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The High Cost of Health Care (Part 5)

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Aired 8/7/09

The high cost of health care is driving more and more people away from the healthcare system. We'll open up the phones and ask our listeners to tell us what they'd like to see changed in the health system.

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Above: "San Diego Week" looks into the issues that have delayed President Obama's push for health care reform.

This is a rush transcript created by a contractor for KPBS to improve accessibility for the deaf and hard-of-hearing. Please refer to the media file as the formal record of this interview. Opinions expressed by guests during interviews reflect the guest’s individual views and do not necessarily represent those of KPBS staff, members or its sponsors.

MAUREEN CAVANAUGH (Host): I'm Maureen Cavanaugh, and you're listening to These Days on KPBS. Now we don’t usually have a These Days program on Friday but we thought after the response we’ve had this week to our series of shows on healthcare reform that we needed one more hour. That’s because the number of calls we’ve gotten on this subject has been overwhelming. Since we were talking with a number of guests, patients, doctors, healthcare policy experts, politicians, and we were trying to find out answers to questions like why is healthcare so expensive and what reform plans are on the table, we just didn’t have enough time to take the volume of calls we were receiving. So today we’re opening the phone lines at 1-888-895-5727.

This is your show. Now if you’ve been listening this week, you’ve heard the arguments for and against various healthcare reform proposals. Some of our guests have said that government can’t run healthcare or that it should be left to the states or that the proposals on the table are too expensive. Other guests have said we should get rid of the insurance companies, expand Medicare to cover everyone or have a mix of public and private plans like many government workers do. And we’ve also heard people talk about how not being able to afford healthcare has affected their lives, like Norah Schwartz, our guest on Monday. She’s a breast cancer survivor but she’s already used up her benefits for the year and now any treatment she gets, she’ll have to pay for herself.

NORAH SCHWARTZ (Breast Cancer Survivor): Well, apparently or I’m not going to get it. I mean, I just can’t afford – I can’t afford to see my doctors, and I’m afraid to see my doctors because I don’t know what the tests are going to say. At this point, I don’t know if I have cancer again. I haven’t seen my oncologist yet. I don’t know about my bone health. I haven’t had a – I need a bone density scan. My thyroid health, I mean, all of these are side effects of the treatment. I don’t know how much that’s going to cost me.

CAVANAUGH: If you have a story, a comment, an opinion on healthcare reform, call us now. How would you like to see access and payment of healthcare changed? Should it stay the same? How do we keep healthcare costs from rising 15 to 20% a year? This is a special edition of These Days on KPBS. Let’s go to the phones. Let’s hear from Ellen in La Jolla. Good morning, Ellen, and welcome to These Days.

ELLEN (Caller, La Jolla): Thank you. Would you like my comments?

CAVANAUGH: I would very much.

ELLEN: So I’m a physician and a family doctor. I live – I work in – here in California. I come from Canada. My parents became elderly and stayed in Canada. I grew up there and worked there. I just absolutely believe in a single payer system, and I feel the nation, our nation here, the United States, we need to mature. We need to not be – A sign of a mature nation is that there’s a right to healthcare. And I fear – And I feel in our fear a loss of freedom. We’ve – We don’t take social responsibility and we – they don’t under – and we don’t understand. We’re so afraid to take social responsibility and people don’t realize that we’ll gain freedom. As a physician, as a person, as a daughter, as a parent, I always felt so much more free in the healthcare system in Canada. So I – makes me really sad. And even with all that’s happening and right now in the arguments, it’s going to be so wasteful whereas a single payer system would be so much cheaper and so much freer and I wish for our country to become more mature and I – I’m happy to answer any question if there’s something you’d like to ask me.

CAVANAUGH: Yes, I would, Ellen, because…

ELLEN: Yeah.

CAVANAUGH: …we hear – You know, critics of healthcare reform have a lot of criticism of the plan up in Canada.

ELLEN: Right.

CAVANAUGH: The national health plan in Canada.

ELLEN: Umm-hmm. Yes.

CAVANAUGH: They say that time, wait – people are waiting a very long time.

ELLEN: Well, time is the biggest issue, right. Right.

CAVANAUGH: Yeah, and that there are not enough MRI machines.

ELLEN: Well, there’s an answer to that if I could share it…

CAVANAUGH: Sure.

ELLEN: …if you’d like. Sure. The issue is, is that in Canada – So right now Canada pays about, I think it’s 9% of their GNP towards healthcare. In America 17% of our GNP is – we pay. But we have 47 million people here. Like there’s no way – Like we have to recognize that we have a 47 million people line in America, and there’s no way to get to the front. So until we have that line addressed and then the 108 million people that need dental care, until we get to the front – to get people that can get to the front of that line, you’re talking apples and oranges. Now the other issue with the lines in Canada is the reason is, is because these liberals, who are like the Democrats, brought in the healthcare system in Canada. But let’s say you’re the Republicans in Canada, which is like the conservatives, you don’t want the system but you know that if you say we want it out, you’ll never get reelected because Canadians love their system. So you undermine it from within. And what I would do is that if we ran – if we had a Canadian self-healthcare system, I would say that no less than 13% of the GNP could go to healthcare so that a particular four-year government couldn’t undermine it from within and say no more MRI machines in Saskatoon and therefore you end up with this situation that it seems like the structure is falling and it’s simply because you need to just have another machine.

CAVANAUGH: It’s underfunded. Well, thank you, Ellen. Thank you so much for your call. We are taking your call. It’s open phones on this special edition of These Days. The number is 1-888-895-5727. Let’s hear from David calling from San Diego. Good morning, David. Welcome to These Days.

DAVID (Caller, San Diego): Hello. How are you today?

CAVANAUGH: I’m quite well. How are you?

DAVID: Good. I’m not a doctor but my wife is a doctor here in San Diego, okay. And the first comment I’d like to make about government running things, the military is run by the government, okay? And that’s something that no one seems to mention. And also, our economy is kind of run by the government so like I think our government actually does a good job running things. Number two is the military has an insurance called TRICARE. It’s a government run healthcare system. Every retired military and active duty military is under TRICARE, and this is the first time you’re ever going to hear about TRICARE in the nation, right this morning. I’ve never heard anyone talk about TRICARE, the government run healthcare of the U.S. military. And for example, my wife, we take – about a third of our patients here in San Diego are TRICARE and it’s one of the best insurances we accept and I don’t know why no one’s talking about TRICARE.

CAVANAUGH: Let me ask you, David, this is different from the V.A. system?

DAVID: It’s TRICARE. It’s the TRICARE system. It’s basically a government run healthcare that every single, you know, active military and retired military has. So I’m not sure why you guys never talked about it. I’m just not sure why Barack Obama’s not talking about it. But it’s there, it’s a great system. We get paid, you know, on time. We actually get paid better than most private insurance companies. So, like, I don’t know why that’s not in the discussion. It’s the first time I’ve ever heard it and it’s the first time anyone’s ever hearing it on the radio.

CAVANAUGH: I don’t know why it’s not under discussion either. I haven’t heard about it before but let me ask you something about something I have heard. You talked about the military running – the government running the military, the government also runs the V.A. healthcare system, which, you know, according to some people, is one of the – is a really, really good healthcare system. What do you think about that?

DAVID: You know, I’m not so familiar with the V.A. system. I mean, you know, of course my grandfathers and, you know, people in my family have gone through V.A. but, you know, it’s – I think it can probably have some improvement but I know that the company that runs the military’s insurance is TRICARE, T-r-i-dash-c-a-r-e. Anybody – You can ask any military person, they’ll tell you about TRICARE. And…

CAVANAUGH: Well, we’ll try to find out more about it, David. Thank you for that call. This is open phones on a special edition of These Days. The number is 1-888-895-5727. We’re taking your comments on healthcare reform. Bobbi is calling from La Jolla. Good morning, Bobbi. Welcome to These Days.

BOBBI (Caller, La Jolla): Thank you so much, Maureen. This has been excellent.

CAVANAUGH: Thank you.

BOBBI: I – I used to work for a hospital. I was Director of Public Affairs and Public Relations for a hospital in the Boston area before I moved here 13 years ago. And I thoroughly believe, and I haven’t worked for a hospital since then, but I thoroughly believe that the problem is not excess charges from hospitals, they’re pinched because of Medicare and Medicaid and I understand why some of them are concerned about this healthcare reform because if they keep getting paid too low, they’re going to be in trouble and also, they have to endure the cost of free emergency care. And it’s not the physicians. I mean, the primary physician, average salary is $120,000 and the usual – the average cost of the going to medical school is $140,000. But as a public affairs director in Boston of a hospital, I had volunteers who worked for us, I had seven volunteers who worked for our department and one of them in particular was a wife of a healthcare executive. Now what she did – what she told us about just absolutely amazed me. She and her husband, her husband was an insurance company exec, had tickets to the Olympics in Russia, whatever year that was. The women all got fur coats, and the family all got leather luggage as well as first class tickets and deluxe accommodations. And I thought to myself, you know, people are struggling to pay their healthcare bills and these insurance company execs are so over compensated. I don’t understand what the value added insurance companies provide. There’s – If they were supposed to make things easier for hospitals and doctors to provide care, that’s not the case. Every doctor you can talk to today and every hospital you can talk to today will tell you that the red tape for – that provided by insurance companies—and every patient—is horrendous. So as far as I’m concerned, they are the main culprits.

CAVANAUGH: What would you like to see done with healthcare reform, Bobbi?

BOBBI: Well, I would love a system that allows some people who are happy with their healthcare, they probably have really great healthcare, keep what they want, but I also do very much agree that we need a healthcare system that is run by the government efficiently and effectively, and I think that’s quite possible. Aside from the low reimbursements for Medicare and Medicaid, they work. And as the caller before said, a lot of things work. And as the caller from Canada said, there are other countries that have these options that are doing much better than America is. I’d like to see that kind of option here for Americans.

CAVANAUGH: Thank you so much for your call. A special edition of These Days right now, and we’re taking your calls about healthcare reform. The number is 1-888-895-5727. Next on the line is Aaron. He’s calling from Carlsbad. And good morning, Aaron. Welcome to These Days. Hi, Aaron, are you there? I think maybe we should go to Jack in San Diego. Good morning, Jack. Welcome to These Days.

JACK (Caller, San Diego): Oh, good morning. I also am a Canadian. Actually, I’m a dual citizen. I’ve lived in both countries. I’ve experienced both medical systems. But I think – Well, there’s two issues that catch my attention. One is they keep talking about this thing called choice. If you go through the Canadian medical system, you simply go into any clinic or any doctor, give them your name and you give them a number, and you’re treated. If you have to go to a higher level, to, say, to a specialist, you get transferred on. Again, you just simply give your number and your name. All the billing goes directly to the government. You never see any billing. You never see any, you call them co-pays or insurance, whatever it is, you never see any of that. You just never – There’s never money transferred in any portion of your medical system. Everybody gets the same system. As far as lineups go, well, I mean, you can exaggerate anything you want but the simple fact is that if you need something immediately, you get it immediately. If it’s something that’s going to take a little bit longer, well, you might have to wait a few days.

CAVANAUGH: Well…

JACK: Umm…

CAVANAUGH: Yeah? Go ahead, Jack. I’m sorry.

JACK: I – I just don’t -- I just don’t understand what the confusion is, as the other physician had mentioned. The gross amount of money that they spend in the government – country of Canada per person is less than what it is here and it’s – You can almost – there (audio dropout) that amount of money to the fees and the benefits and the profits that the individual corporations get from it. It’s – Sorry.

CAVANAUGH: No, that’s okay, Jack. Thank you so much. I think you put it very well. That was Jack calling from, I think, San Diego. And we have to take a short break. When we return, we’ll continue to take your calls. First, though, before we take a break, I want to hear – I want to play a clip from one of our guests, Dr. Jeoffry Gordon, from the shows that we’ve had this week. He is a member of Physicians for a National Health Program, and he talked to us about our present – his ideas about our present health insurance plans.

DR. JEOFFRY GORDON (Physician): When the congress people stand up and say everybody loves their health insurance, there are two kinds of people who love their health insurance, an insurance plan that, by accident, gave them a good doctor who they love. They love their doctor. They don’t choose their health plan; their employer does. They happen to have good medical care from a good physician. Secondly, the people that like their insurance have never used it. Everybody who uses their insurance is now running for their wallets and finding their wallet isn’t big enough.

CAVANAUGH: Give us a call with your comments when we return. The number is 1-888-895-5727. You’re listening to These Days on KPBS.

[break]

CAVANAUGH: Welcome back. I'm Maureen Cavanaugh. You're listening to a special edition of These Days. We’ve opened up the phones so more people can get a chance to let their voices be heard on the issue of healthcare reform. Our number is 1-888-895-5727. All this week, we’ve been talking about guests (sic) about various aspects of healthcare reform. One aspect that’s developed just about over the past week is that we’ve been seeing angry crowds at healthcare town hall meetings that are being held by congressmen in their home districts. The protestors are expressing outrage against healthcare reform and many are questioning whether the outrage is actually being fueled by rightwing organizations and special interests. And I’d like to know, do you think these protests are genuine? And, really, the deeper question is, what are people afraid of about healthcare reform? Are you concerned about the changes you’ve heard proposed? Give us a call, 1-888-895-5727. Let’s take a call from Bob in San Marcos. And good morning, Bob. Welcome to These Days.

BOB (Caller, San Marcos): Good morning.

CAVANAUGH: Yes, how – What is your comment?

BOB: Well, I’ve been a Republican all my life and I have to say that I’ve worked for big business, I’ve been a small business owner, and I, just in the last year and a half, converted to MediCal, Medicare and Social Security. And I find it works fine so far.

CAVANAUGH: So – And you thought maybe it wouldn’t?

BOB: Well, I was concerned because, you know, there are additional coverages that you can buy and I’m still not 100% satisfied. They’ve got me in the donut hole now and I’m on a medication that’s a maintenance drug and I’ve been paying the co-pay and the pharmacy nine dollars and forty dollars and thirty dollars and now all of a sudden I find out I’m in the donut hole…

CAVANAUGH: Oh, I – That donut hole where you have to pay for your own prescriptions.

BOB: My drug is now a thousand dollars.

CAVANAUGH: Wow. Wow.

BOB: Just turning over. So I think – I’ve been in big business. I’ve seen the way companies try to provide for their people. I’ve been a small business owner and I’ve tried to persuade people to get coverage and be covered. And I’ve been a Medicare, MediCal, Social Security person that, for the last year and a half, has been involved in that part of it. But my suggestion would be – I think the Republicans have abandoned – they’ve abandoned the citizens, to be sure, because they haven’t said anything reasonable in the last six months since our new president’s involved. And I didn’t vote for him but I think we owe him the courtesy of letting him get on with the job.

CAVANAUGH: I want to thank you so much for your call. And I also want to remind our listeners that we have been talking about healthcare reform all through the week. And we did talk to a small business owner who also happens to be a member of the Regional Chamber of Commerce, Vince Mudd, we talked to him on Wednesday. And he told us why healthcare is important to him as a small business owner.

VINCE MUDD (Small Business Owner): I pay 100% of the healthcare for my employees and when my kids are in school, I want to make sure the child they’re sitting next to doesn’t have tuberculosis and that they’re going to the hospital and being taken care of. So I’ve come down on the side of saying that I believe that life, health, safety issues in our country are things that should be provided for for our citizens. We should be able to take care of that. How we do it is what’s up for debate. And on the single payer question, just so we’re clear, as a business guy, I don’t – single payer means different things to different people. I’m not prepared to say we’re going to put all the insurance companies out of business. I think that if you don’t provide a benefit to people, you shouldn’t exist, so some insurers don’t provide any benefit so they don’t exist. What I don’t want to do right now – What I’m doing today as an employer is I’m paying healthcare to my work – through my health insurance premium and my auto insurance and my homeowners insurance, my general liability insurance. I’m paying healthcare in about 25 different places, and I’d like to only have to pay it in one place. And so that one place could be my primary premium that I’m paying currently to my insurer but the answer to your question is where I’ve come down as an individual is that healthcare is something that I want to make sure everyone in this country is healthy enough to sit next to my child in school.

CAVANAUGH: That was Vince Mudd, one of our guests. He’s from the San Diego Regional Chamber of Commerce. He was – joined us on Wednesday to talk about healthcare. We’re taking your calls and asking for your opinion about healthcare. 1-888-895-5727 is the number to call. Let’s take a call from Larry in Del Mar. Good morning, Larry, and welcome to These Days.

LARRY (Caller, Del Mar): Good morning. Thank you.

CAVANAUGH: You’re welcome.

LARRY: I had a – my thought comes that if the government pays for the physician’s professional liability insurance and takes care of that, then they won’t be practicing defensive medicine and ordering all these extra tests for people who want one for their mother who’s got a bump on her hand every, you know, every two or three weeks. That would be one step in taking down the cost of healthcare for tests that don’t need to be run.

CAVANAUGH: And have you experienced rising healthcare costs?

LARRY: Absolutely. Everybody has. You have to live under a rock not to have seen that.

CAVANAUGH: I remember one of our guests this week was talking to us about the fact that if we did, indeed, require people to be covered by healthcare, that he thought that would immediately drive down the cost of healthcare and curb healthcare premiums. Have you heard about that? What do you think about that?

LARRY: Well, when you put everyone in the pool, it smooths it all out and you don’t – I don’t know how that would work. I just know that the cherry picking that goes on with the insurance companies is leaving a whole lot of people uninsured. And you judge a coun – you judge a people by the way they treat their old and their infirm, and we’re not doing a very good job at this point.

CAVANAUGH: I want to…

LARRY: And…

CAVANAUGH: Oh, I’m sorry. Go ahead, Larry.

LARRY: And I think those people who are banging the drum that this is the wrong thing to do need to look into their hearts and decide what they would do if it was a member of their own family who was uninsured.

CAVANAUGH: Thank you, Larry, for your comments. You’re listening to a special edition of These Days. Our number for – our call-in line number is 1-888-895-5727. Holly is calling from Poway. Good morning, Holly. Welcome to These Days.

HOLLY (Caller, Poway): Good morning. I wanted to – and thank you for taking my call. I wanted to say that recently there’s been a lot of polls showing like declining support. I think even NPR had one for health reform. And I find that a little hard to believe. Like it doesn’t say, the polls that I’ve heard, don’t – don’t ask specific questions. Because everybody I meet is either unhappy with the cost of healthcare, they’re having trouble getting coverage, they’re having trouble seeing a doctor. So I really can’t believe that people don’t want these improvements in cost and access to care and so I think maybe the polls aren’t asking the specific enough questions. And, really, I think that the – everybody does want at least a public option that’s not a single payer plan. And I think when the midterm elections come out that the Representatives that don’t support what the people want will be voted out.

CAVANAUGH: Thank you for your comments, Holly. I really appreciate it. The number is 1-888-895-5727. The report that Holly mentioned, I believe she was talking about a report by Liz Halloran earlier this week and it was titled “The Public is Baffled by the Healthcare Arguments.” And the polling listed in it was when pollsters ask straight-up questions about whether people support favor – or whether people favor or oppose revamping healthcare, there is little more opposition than support. In other words, there’s a little more opposition than there is support for the plan. But when the surveyors asked more specific questions about what the plan might include, then there is remarkably consistent support in the 55% range. So I guess it does matter what questions are asked to find out how many people actually do support healthcare reform. We’re taking your calls at 1-888-895-5727. And Lamise (sp) is calling from San Diego. Good morning, Lamise. Welcome to These Days.

LAMISE: Yes, good morning.

CAVANAUGH: Hi.

LAMISE: Thank you for taking my call. I would think, first of all, fear and dependency comes to my mind regarding health and things that would help decrease that, and we do want freedom, is probably preventive care, education and empowerment. So, you know, like these kind of things. And President Obama did mention that aspect and I think like in schools, programs, things that would help in the long run to bring the health costs down and teach people on how to take care of themselves, how to eat properly, how to exercise, right from grade schools through and that would, in the long run, help us. And then in the immediate, it’s education, even for those who are dependent on the system, to show them and support them, spend more time to show them on how they can be – take care of themselves and, you know, prevent some things and stuff like that.

CAVANAUGH: You know, Lamise, we just heard those sirens in the background. It’s interesting we’re talking about healthcare and there could be ambulances driving around your neighborhood. I’m wondering, you’ve heard the debate over healthcare reform, where do you come down on this? What proposal do you support?

LAMISE: If I’m – I don’t know about the detail of the proposals but I think the preventive aspect of the proposal so – And then they can – I think that the – whatever they will propose will have to be changed in time depending on how we do it. It’s not – It shouldn’t be like a rigid thing that they decide on and that’s it. And that’s what we do. We decide on something and a system and then it stays fixed. It should be a process that is continually changing as we’re improving. That’s my opinion.

CAVANAUGH: Thank you for your call, Lamise. You know, Lamise’s opinion was quite similar to an opinion of one of the guests we had on our show this week. Dr. Mimi Guarneri is a cardiologist and Medical Director of Scripps Center for Integrative Medicine, and she talked a lot, when she appeared on Tuesday’s show, about the kind of healthcare system we already have and what we need to change it in terms of preventative care.

DR. MIMI GUARNERI (Medical Director, Scripps Center for Integrative Medicine): I would just like to take a step back and be as bold to say that we don’t have health care in this country. We have disease care. We have a ‘we will fix you when you break down’ mentality. And for many years, that’s what we have been doing. The end result of that is no focus at all on prevention, and when we think about chronic disease—and I agree with you, Mike, this is the key—most of the healthcare expenditure is going into chronic diseases like heart disease, diabetes, all the results of obesity and so on. What do we do to prevent these diseases?

CAVANAUGH: And that was Dr. Mimi Guarneri. She was a guest on Tuesday’s show. She’s Medical Director of Scripps Center for Integrative Medicine. We are taking your phone calls on healthcare reform at 1-888-895-5727. Let’s hear from Alan in North Park. Good morning, Alan. Welcome to These Days.

ALAN (Caller, North Park): Good morning. Hey, you may remember that back in the spring of 1994, thousands of volunteers in the State of California helped to gather more than a million signatures to put an excellent single payer healthcare plan on the ballot here. But in the fall when the election came around, the insurance companies used their money to frighten the public with really misleading advertising and, unfortunately, the vote was lost. Now this time around, we, the people, don’t even get to vote. It’s in the hands of congress. And I kind of think that the insurance companies can pretty easily badger and bully enough members in congress to really water down any kind of genuine healthcare reform. So what we need to do as the general public is to really educate ourselves, our neighbors, our coworkers, our friends, and learn what single payer is really all about. It eliminates the bloated profits that the insurance companies make. It takes that savings and uses that money to make sure that everybody gets the healthcare that they want, that they need, and it just sets up a system where a single agency does that process for far less overhead and paperwork, and it would be a wonderful thing for our country to have such a system that we could all have universal healthcare for all of us.

CAVANAUGH: Now, Alan, as I suppose you know that single payer plan is not even on the table as congress tries to make up some sort of healthcare proposal but a lot of other changes are on the table like pooling health insurance plans and coming up with a public option and eliminating the need for preexisting conditions. And I’m wondering, is that, anything you’re hearing coming out of congress, is that something you might be able to support?

ALAN: There are some things that are coming out of congress that will be greatly beneficial and will be helpful but I think we have an opportunity now, as a citizenry, to ensure that we put the pressure on congress to come up with a reasonable, good single payer healthcare plan, a universal plan that provides something for everyone in an equitable way so that we can have a good healthcare system in this country, which we all deserve.

CAVANAUGH: Thank you for your call. I appreciate it, Alan. We’re taking your calls at 1-888-895-5727. This is a special edition of These Days to let your voice be heard on the healthcare reform issue. Peter is calling us from Point Loma, and good morning, Peter. Welcome to These Days.

PETER (Caller, Point Loma): Yeah, thank you so much for taking my call.

CAVANAUGH: You’re welcome.

PETER: Actually, I have my wife on the line and (audio dropout) question.

CAVANAUGH: Uh-huh.

PETER: Dana.

DANA (Caller, Point Loma): Yes, hello.

CAVANAUGH: Hi.

DANA: Hi. I just – my husband just called and patched me into your radio show. I am an emergency physician assistant. I work throughout various ERs in the state of California.

CAVANAUGH: Umm-hmm.

DANA: And I just want to state that I would say close to 60% of my patients that I see in the emergency rooms are illegal immigrants whose bills are paid by Medi-Cal, which means that you and I, as taxpayers of this state, are subsidizing the healthcare for illegal immigrants. These are people that are not – do not have medical emergencies but come to the emergency room for non-emergent medical care, particularly for their children. One of the reason there’s a disparity in the cost of healthcare, at least in the state of California, is because we, as taxpayers, have to pay higher premiums to subsidize this care. Why this situation is not addressed is an absolute mystery to me. And I can tell you there are days when I work in the ER that I never speak a word of English.

CAVANAUGH: Well, I wonder, as the healthcare debate goes on, there are about 50 million U.S. citizens who don’t have healthcare insurance and could wind up in emergency rooms as well. What do you think about that, Deana (sic), the proposals that are being talked about, changing the healthcare system? And perhaps we can address the illegal immigrant issue later. The actual healthcare proposals for U.S. citizens, what do you think of those?

DANA: Right, well at this point, because of the illegal immigration population, I don’t know if you can really parse out the two situations. I think they’re intertwined at this point because whatever single payer plan you propose, you’re going to have to address the fact that illegal immigrants are also going to benefit from a single payer. Having said that, I do agree that there needs to be some kind of overhaul of the United States healthcare delivery system, although nobody who comes to an emergency room is denied healthcare, nobody.

CAVANAUGH: Okay, well…

DANA: But as far as making it equitable, I do think there needs to be some changes but you have to factor in the tremendous burden of the illegal immigrant population who is skewering the costs, the cost ratio of a legal versus an illegal U.S. citizen. I think that has to be addressed.

CAVANAUGH: And you have. And I appreciate the phone call. Thank you so much, Deana. We will continue our special edition of These Days, taking your calls on healthcare reform proposals, 1-888-895-5727. We have to take a short break. We will return in just a few moments.

[break]

CAVANAUGH: Welcome back. I’m Maureen Cavanaugh. You’re listening to a special edition of These Days. We’re taking your calls about our series of programs on healthcare reform and we’re opening up the lines, hearing your voices about healthcare reform. What do you think will happen if congress does nothing? Will private insurance companies in the free market fix the rising costs of healthcare? How many uninsured Americans can fall through the cracks before the rest of us all – we all start feeling the pain? A guest on Tuesday’s show was Victor Fuchs. He was professor emeritus on economics and health policy and research at Stanford University. He told us what he thinks will happen if we don’t do anything.

VICTOR FUCHS (Professor Emeritus, Stanford University): Costs will continue to increase at about 3% per annum, faster than the rest of the economy. The first big explosion will be when the Medicare trust fund runs out of money but sooner or later there will be a real medical care crisis. Alice Rivlin, a very distinguished economist, put it very well. She said long run fiscal policy in America is health policy. If we don’t get our health policy right, we won’t have our economy in the correct position.

CAVANAUGH: We’re taking your calls at 1-888-895-5727. And let’s hear from Susie in El Centro. Good morning, Susie. Welcome to These Days.

SUSIE: Hello. I’m here. I wanted to talk about a situation that happened three and a half years ago, well actually longer than that. My husband had to have a liver transplant which, curiously, was necessary because of a transfusion in 1968 where he got hepatitis C. There’s two things, one, we had to travel frequently from the Imperial Valley to San Diego and that was costly. We do have good insurance. However, the associated costs meant that we had to borrow from a pension fund and because we had that option, then we were able to do that. And the other thing is, the inequity of the system was really evident because in qualifying for a transplant, one of the items that is assessed is your ability to pay for your prescriptions after the operation.

CAVANAUGH: I didn’t know that.

SUSIE: And if you don’t have good insurance, then you’re not going to qualify at the same level as someone who does.

CAVANAUGH: May I ask you, Susie, how expensive was it for you? How much did you have to draw out of your pension?

SUSIE: $10,000.00.

CAVANAUGH: And that was over and above the health insurance that you had.

SUSIE: Right, because we had to stay in San Diego for two months. We had to commute back and forth from time to time throughout the very first year. I mean, we had to see the doctor at least once a week initially and then once every two weeks and so on and so forth. And, of course, we had to have meals over there and all of those sorts of things because we live, you know, in the Imperial Valley, and that’s a two-hour drive.

CAVANAUGH: I’m wondering, Susie, what would you like to see changed in our system of healthcare?

SUSIE: I want to see a public option. I want to see us all level and I think that’s going to reduce the cost for everyone and it’s also going to provide the kind of care that we really ought to have in this nation. We ought to have healthcare for every single person.

CAVANAUGH: Susie, thanks for the call. I appreciate it. The number is 1-888-895-5727. Larry is calling from San Diego, and good morning, Larry. Welcome to These days.

LARRY (Caller, San Diego): Good morning. Thank you. I also would like to address the cost of insurance and I think with another government option, or a public option, it certainly would drive the cost down. My situation, briefly, is I’m self-employed. My wife lost her job two years ago and we had health insurance through her company, which put us onto the California COBRA plan. The California COBRA plan, two years ago, was $1200.00 a month. Last year it went to $1500.00 a month, and now I’m paying $1800.00 a month, $23,000 a year for health insurance. I’m in that donut hole, I guess if you call it, because I’m 62, I’m not eligible for Medicare, I’m a Vietnam era veteran but I make too much money so I can’t use the V.A. system. So I think with the government option, it would drive the cost of health insurance down for everyone and I think – I think anyone who opposes that is, you know, is – they’re not thinking of the healthcare system. They’re just thinking of themselves. They’re selfish personalities, I guess. And I wish I could’ve got through to Mr. Bilbray yesterday because I would like to know how much money he’s taking from the pharmaceutical lobbies. So that’s kind of my comment.

CAVANAUGH: Well, Larry, I appreciate that comment. And we heard from a retired San Diegan who had also dealt with healthcare issues during our show on Monday, Alan Bennett, and he talked to us about what a government run healthcare plan would look like that he would like to see.

ALAN BENNETT (Surgical Patient): I want that system. I want a V.A. system. It’s the highest rated on 294 point criteria. They are the highest rated medical delivery system in the United States. And I think one of the reasons why they are so well respected and families love them is because they have a well system. They’re – they have their patients for life, not cut off at 52, so they take care of people before they get sick and that really holds down medical care. I’d love to see single payer universal healthcare like our congress and Senators have.

CAVANAUGH: We’re taking your calls at 1-888-895-5727 on this special edition, this Friday edition of These Days. Let’s hear from John in La Jolla. Good morning, John, and welcome to These Days. John, are you on the line? Okay, let’s try to hear from Katherine in San Diego. Good morning, Katherine. Welcome to These Days.

KATHERINE (Caller, San Diego): Good morning.

CAVANAUGH: Yes. How can we help you?

KATHERINE: I was interested in saying that Obama’s first words on healthcare were that a single payer was the only way we were going to pull national costs down. I thoroughly agree with that, and I’m distressed that it’s not even on the table. I do feel that in terms of what must be in the bill that he actually ends up signing, and he’s got to sign a bill, there’s just no two ways about it, we have got to control costs in this country. It’s crazy.

CAVANAUGH: Katherine, I’m sorry. I don’t mean to interrupt and I want you to finish what you wanted to say but it sounds to me as if you’ve been following this whole healthcare reform issue very closely.

KATHERINE: Yes.

CAVANAUGH: I’m wondering, what do you think about the disruptions that are going on at the town hall meetings that you’ve been seeing on television?

KATHERINE: Oh, I think it’s just a whole lot of people who are being paid to be there or something. I don’t know how they’re getting all those people there but they’re just a complete betrayal of, you know, public access to the Senators and congress people that are trying to hear from their constituents. And I’m sure the healthcare money is behind it. We’ve got to get that – I mean, the insurance money. We’ve got to get insurance money out of public healthcare, that’s the other thing. We must cover everyone. There is no excuse for this country not having every single person covered, and we must get the healthcare – I mean, the insurance companies out of the public money because their job is to make money for their company; their job is not to cover human beings and take care of them. And that’s so clear with what’s going on. I was in the hospital for three days. My bill, when I checked it, was $43,000…

CAVANAUGH: Wow.

KATHERINE: …and my health insurance people—this is when I realized how broken we were—my health insurance company settled for $4800.00, that bill. So that means that people who are covered are…

CAVANAUGH: Pay less.

KATHERINE: Yeah.

CAVANAUGH: Yeah.

KATHERINE: And the people who are not covered are left with the $43,000 bill and losing their homes and going bankrupt and it’s just so inequitable. It’s just not fair. And I know that’s my healthcare and I have good healthcare…

CAVANAUGH: Well, thank you.

KATHERINE: …but it’s not fair.

CAVANAUGH: Katherine, thank you so much for your call. I really, really do appreciate it. Let’s take another call. Hugh is calling from El Cajon. Good morning, Hugh. Welcome to These Days.

HUGH (Caller, El Cajon): Good morning. You just had a call a couple of minutes ago from a doctor who states that she works in emergency rooms throughout the county.

CAVANAUGH: Right, a nurse.

HUGH: And part of her statement – Oh, a nurse?

CAVANAUGH: Yes.

HUGH: Well, anyway, part of the statement was that everyone has access to healthcare because everyone can go to an emergency room. That’s nearly malpractice, that statement. I’m a nurse. When you go to the emergency room, you don’t get healthcare. You are treated for an emergent situation. Healthcare is being able to see a primary physician, is being able to continue treatment, after the visit, with medication. People who go to the emergency room don’t have insurance in – to follow up with medication past being in the hospital or past being in the emergency room, so that’s not the same thing as healthcare. And in matter of fact, having access to an emergency room and not having access to healthcare is exactly part of the reason that causes people to not get healthcare because they continue to go back to the emergency room. So you have an emergent problem, they go in, they get their heart treated that day. Two weeks later, they can’t get more medication, another week later, they’re back in the emergency room. It’s a cycle that continues to cause people to visit hospitals and get the most expensive care available as opposed to getting healthcare. And this is part of – of course, part of the problem and why we need to have a single payer system where everyone has access to healthcare, not access to an emergency room.

CAVANAUGH: Thank you for your point, Hugh. Thank you very much for that call. And let’s hear from Jerry in La Jolla. Good morning, Jerry, and welcome to These Days.

JERRY (Caller, La Jolla): Thank you so much for taking my call. I’m going to pull over now because I’m on my way driving to my doctor.

CAVANAUGH: Okay, that’s a good idea, Jerry. What did you – what kind of comment did you want to add to our discussion on healthcare reform?

JERRY: Here I am. I’m the co-founder of the San Diego Coalition for Single Payer. And I really appreciate the program that you’ve been running all this week, and it’s been excellent. In view of the fact that so many of your callers, your people that called in, are looking for some sort of public option or single payer, I have news that doesn’t seem to have been on the program at all and that is that we have now a small window of opportunity to get single payer. Now I’m not talking about Obama’s plan, I’m not talking about HR-3200 (audio dropout) …bill that has been a convoluted compromise that the Democrats have come up with. I’m talking about HR-676, the true (audio dropout) bill which gives Medicare for everyone. Now that’s going to be on (audio dropout) …congress. It’s going to be voted for within three or four weeks. And it’s very important that people call their congress people, their congress representatives, and to call Henry Waxman and call John Conyers’ office. We need to have this bill scored by the CBO, the Congressional Budget Office. It would…

CAVANAUGH: You know, Jerry, I have to stop you because your connection is not really terribly great. But let me just make sure you’re talking about HR-676?

JERRY: Yes, we are.

CAVANAUGH: Okay, I’m going to have to end it there with you, Jerry. Thank you so much for calling in. And you got that message out. I think we’re going to be taking Luis in Yuma calling us now. Good morning, Luis.

LUIS (Caller, Yuma): Good morning. Thank you for having – I just want to say – I actually drive 30 minutes out of town because I don’t get your station…

CAVANAUGH: Oh.

LUIS: …and I actually drive to a rest area out of town to listen to the station.

CAVANAUGH: Well, thank you for that.

LUIS: Yes, I heard a gentleman call earlier about how he would like to have the whole V.A. system for everybody and as a three-time Iraqi war vet, I am currently going through the V.A. system to get my health. I have several health issues resulting from the war. And I’ve been out of the service now for a year and a half and they are just now getting my case and they are just now getting me the emergency specialist care that they’re – they’re calling me. So if that’s what the country’s going for, for that kind of waiting time, then I don’t think this new program would work. I don’t think any of the new proposals would work.

CAVANAUGH: Okay, you know, thank you for that, Luis. Thank you for driving to hear us. We really do appreciate it. And thank you for calling us. We have been conducting a special edition of These Days and we’ve been taking your calls and comments. We’ve been talking about healthcare reform all week. And if this week of shows on These Days has gotten you involved in the healthcare reform debate, there are some other things that you can do. First of all, if you’d like to, you can listen to the series again or you can read the full transcripts at our website, KPBS.org/TheseDays, and we invite you to add your comments to those already posted there. I know there are some people on the line that I’m not going to be able to get to today. Please go to KPBS.org/TheseDays, post your comments. They are read by us and by interested people. You can also e-mail and call your Senator and member of congress and even the president about how you feel about healthcare reform. I think we have all learned this week that reforming the nation’s healthcare system is too important to leave it to the people with the loudest voices and the biggest bankrolls. I want to thank all of our guests and, of course, all of our callers who participated in our special series this week. Tonight on San Diego Week, they’ll continue this discussion on how to reform healthcare in America. That is 7:00 p.m. on KPBS Television. I’m Maureen Cavanaugh. You’ve been listening to a special edition of These Days on KPBS.

Comments

Avatar for user 'MikeM'

MikeM | August 7, 2009 at 12:02 p.m. ― 5 years ago

To those citizens who have been made afraid of the prospect of Government run health programs, probably by private health lobbyists and successful physician-businessmen, I offer that I have been a very satisfied recipient of single payer Government health for over 48 years. First as a member of the military, then as a government civilian employee and now as a retired Medicare recipient. Frankly, if I were young and still working, I would be very worried about future coverage, cost and availability of private health plans offered though my employer.

I ask KPBS to ask Brian Bilbray tonight what form of health coverage he and his family have. If it is not the Federal Employee Health Benefit Program, which is a single payer Government run program, then it is probably a Government subsidized VIP version of the same.

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Avatar for user 'msmaileann'

msmaileann | August 7, 2009 at 2:50 p.m. ― 5 years ago

As an academic physician I consider myself lucky that my salary is not dependent on how many patients I see. Thus I am allowed 30-60 min per patient and so am able to address most of my patient's needs and thus have great job satisfaction (granted I am paid 3-4 times less than my counterparts). I think universal health care is vital (and possible) for our country especially as our baby boomers mature. Although for it to truly work, I think Americans in general will need to undergo a change in their healthcare expectiations.

With the government more involved with healthcare decisions, healthcare will change. The limited resources that currently exist (cancer treatments, organ transplants, dialysis machines, and even primary care physicians) will become more limited. Hopefully this will encourage physicians to make medical decisions soley based on a patient's need vs the current occassional practice of ordering tests and procedures out of fear of being sued, or at the request of patients (there probably needs to be legislation regarding malpractice suits for this practically to happen).

However if that happens gone will be the practices of dialyzing 85 year olds, or keeping comatose patients with no chance of meaningful recovery alive for decades. On a simpler level it will also mean no antibiotics for a simple cold, less and possibly delayed referrals to specialty care, even shorter visits with your primary care doctor (think about the addition of another 50 million people into the system without an increase in the doctors that can see them) as well as other practices that we as Americans expect out of our healthcare today.

Whether or not one considers these changes a positive or negative thing is determined by the expectations of the individual. There are numerous countries around the world who already have a system like this and in general most seem pretty satisfied. However, we live in a unique culture and I wonder will we be able to similarly adapt?

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Avatar for user 'SteveObrother'

SteveObrother | August 9, 2009 at 8:09 p.m. ― 5 years ago

I was struck by the thoughtful and courteous contributions by your guests and callers during this past week. This was in contrast to the acrimony and divisive discussions regarding health care reform on Friday's Editors Roundtable program. It is my observation that the confrontational nature of the health care reform can be attributed, in large part, to the media, e.g., over-the-air, publications and Internet-based commentators. A significant portion of the health reform related information provided by media commentators is subjective and presented in a confrontational manner. I am reminded of 1964 and 1965 when the debate to establish Medicare took place. The same corrosive atmosphere existed at that time with similar "scare" tactics, exaggerations, threats and arm twisting during that debate which ended with the establishmnet of the Medicare program in 1965.

Given the state of the economy in this country, President Obama's insistence to push forward this health reform initiative may be questonable, however it has been placed squarely at the forefront of his Administration's agenda and should be honestly and forthrightly adressed by Congress. This issue has been "on the table" since 1993 so I am nonplussed by those who contend that the issue is being rushed and pushed upon them. It is said that the members of the House of Representatives and the Senators need to go back to their respective Districts and states to get the "input" and ideas of their constituents. That is code for delaying any meaningful action on the bills before the various Congessional committees, and an opportunity to rachet up the invective whirling around this complex issue. Most of these legislators have heard, over the past fifteen years, the complaints, suggestions and frustrations regarding health care or lack thereof. Most Americans, if asked, would say what they want from a health care plan is one that provides the most health services provided at the least cost to them. So any legislation concerning health care reform will not be a result of any grand collaboration of the American public.

There are numerous existing American health care models that could be used to create an effective private/public health care delivery system for virtually all Americans, e.g., employer sponsored plans, HMO/PPOs, Tri-Care (military members, veterans and spouses), the VA system and Medicare/MedicaeAdvantage/Medicare Supplemental plans. The primary focus of any legislation should be the more efficient distribution of services and allocation of costs. It is time for serious people to get serious about this issue. Our legislators need to stop talking around the edges of the issue and go about the business of honestly writing legislation to accomplish meaningful health care reform. This Pesident and this Congress should look to the model of President Johnson and the 89th Congress as they finally wrote and enacted the legislation that created the Medicare program!

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