President Obama and congressional Democrats are continuing their push this week to pass a health care overhaul bill with sweeping provisions such as mandatory insurance coverage, protections for older Americans and help for the uninsured. We asked doctors, insurers, policy experts, advocates and consumers for their thoughts on how these reforms might be felt in Florida. Here's what they said:
Lori Parham, state director of AARP Florida: Parham praised proposals that would make insurance more affordable for those aged 50 to 64, such as ending pre-existing coverage restrictions and certain coverage limits. She said people 65 and older would benefit from the closing of the Medicare prescription drug "doughnut hole," when the prescription drug coverage limit is reached. "Medicare beneficiaries currently can spend as much as 30 percent of their incomes on Medicare out-of-pocket costs," she said. "We're encouraged by what we're seeing, but we're waiting to see what will be in the final package."
Robert Clark, a 58-year-old Christian Science practitioner from Belleair: Clark, who believes in healing through prayer, is among millions of Americans who are voluntarily uninsured. He opposes requiring everyone to have health insurance, particularly if spiritual-based healing isn't covered. "If everyone has to participate, then everyone should be able to choose the kind of care they get," he said.
Dr. Kiran Patel, cardiologist and president of Tampa-based Freedom Health, a Medicare Advantage company: When it comes to paying for health reform, Patel knows Medicare Advantage companies are an easy target because the government spends more per beneficiary on these managed-care plans than the traditional fee-for-service program. But he argues that with 85 cents of every Medicare Advantage dollar being spent on actual health care, any funding cuts will have to be passed on to seniors. "They will feel the pinch," Patel said. "The senior citizens will have to pay more out of their pockets."
Randy Kammer, vice president of regulatory affairs and public policy for Blue Cross Blue Shield of Florida: Kammer supports requiring everyone to have health coverage, subsidies to low-income families and efforts to address fraud, waste and abuse in the health care system. But eliminating annual and lifetime benefit maximums would end some low-cost plans, such as a catastrophic policy that includes up to $25,000 in annual hospital coverage. "If you were not allowed to have annual limits, you wouldn't have a product like that," she said.
Jay Wolfson, health policy expert, University of South Florida: Wolfson applauds proposals such as creating purchasing pools so small employers can band together to get better insurance rates. "That makes tremendous sense," he said. But Wolfson said the bill is silent on how to pay for reform. Eliminating pre-existing coverage restrictions, for instance, has to mean higher premiums. Real reform won't occur unless the way care is provided changes, and the bill as proposed won't do that, he said. "We're simply shoving more people into a crowded room. It's more of the same."
Barbara Gardner, 57, of Brooksville: Gardner supports provisions that would make it easier for people like her and her 62-year-old husband, David, to buy health insurance. Both self-employed — she's in real estate sales, he's a plumbing contractor — the Gardners have trouble getting health insurance because of pre-existing medical conditions. What she found is expensive ($1,100 a month) and has a high deductible ($5,000). "I wish there was a public option. At least I'd have a choice," Gardner said. "I'm worried that at some point I may not be able to afford insurance."
Dr. James Orlowski, chief of pediatrics, University Community Hospital in Tampa: He applauds health coverage for more people, but notes that doctors are facing a 21 percent cut in reimbursements for Medicare patients. "The likelihood is doctors are going to be making a lot less money and doing a lot more work," Orlowski said. Also, he's skeptical that the government will do a better job managing a new health care program than it has with Social Security and Medicare. "I'm not sure health care reform is going to be what everybody hopes and thinks it's going to be."
Dan Krassner, Florida Chamber of Commerce spokesman: Krassner says that while the chamber supports the "effort to find a meaningful solution to health care reform, it has to be without increased costs or mandates on employers." Already, Florida ranks 11th in state-imposed insurance mandates, he said. The federal legislation "will do very little to control costs," Krassner said.
Dr. Cecil Wilson, internist from Winter Park and president-elect of the American Medical Association: Wilson praised what the bill does to expand coverage. But he's concerned that there's no legislation to address the Medicare cuts doctors face at the end of March. "To have meaningful reform, you cannot do that without a stable Medicare program," he said. "We're putting seniors at risk."
Richard Martin can be reached at email@example.com or (727) 893-8330.