Friday, November 13, 2009
JOANNE FARYON (Host): Healthcare reform is one step closer to a Senate vote. In the bill’s current form it’s estimated two thirds of San Diegans without insurance would be eligible either for Medi-Cal or government subsidies for private insurance. Gary Rotto is the director of health policy for the Council of Community Clinics. We asked him how the legislation in its current form will impact community healthcare clinics. Here’s what he had to say.
GARY ROTTO (Director of Health Policy, Council of Community Clinics): The clinics look at the aspects in particular of the number of uninsured. And see that in the bill that has passed, and the senate version as well that two thirds of the people who are currently uninsured in San Diego County will now be covered by some form of insurance. So that's 360,000 people approximately who will be eligible either for Medi-Cal or for subsidized payments to their private healthcare premiums. That's a large number, a number we're very excited about. A number of those people, about 140,000 already come to clinics. That means there are a little bit over 200,000 people who currently don't have a medical home. Who don't have a primary care provider probably. And, we have an opportunity to bring them into our system to make sure that they stay healthy and keep them out of the emergency room. Able to manage their care, whether it's because of a particular disease they have - diabetes, asthma, hypertension, or just every day situations.
FARYON: Joining me now to discuss the progress of the health care reform bill are Hieu Tran Phan, specialist editor for the San Diego Union-Tribune, and Davis Roland, editor of San Diego CityBeat. Lets start with you, Hieu. We just heard Gary Rotto say thousands of San Diegans could be insured if this bill were to pass in its current form. Republicans argue, though, that those subsidies would cost money. In the end, do we really solve the problem of escalating health care costs?
HIEU TRAN PHAN (San Diego Union-Tribune): Boy, this is one of a long list of questions that we’re going to see debated in the Senate over the next few weeks. And perhaps months if it goes beyond what Harry Reed says will be the December deadline that he hopes to have for passage of this Senate version of the bill. I think that everyone’s goal, at least on the majority side, is to get more coverage for more Americans. Whether that’s going to result in savings for the United States, I’m not sure. And this is really the crux of why we even started the healthcare reform bid in the first place. We were spending way too much; our premiums are rising at double digits every year. We’re outpacing inflation and we need to reign in costs. Will that do it? I don’t think any study has definitively said whether we need to reach a trillion dollars, eight hundred billion dollars, and that will be the magical number. I think this is going to take a few years to sort itself out.
FARYON: And, David, this bill also would require the state to kick in some money as well. How is California going to do that? It’s broke. We know it’s dealing with a huge financial crisis.
DAVID ROLAND (San Diego CityBeat): California doesn’t have any money that’s for sure, as you note. You know, the interesting thing here is to me, all the debate has been a little shortsighted in the window in which it’s looking at the financial aspect of it. We were really focused on what it’s going to do in the next ten years. And that’s really difficult. The idea here, I think the impetus for healthcare reform was to get more people access to it. And that is expensive in the short run. I think the idea though is for people like me who want to look at it more in the long view. I think when you have a healthier – you’re giving people access to preventative maintenance of their bodies. Over the long run, if you have a healthier populace, I think you have long-term cost going down.
FARYON: And we know that, as a nation, we’re still spending more than other countries that provide universal healthcare. It’s something like sixteen or seventeen percent of our GDP. So we’re spending more but not giving people more?
PHAN: Right, Joanne. I mean whether we want the reform or not, our current situation is going to lead us to fiscal bankruptcy. I’m sure of it. Everyone has said that for at least a decade now. The basic problem is that all the special interest groups whether they’re doctors, hospitals, patient advocacy groups and so forth don’t want to give up any of the revenues that they currently have. And so this is driving up costs along with new technology that sometimes are unproven. Also a quantity of care that sometimes is not the most efficient and doesn’t bring you the most effectiveness but is still done because they bring more money per procedure. And so if we’re going to keep doing this the GDP, as you said, is eighteen percent currently and I suspect it to go into probably past twenty percent if we wait another decade. And that’s just going to, I think, cripple the rest of our economy if we don’t try to fix it now.
FARYON: David, what do you see as the big stumbling blocks to this bill in the Senate?
ROLAND: Well, the stumbling block in the Senate is the procedure for the filibuster. The democrats have sixty people in the Senate including two independents who caucus with the democrats, but you’ve got one, Joe Lieberman, who said he will stop at nothing to stop this bill from even getting a floor vote. So, somebody has got to do something about the Lieberman problem to begin with. Do you instead go to someone like Olympia Snowe, a republican from Maine? Well, I don’t know. She's not any more enamored of the public option in the House version of the bill than is Joe Lieberman. So, Harry Reed has a lot of work in his path to get this just even to the floor of the Senate.
PHAN: David and Joanne, we also mentioned that there's this abortion/anti-abortion debate in terms of whether federal money should be spent on abortion services. This was a huge issue in the House. Finally they got one republican legislator to come over after an amendment was passed barring federal funding for such services. We’ll see if Obama and Senate democrats are going to be able to change that in their own version of the bill or through reconciliation.
FARYON: We’ll have lots more to talk about this, I’m sure. We’re going to move on to the next topic.