Health-care overhaul shouldn't be rushed, Rep. Jo Ann Emerson says at Cape Girardeau forum

Overhauling health insurance coverage in a way that can win support from both Democrats and Republicans in Congress is an idea that should not be rushed, U.S. Rep. Jo Ann Emerson said Thursday.

Speaking at the end of a two-hour forum on health care at Cross Trails Medical Center in Cape Girardeau, Emerson noted that President Obama has called on Congress to enact sweeping changes that would cut deeply into the estimated 50 million Americans without health insurance. But to gain substantial bipartisan support, Emerson said, the discussions shouldn't operate under a timeline.

"That would make for a much better program," she said.

Emerson brought physicians, other health-care providers and business owners together to hear their views on what should be done. Business owners described their struggles to maintain good benefits while prices escalate each year at a rate faster than inflation; providers focused in part on the need to expand coverage to take the pressure off costs and hospital emergency rooms.

Dru Reeves of Horizon Screen Printing said his company has altered its insurance plan from one that pays 90 percent of covered costs with a $250 deductible to one that covers 70 percent of the costs with a $2,500 deductible.

"I know that the answer is not government," Reeves said.

But Will Richardson of the SEMO Alliance for Disability Independence said the system can only be fixed by government intervention. People with disabilities from birth or accidents must have quality, lifelong care, Richardson said. Insurance companies don't want the disabled on their rolls, he added.

"I couldn't disagree more that government doesn't have a role in this," he said.

A major issue facing rural regions, Emerson said, is a lack of choice among health insurance providers. Federal employees can choose from about two dozen plans, she said, while in Southeast Missouri, an employer is lucky if four companies compete for the business.

For providers, challenges come in various forms. For hospital administrators, controlling the costs of treating people who come to the emergency room with no insurance is a major concern, said Steve Bjelich, president and chief executive officer of Saint Francis Medical Center. Bad debt by those patients is up 12 percent in the most recent year, he said.

"That cost is being paid by all of us," Bjelich said.

At the other end of the scale, at Cross Trails, the story is one of being unable to obtain screenings and diagnostic tests for patients who have no resources. Patients come in with uncontrolled diabetes, high blood pressure or asthma and they can't afford the $20 fee for low-income patients, noted Daniel Domjan of Cross Trails.

The most likely outcome, Emerson said, was a system that required each individual to buy insurance, with subsidies to low-income people. And the insurance companies will have to endure new rules, such as pricing based on a community's health record rather than just a handful of people at a single company.

"I know nobody likes the word mandate, but in order to cover everyone, the question of mandates comes up," Emerson said.

rkeller@semissourian.com

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