U.S. Sen. Christopher Bond and 8th district U.S. Rep. Bill Emerson heard from individuals with a variety of concerns about health care reform Thursday in an hourlong public hearing.
One point just about everyone seemed to agree on was that some type of health care reform is definitely needed.
But many people expressed concern about President Bill Clinton's plan, particularly provisions that would require businesses to provide health insurance for employees and concerns that a new government-run bureaucracy would be set up to administer the program.
Hospital officials said they needed some guidance on how to work with other hospitals and medical groups without violating federal anti-trust laws.
Another issue raised several times dealt with the practice of health insurance companies picking and choosing who they want to insure.
Bond acknowledged that "avoiding risk is a very real problem," and both he and Emerson said some of the individual horror stories about the health system came from people who were passed over for coverage by companies.
The senator distributed a brochure which outlined a plan he is offering along with Sen. John Chafee, of Rhode Island, called the Health Equity and Access Reform Today act.
The people offering testimony provided most of it in writing and offered only general, summary comments.
Ruth Meyer-Hollenback, regional vice president for Blue Cross/Blue Shield in Southeast Missouri, said "We support reform that ensures that all Americans have access to the best health care available."
But to eliminate the "cherry picking" by companies, Hollenback said they should be required to provide standardized benefit packages to everyone, be prevented from canceling policyholders for claims, and have plans that can be transferred when someone changes jobs.
She said her company also supports a community rating system. "We need to bring everyone back into the business of managing risk," she remarked.
Dr. Mel Kasten, president of the Missouri Medical Association, voiced his opposition to the proposed health reform plan.
"This bill is completely socialized medicine," declared Kasten. He warned that the Canadian system, which is often used as an example, is badly flawed. Kasten noted that 40 percent of the open heart surgeries done in the United States are on citizens from Canada because they can't get it done there.
Kasten contended that Canada's system is not very good and is sending the country into bankruptcy.
Larry Stahlman, from the public affairs office at Procter and Gamble, said his company, both locally and nationally, supports reform.
"We believe health care reform can be achieved only by having a strong reliance on the private sector," said Stahlman. He noted that in countries where the health care system has been government-run, costs have gone up and quality has gone down.
Dennis Reagan, the local administrator for the Division of Family Services office, said one of the biggest problems his 5,000 clients on Medicaid have to deal with is finding physicians who accept Medicaid patients.
Reagan added that paperwork for Medicaid needs to be simplified. He also said that inequities in the program over who can receive benefits should be addressed, and he expressed some concern about the quality of health care people receive from managed care.
One hospital representative pointed out that it is reimbursed just 65 cents for every dollar it bills for Medicare patients.
August Smirl, representing independent retail pharmacists, said he wanted to see a level playing field in the pricing of medication. He said some products can be bought cheaper by larger pharmacies at a 92 percent lower cost than he pays.
Smirl also complained that some insurance companies restrict what pharmacies people they cover can use.
Howard Courtney, from the Cape County Health Department, reminded the legislators that preventive care should be provided for in any health care plan.
"By keeping preventive care in whatever bill comes out, you will be helping keep people healthy and save future dollars that would have to be paid on treatment," said Courtney.
Emerson told the group of about 75 people that regardless of what is done, health care reform will have a cost.
"If indeed health care is a priority, we have to do without some other things to fund it," said Emerson.
Bond said to provide health care coverage for everyone, it is not necessary to mandate that employees provide the coverage Clinton's plan calls for.
He complained that the Clinton plan "has price controls, global budgets, and a huge new bureaucracy to control health care."
After traveling around Southeast Missouri Thursday, and the other stops he made around the state earlier, Bond said it is clear that people are frustrated with the current system and want action.
Bond predicted there would be bi-partisan support for a plan that ensures everyone is covered.
"This is the year we can do health care reform," said Bond. "We should fix the things that are broken; we can do it on a bi-partisan basis."
Thursday's meeting was co-sponsored by the Community Caring Council and the Cape Chamber of Commerce.
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