Local health advocates differ on reform

CLEVELAND -- The majority of local healthcare providers agree the system needs to be changed and advocates are watching Capitol Hill very closely. But some have differing views on what should be in the measure.

University Hospitals heart surgeon, Dr. Arie Blitz thinks this current health reform bill is like a runaway train --without an experienced conductor. 

"Physicians have played a monumentally small role in fashioning this bill," Dr. Blitz says. He's upset that it doesn't address frivolous lawsuits that have caused malpractice insurance to skyrocket.

 "Tort reform would be an extremely important component of healthcare reform and I cannot believe they aren't considering it," Dr. Blitz says.

Nevertheless he expects reform to pass through the Senate. "Sure we'll be able to provide broader healthcare to a greater part of the population but we will be paying for that in oh so many ways in hidden taxes."

Danny Williams, who runs the Free Clinic of Greater Cleveland, sees the desperate situation daily.

"We're encouraged this is the closest we've gotten to any kind of comprehensive health reform ever," Williams says.

He firmly believes healthcare is a right, not a privilege and believes reform will help many of the Free Clinic's patients.

"While it's nowhere near universal care, it's much closer to providing care to a larger percentage of people than we've had in the past," Williams adds.

He also believes it will pass but hopes the Senate respects the guts of the House bill and doesn't remove valuable elements.

"I hope they don't take out the ban on pre-existing conditions or to take out the ban on discriminating people based on their age and premium levels."

The Free Clinic released its position on health reform and believes it should do the following"

1. Provide basic, comprehensive health coverage and access for the approximately 46 million people currently without health insurance in the United States.

2. On public health grounds, allow undocumented immigrants to purchase coverage through a proposed health care exchange to lessen the unnecessary use of emergency rooms and to diminish the transmission of infectious diseases.

3. Maintain or create incentives and/or penalties to influence employers to offer health coverage to their workers, with appropriate exemptions for smaller employers.

4. Expand Medicaid to all individuals with incomes up to 150 percent of FPL and increase Medicaid payment rates for primary care providers to 100 percent of Medicare rates.

5. Prohibit insurance companies from: excluding individuals from coverage based upon pre-existing conditions; discriminating on premium levels based on gender and age; and canceling coverage that has already been purchased, except in cases of fraud.

6. Create a "public option" mechanism that allows individuals not covered through other avenues to purchase insurance at affordable rates.

7. Establish a benefit design with the following components:

a. An "essential health-care benefits" package that integrates physical and behavioral health care, provides coverage for mental health and substance use disorders at a level consistent with other health conditions, and consists of a comprehensive set of services equal in scope to the benefits in a typical employer plan.

b. No annual or lifetime limits on coverage.

c. Reasonable limits on individual and family premium cost sharing (e.g., $5K individ./$10K family)

8. Provide incentives to promote prevention and wellness designed to reduce chronic diseases and address health disparities.

9. To accommodate the anticipated increased patient load, provide incentives to encourage the training of a diverse corps of primary and behavioral health professionals who will practice in underserved areas.

10. To address the anticipated need for institutional capacity expansion, provide financial support to safety net providers, including the nation's more than 1200 free clinics, to address the health care needs of lower income individuals.  

The current bill includes versions of almost every point except number 2.