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Merkley Health Care Telephone Town Hall - September 30, 2009

(I missed the first half-hour of the telephone “town hall” — I thought I had missed it entirely but apparently someone in Merkley’s office found my late registration and got me on the call. Here’s what folks around the state asked Sen Merkley and his responses.)

The most important points, as it turns out, were being made as I joined the call: Health care costs will double in the next 7 years (if we do nothing). No argument anywhere about that, just whether or not that’s a bad thing. The insurance and medical provision companies are pretty good with that; profits will double much sooner, no doubt. The rest of us: not so much.

Second, Merkley pointed out that for an average family paying high premiums ($80 - $10,000 per year), $1,000 or more of that is to pay for people without insurance coverage who receive emergency room treatment. And if folks need something to look forward to, this will get worse as more people lose coverage, go to the emergency room, drive up costs, drive people out of their coverage…. Yea, ugly.

Please don’t try to reinvent the whole system; work on specific problems. How about a system where people pay for the services they use, not simply have the choice to be covered for unlimited services (which they’ll use, and which will be very expensive)?

Many people have requested that we build upon what we already have, in particular the employer-based system. What we’re trying to do in Congress is make sure employers have affordable options to provide their employees.

We’re also trying, through the insurance exchanges, trying to make it possible for an insurance provider to enter a new state without facing the huge start-up costs. An exchange will allow companies to offer their services as lower, competitive rates both by avoiding those up-front costs and by having a pool of millions in which to spread risk.

Finally, people should be able to purchase health insurance at the same cost whether they are getting it through their employer or on their own.

I am 81, have good insurance (Medicare and ODS) but not long-term insurance; it’s getting increasingly expensive — will it be part of reform?

We know that allowing people to stay in their homes to receive care provides for a higher quality of life; therefore, we have a good incentive to provide long-term insurance. It’s something Ted Kennedy worked hard on in the HELP Committee but it’s not getting the attention it should. It would improve the quality of life for seniors.

I’m a senior citizen receiving Medicare. We’ve heard lots of scary things about the public option taking money away from Medicare. How will this affect seniors?

First, the health care bill should be online; if you have trouble finding it, call the DC office (202.224.3753) and we’ll help you find it — and a summary (the actual bills are tough to read).

I do not believe Sen Baucus was trying to take anything away from seniors. I’ll fight very hard to make sure Medicare is well protected — and many Senators feel the same way.

We’ll be looking for savings, bu we won’t allow anything to take away from quality of care. For example, the kind of waste ($65 billion in excess costs over 10 years) that resulted from the Medicare Part D ban on government negotiating costs — not gonna happen again. “But we won’t cut benefits in any way, shape or form.”

Why isn’t single payer being discussed? It works in other countries, and people don’t have the fear of losing coverage — or losing their homes.

There has been discussion in the HELP Committe; there will be amendments and debate on the floor. The core question is how do we improve insurance for those who have it and extend itto those who don’t? Expanding choices for citizens and businesses will be enormously helpful — being part of a huge pool will reduce costs 15% or more.

Doctors for Single Payer are coming to DC soon; that will amplify the discussion.

How can you guarantee illegal aliens won’t be covered under reform?

Both House and Senate bills require citizenship to receive care. “That issue should be put to rest.”

I work with the Oregon Office of Rural Health raising money to train rural emergency and health care providers. Lots of rural folks don’t have insurance so they are part of the rising costs problems; many doctors leave rural areas because of these costs. A public option would cover these people, allowing doctors and care givers to remain there.

This is a huge challenge. Hospitals can increase costs to cover the uninsured but this is harder to do in rural areas where care is not provided in large hospitals. Getting doctors to serve in rural areas is difficult. The HELP bill tries to increase the number of practioners, the number of primary care providers and the number of doctors in “under-served areas”. There are a host of incentives. “You don’t really have health care if the neared health care center is a couple of hundred miles away.”

People are struggling to pay their premiums. I’m concerned we won’t do enough to make premiums affordable.

Trying to achieve the insurance reforms we want (cover everyone, no pre-existing conditions, no one getting kicked off) while also avoiding “adverse selection” (a system where the ones who opt in are those who are most expensive to cover). One major topic of discussion has been to have a reasonable sliding scale, have an opt-out fee for those who choose not to buy into any plan to avoid them transferring their costs via the emergency room later on, and possibly providing catastrophe-only plans. “We absolutely have to stop runaway costs.”

Please continue to send your stories to merkley.senate.gov.