The Affordable Care Act will be “gutted” and replaced with piecemeal legislation, U.S. Rep. Jason Smith predicted Wednesday.
“I don’t think you will see one huge bill,” he said.
Smith voiced his comments at a meeting in Cape Girardeau with about 30 business leaders, local lawmakers, hospital administrators, doctors, pharmacists and other health-care providers.
The 8th District Republican congressman from Salem, Missouri, met with the group to solicit their views about current challenges in providing health care under the Affordable Care Act and possible solutions.
The roundtable discussion, held at the Cape Girardeau Area Chamber of Commerce’s new offices on Fountain Street, was one of three such discussions Smith held Wednesday around the district.
He is scheduled to hold three more roundtable events today.
The discussion in Cape Girardeau focused largely on the high cost of health care.
SoutheastHEALTH CEO Kenneth Bateman voiced concern about “the growing trend” toward unaffordable health-care coverage.
Higher and higher deductibles for health insurance are making it increasingly hard on consumers, he said.
Bateman said federal regulations on hospitals and health-care providers drive up costs.
Dr. Charles Cozean, retired ophthalmologist, criticized the concept of insurance coverage that limits consumers to the use of a narrow network of providers.
“People object to being told what doctor to choose,” he said.
“I would just totally repeal Obamacare,” he told Smith.
David Soto, whose Cape Girardeau company manages rental properties, said he can’t afford to provide health insurance for his employees.
Soto said many people are in debt for health-care expenses — so much so, his company excludes medical debt when it does credit checks on potential renters.
Without such an exclusion, Soto said many people would be unable to rent.
Dr. Clifford Talbert, a cardiologist, said doctors used to provide charity care before the federal government intervened in health care.
“We took care of the poor. We never refused anybody,” he said.
Talbert said hospitals should state up front what the cost will be for a procedure, both with and without insurance.
He suggested “even the poorest person” should have to pay part of the cost of his or her health care.
Dr. Alan Barnette, a neonatologist at Saint Francis Medical Center, said most of his patients are “quite poor,” and most are on Medicaid.
Most would not go to the doctor if they had to pay for it, he said.
Several participants at the meeting said consumers don’t know what health-care services cost.
Providing information on such costs would spur competition and benefit health-care consumers, they said.
Abe Funk, a pharmacist, said the federal government under the Affordable Care Act cuts payments to hospitals, physicians and pharmacists on the basis of patient outcomes even when the patient does not take medicine as prescribed or follow the instructions of health-care providers.
“Nowhere are we holding a patient accountable for their own health,” Funk told Smith.
It was suggested patients could be encouraged to take better care of themselves if they were rewarded with lower copays.
Dan Drury of Midamerica Hotels Corp. said his company plans to provide telemedicine services at no charge to its 1,800 employees next year because it will be more affordable than conventional office visits.
State Rep. Kathy Swan, R-Cape Girardeau, expressed concern about the lack of mental-health facilities in the region.
“We don’t have enough beds. We don’t have enough services for people,” Swan said.
Regarding health care in general, Swan said insurance companies too often are making health-care decisions for patients by determining what treatment or medication they can receive.
Such decisions, she said, should be left to the patients and their health-care providers.
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