Local doctors have questions, concerns about health care bill

The introduction of the U.S. Senate's health reform bill Wednesday left local doctors and health care professionals with mixed reactions and many questions.

Some, however, already have formed strong opinions about the $848 million, 2,000-plus-page bill introduced by Sen. Harry Reid, D-Nev.

For local pulmonologist Dr. Vince Viscomi, the plan has one goal: the public option.

"Driving people to the government plan, that's what this is all about," he said.

While both the House bill, passed Nov. 7, and the Senate bill offer a government-backed insurance plan -- what's been called the public option -- the Senate bill offers states the ability to opt out.

Other local doctors said they haven't had time to digest the language and components of the bill.

"What I'm picking up is that the organized medicine (community) likes the House bill better," said Dr. B.W. Ruffner, president-elect for the Tennessee Medical Association. "I don't know enough to inform you why."

INSURING THE UNINSURED

A major difference between the House Bill and the Senate bill is that the latter would insure 36 million of those currently uninsured compared with 31 million under the former.

Though the bill is expected to help those without health insurance due to pre-existing conditions or low incomes, some doctors worry about the millions of people who will remain uninsured.

"I worry about a reform bill that does not make a greater reduction, a more substantial reduction, in the number of uninsured people," said Dr. Clif Cleaveland, a retired Chattanooga physician and former president of the American College of Physicians.

The Senate bill would allow the new government insurance plan to cover abortions and let companies receiving federal funds offer insurance plans to include abortion coverage.

Both the public option and the abortion provision were important to Dr. Laura Helfman, who lives in Coalmont, Tenn., and works in the emergency departments at T.C. Thompson Children's and Memorial hospitals.

She said she would not support any bill that limits reproductive or pro-choice issues. And while she thinks a public option is worth a shot to reduce those ineligible for coverage, she doesn't expect it to be effective.

"If people have to use 25 or 30 percent of their income to get (public option) insurance, then it's really no better."

Public option

Dr. Viscomi, the immediate past president of the Chattanooga/Hamilton County Medical Society, has many concerns with the bill, one of which is that it drives people to the government-based insurance plan.

Companies can opt out of providing insurance for employees and eventually pay a $750 fine, which is cheaper than providing a month's worth of coverage for a family, Dr. Viscomi said.

He's also concerned about where money to fund the bill will come from, especially if it's taken from Medicare payroll tax, he said.

To pay for itself, the bill depends partly on reducing Medicare reimbursement rates to physicians.

"Most providers just think it's sort of silly that there's that much revenue to be taken from Medicare," Dr. Viscomi said. "It's robbing from one entitlement program to generate a new one."

SENATOR REACTIONS

* U.S. Sen. Lamar Alexander, R-Tenn.

"There's a new payroll tax that is exactly the wrong medicine when there's 10 percent unemployment. And there's a new government-run insurance program into which millions of Americans will be pushed when their employers drop their health care coverage as a result of this bill."

* U.S. Sen. Bob Corker, R-Tenn.

"From what I've seen of the 2,074-page bill thus far, it looks even more sinister. This is taking the debate and our country in exactly the wrong direction. We're literally spending our future away."

* U.S. Sen. Johnny Isakson, R-Ga.

"The latest proposal from the Democrats is more of the same. It would still result in a major expansion of government into our health care, and the true cost of this bill when fully implemented in 2014 would be a staggering $2.5 trillion."

* U.S. Sen. Saxby Chambliss, R-Ga.

"I am alarmed by the deep cuts to Medicare included in this bill. I am also concerned about the taxes that will be placed on families and businesses."

HEALTH CARE POLICIES

According to health economists, the Senate bill has four key parts:

* Fee on insurance companies that sell high-premium plans

* Establishment of independent Medicare commission

* Reforms to health care delivery system that will reward providers for taking better care of patients and getting them well faster

* Overall deficit neutrality

Source: White House Office of Health Reform