at least some kind of healthcare plan. Drug
plans, for example, could help in-patient costs. Mr. Ries
also stressed the need for a solution to insure those in the
middle who do not qualify for Medicare. He serves as
Executive Director for Anthem Senior Advantage for Anthem Blue
Cross/Blue Shield.
Panelist Todd Marsh noted that
prescription drugs are paid for when in a nursing facility and
that Medicare does not pay for long-term care. Mr. Marsh
is an Administrator for Regency Health Care Center.
Ms. Mary Mahoney pointed out that
seniors want to stay in their homes as long as possible and,
therefore, a program to benefit those that need some help but
are not ready for a nursing home. Ms. Mahoney works for
United Seniors Association, Inc. as the Director of Policy.
Dr. William Haley decided it
would save a lot of money in the long run if Medicare would
focus on preventative care rather than fixing problems once in
effect. Dr. Haley is a retired dentist and Medicare
beneficiary.
KEYNOTE SPEAKER
Ms. Deborah Steelman, president of Steelman Health Strategies
Inc., focused on current healthcare issues in her keynote
address. She covered topics that were discussed throughout
the forum, as well as new issues. Noting the differences
between the public and private healthcare financing systems,
Steelman investigated the pros and cons of each. She
outlined money, talent, innovation, and voluntary aspects as
positives for private healthcare financing. Negatives were
inequities, dissimilarities, distrust, and, again, the voluntary
aspect. For public healthcare financing, she saw its
universality, sense of fairness, and mandatory nature as
beneficial. Slow to adapting, budget-driven decisions, and
the mandatory component were negative aspects of this system.
All in all, Steelman challenged that the ultimate goal for
healthcare reform involved maximizing the benefits of both
systems while minimizing their weaknesses.
While a current tax surplus
exists, it remains unclear where to spend the money in preparing
for the retiring baby boom generation. For example, three
healthcare dilemmas, improving payments to Medicare providers,
enacting new Medicare benefits, and reducing the number of the
uninsured are all needs for reform. But finding a
consensus of importance among these healthcare priorities shows
disparity. Also crucial to improving the healthcare system
is the government’s role in expansion versus an enlarging
private initiative.
Looking towards the 2000 presidential election, Steelman noted
differences between the Bush and Gore Medicare prescription
coverage plan. Whereas Gore would pay for 50% of program
costs for all beneficiaries, Bush would only pay 25%. Bush
foresees spending a federal cost of $158 billion over the next
ten years; Gore wants to pay $250 billion. Bush looks to
creating beneficiary choice among comprehensive health plans,
whereas Gore wishes to leave the system as it is. In
conclusion, Steelman urged creating change through knowledge,
responsiveness, and responsibility versus the current “do
something, do anything” mentality. Steps must be taken
slowly and surely, but an educated direction must ensue.
Working with others and making one’s opinion heard proves
crucial for future healthcare success. |
