Officials discuss health care plans

The boy's name was Michael, and he was a 10-year-old from Coffeyville who was too close to death.
Michael had a medical insurance card, but lacked access to care, and it was showing in his mouth. He had a severe abscess in one of his teeth, and by the time he got to the Community Health Center of Southeast Kansas, he had spiked a high fever. The doctors and dentists there were able to help him, pull the tooth and prevent anything bad from happening, but it was too close a situation said Krista Postai, CHC/SEK chief executive officer.
"Now he's just a happy little boy from Coffeyville," Postai said. "But it also shows some of the problems that people have been having with health care."
The health care system is one that both candidates for U.S. President, U.S. Sen. Barack Obama, D-Ill. and U.S. Sen. John McCain, R-Ariz., have pledged to fix. But both will face an uphill battle against a topic that Jonathan Davis, Mt. Carmel Regional Medical Center chief executive officer, calls "extremely complicated."

The similarities
McCain's plan, which he referred to on his Web site as "common sense initiatives," includes increasing competition for drugs by importing them safely through other countries and by pushing for a faster introduction of generic drugs. It's a stance mirrored by Obama.
Obama's Web site writes of the need to straddle two extremes in health care – government run health care that drives up taxes or letting insurance companies operate "without rules."
Both are attempting to provide affordable, accessible health care, and both are for transparency in terms of both health care cost and quality. Both also acknowledge the importance of promoting public health and giving people the information needed to make healthy choices. Along with that, the need for early prevention and intervention is key, they said.
Both candidates have also stressed the importance of finding a way to help businesses with the cost of providing for employees, and have said they want to protect doctors against frivolous or overblown malpractice lawsuits.

The differences
But while many of the general parts of the plan are similar, the devil, as always, is in the details.
Obama's plan would require insurance companies to cover all pre-existing conditions so all Americans, regardless of health status or history can get comprehensive benefits at "fair and stable premiums." Obama said he wanted to lower costs for businesses by covering a portion of the health costs they pay in return for lower premiums for employees. He also said he would establish a National Health Insurance Exchange for with a range of private insurance options and a public plan based on benefits available made to members of Congress.
"Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year," Obama said. "If you don't have health insurance, you will have a choice of new, affordable health insurance options."
Obama said he would ensure everyone who needs it will receive a tax credit for their premiums, and said he would pay for his reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.
McCain's plan is based largely on allowing people to purchase health insurance nationwide, across state lines, and would reform the tax code to offer more choices beyond employer-based health coverage. He also favors insurance that follows from job to job.
While still having the option of employer-based health care, each family would receive a direct refundable tax credit of $2,500 for individuals and $5,000 for families to offset the cost of insurance, money that would be sent directly to the insurance provider. Those who obtain insurance that costs less than the credit can deposit the remainder in expanded health savings accounts.
McCain pledges to reform the payment systems in Medicaid and Medicare to compensate providers for diagnosis, prevention and care coordination. He said Medicaid and Medicare should not pay for preventable medical errors or mismanagement.

Will either work?
"We do not adopt one candidate or the other's plan," Davis said. "Although you could certainly say that they both have their strengths or their weaknesses."
Postai said she agreed with that statement.
"At the end of the day, it has to be a composite of all the best plans," Postai said. "You have to put a lot of smart people in a room and try to figure it out with multiple viewpoints.
"But it's definitely positive that they're putting this kind of emphasis on health care," Postai said.
Davis said an ideal health care plan would pay attention to six factors, paying special attention to: the poor and vulnerable, enhancing the health status of communities through education and prevention, fair financing, transparency, a coordinated and integrated patient centered approach through all stages of life and quality by expanding the use of information and technology.
Davis said one of the hardest parts of that formula was the transparency part because of the sheer number of health plans available.
"It's certainly a struggle to be as transparent as we should," Davis said. "It's just part of the overall complexity with health care itself."
Jason Wesco, CHC/SEK chief operations officer, said it would be a huge step just to get all health insurance companies to use the same forms, a move that he said would save "millions of dollars."
"Studies that I've seen show that 30 percent of health care costs are administrative," Wesco said. "You're talking about 30 cents on the dollar that doesn't go to actual health care. So it can't just be about health insurance. That doesn't mean access to care."
Wesco said that the candidates should look at more community health centers.
"It's a cost-effective way to look at things," Wesco said. "We're cheap, relatively speaking, and we offer all kinds of health care options. Most importantly, people have access. We've done really well here. But we can't treat everybody by ourselves.
"Whatever they do, it can't just be a private solution, an insurance solution," Wesco said. "You see people now who have a $5,000 deductible. Are they insured? I guess, technically."
Postai said the CHC/SEK building, which was built just last year, had already hit capacity, and added that she was looking for two physicians to deal with the increase in care. She called the health care problem "an access issue," a lot like the one that Michael faced.
"We get that all the time," Postai said. "We have people come in and we have to tell them, 'Your cancer is so advanced, all we can do is make you comfortable.' Everybody can be insured, and that's great. But if no doctor's taking you, that's an issue."
Postai said she was looking forward to the election.
"We have the next four or eight years to focus on it, but the fact that they've thought it through in such detail is definitely a positive," Postai said. "I want you to ask me these questions in four or eight years and we'll see how the answers change.
"Right now, neither plan is the ultimate solution," Postai said. "But it's a start."