Health options limited by cost, panelist says
A man with prostate cancer faced a choice: undergo an effective, standard therapy or try a newer treatment option with less chance of causing incontinence or impotence.
The difference in price: $60,000 for the standard treatment versus $140,000 for the newer option.
Insurance executive Doug Freeman shared this real-life example from one of his client companies Thursday during a community forum about health-care reform.
His client opted to allow the employee to get the higher-priced option if he paid the difference between it and the standard treatment. But these types of issues, he said, aren’t being addressed in the nation’s current health-care reform debate.
”There are tremendous ethical issues involved in cost control. Nobody wants to bite that bullet,” said Freeman, president of Medical Benefits. The insurance company based in Newark specializes in processing claims for large self-insured employers.
About 65 health-care providers, insurance representa
tives, business leaders and consumers attended the forum — ”What Does Health Care Reform Really Mean to You?” — at the University of Akron’s Martin Center.
The event was the fifth Northeast Ohio Healthcare Summit organized since 1996, with the goal of improving health-care delivery in the region.
The event included a panel discussion with Freeman and representatives for U.S. Rep. Steven LaTourette, R-Bainbridge Township; Betty Sutton, D-Copley Township; and Sen. Sherrod Brown, D-Ohio.
Bill Hayes, head of the Health Policy Institute of Ohio, a nonprofit research group, also sat on the panel and served as the event’s keynote speaker.
The legislation pending in Congress centers around lowering the cost of health insurance, not the cost of the care patients get, Freeman said.
”Cost control has been defined as insurance premium control,” he said. ” . . . We’re in a down economy. Employers are not looking to take on more cost.”
There are national and state efforts to create ”medical home” or ”accountable care organization” models that bring a variety of health-care services together, Hayes said. Everything from home care to hospital care could be grouped and paid a flat amount to share in the management of the patient.
”The general sense is we have to change how we structure payment,” Hayes said.
During Thursday’s panel discussion, the representatives from the legislators’ offices updated the audience about the status of health-care reform bills.
The House and Senate have passed their own versions.
It’s unclear whether lawmakers will opt to hash out a new, scaled-back version of health-care reform, attempt to pass one of the existing proposals or come up with a compromise bill, said Nick Ciofani, a representative from LaTourette’s office.
LaTourette voted against the reform legislation, but supports some aspects of the bill, including measures to stop insurers from denying people coverage because of pre-existing health conditions, Ciofani said.
”There definitely needs to be some changes in our current health-care system,” he said. ”The question is how fundamentally you want to change it.”
Liz Walters, a representative from Sutton’s office, said the plan the House approved doesn’t provide coverage for illegal immigrants or abortion services, despite rumors to the contrary.
It also includes payments for doctors to provide ”end-of-life” counseling, but does not have the so-called ”death panels” that some proponents have claimed, Walters said.
Reform legislation also must prevent insurance companies from dropping people when they get sick or from charging women higher premiums, said Max Blackman, a representative from Brown’s office.
Some other key components, he said, include plans to allow small businesses to pool together to buy insurance, allow poor Americans to buy into Medicaid and address the gap in coverage some seniors face in Medicare prescription drug plans.
”For the 390 Ohioans who are losing their health insurance every day, we cannot act quickly enough,” Blackman said.
Thursday’s event was a collaborative effort among the Summit County Health District, the University of Akron, the Health Policy Institute of Ohio, Healthy Connections Network, the Rehabilitation Health Center at Park West, the Northeastern Ohio Universities Colleges of Medicine and Pharmacy and the Greater Akron Chamber of Commerce.
Cheryl Powell can be reached at 330-996-3902 or chpowell@thebeaconjournal.com.
Tags: health care reform, nonprofit research group, pre-existing health conditions, prostate cancer, University of Akron's Martin Center
There are several very good arguments debated here.
Usually, I’m not very keen on politics. but, from time to time all of us have to pay attention. Interesting, thank you.