Murray, KY – News of health reform seems unavoidable. But for western Kentuckians battling illness, working at local hospitals, or trying to sell insurance to floundering families, the issue has been inescapable for some time. As Carrie Pond reports, one solution that's not really being discussed by legislators has growing support among Kentuckians.
The Murray Calloway County Hospital normally nets a profit each month, but May was a different story. MCCH's chief finance officer, Brad Bloemer, says the hospital saw a 55 thousand dollar net operating loss that month. The reason the hospital's budget found itself in the red is in part due to the rising number of uninsured patients 4 or 5 years ago only about 3 percent had no health insurance but now that number's tripled to 9 percent. Bloemer says uninsured patients with a low enough income are given free care.
And so anyone who is above those guidelines we work with them to come up with a payment plan. But generally, you don't collect as much from uninsured patients as you do from patients with insurance, Medicare or even Medicaid for that matter.
Bloemer says he's noticed an increase in underinsured patients as well people are coming in with larger deductibles and co-pays. Jennifer Smith of Paducah is one of the underinsured. She was diagnosed with breast cancer 5 years ago and says she's been forced to fight not only the disease but also her insurance company her deductible is five thousand dollars an individual, and her provider hasn't paid for a mammogram or other important screenings in 4 years. Smith says after just the first year and a half after her diagnosis, she and her husband had more than 15 thousand dollars in debt.
It's one of those things where you're so close (sighs) to having that domino effect and having everything snowballing into bankruptcy, because it's like what bill do you not pay this month so you can have healthcare? But, and I just feel for me, the hardest thing is just looking at my husband's face. No one signs up for cancer.
Smith recently quit her job to care for her father, recently diagnosed with advanced stage colon cancer, so the couple relies on her husband's salary alone to cover healthcare costs. She's stopped taking all her prescriptions except for one, and hasn't been following up with her regular doctors as often as she should even though those visits are crucial to catch the damage her cancer treatments could cause.
If you go the co-pay's just the beginning, because if he writes you a prescription or has you go for a test.
Smith is not alone in forgoing medical treatment in a recent study by Families USA, more than one in three adults with insurance reported going without necessary tests, treatments, and follow-up care due to cost.
It is truly scary the number of thousand dollar a month range premiums that I show families in our community that you know these people are living in 5 or 6 hundred dollar a month housing.
That's Greg McNutt, an insurance salesman at McNutt insurance agency in Murray. He says he turns away people every week for coverage due to pre-existing conditions. But in his experience, most people in the region are like Jennifer insured but being forced to take on higher premiums and co-pays.
The couple who has to take on a 5,000 dollar deductible in order to maintain coverage has done themselves a favor in having the catastrophic protection, but in the event that they need to deal with a hospital for outpatient or inpatient care and the cost thereof, they may still have severe financial pain in trying to come up with the 5 thousand dollars.
Financial pain is exactly right recent studies show more than half of personal bankruptcies result from medical costs and illness. Several groups that have sprung up at both the national and state levels say they have a solution for both hospitals and patients single-payer health care. Coordinator of Kentuckians for Single Payer Health Care Kay Tillow says this option removes private insurance agencies from the equation. Instead the government pays hospitals a global annual budget to cover costs through a single, tax-funded insurer, similarly to how local fire and police departments are paid right now.
We've said they're too important to be left to the whims of private business and health care is one of those.
This idea has its critics, including First District U-S Congressman Ed Whitfield. Whitfield serves on the House Committee of Energy and Commerce, which is currently discussing a healthcare reform bill. Whitfield acknowledges reform is necessary soon, but perhaps not during an economic recession and especially not one with an estimated trillion dollar price tag.
At this particular time when we're trying to strengthen the economy, create more jobs, I really think it's maybe a mistake to add the additional tremendous debt.
President Obama said during a news conference Wednesday two-thirds of the estimated cost will be covered by reallocating money that is being wasted in federal healthcare programs. Garrett Adams is the State Coordinator for Physicians for a National Health Plan. He agrees that the plan currently being discussed in House committees doesn't have guaranteed ways to control costs. That's why he thinks legislators should consider a national health plan. He says administrative costs consume 31 percent of health spending, much different from countries with single-payer systems.
Where we're losing 30 cents on a dollar, the Canadian administrative cost is somewhere around, I've even read as low as one percent.
Plus it takes the burden of health care spending off the consumer which is especially important right now. Jennifer Smith is a big supporter of single-payer. She lived in Canada for 12 years before moving to Paducah and says her healthcare was the best she's received in her life and at a cost of only $54 dollars a month for her family of 5.
A bill that outlines a national health plan, HR 676 is in committee in Congress, but hasn't received its moment in the spotlight. There's hope, however. NY Congressman Anthony Weiner recently proposed an amendment to the bill under consideration by Congress that would conform it to the standards of HR 676. Kay Tillow hopes legislators will consider it, rather than attempt to institute patchwork reforms that she says won't fix the problem.
We in this country are 37th in the world in terms of our healthcare system and it just is wrong. We deserve better than that. We'll find a way for people to make what's morally right also politically possible.
Congressman Whitfield doesn't seem ready to discuss a single-payer option yet. He does say trying to rush a plan through will only hurt chances of quality reform efforts, a sentiment Greg McNutt shares.
I'm an advocate for change. I don't think what we're doing works. But setting setting a time date and saying "we're going to pass something." I don't support that.
Jennifer Smith understands discussion is important. But she believes the longer legislators wait, the harder it becomes for people like her to keep their heads above water.