Locals discuss current plans for reform

Published 12:00 am Sunday, January 10, 2010

NATCHEZ — As talks continue on merging the House and Senate health care bills, many locals are no closer to understanding what may be coming down the pipe.

Jack Stephens, vice president of Stephens and Hobdy Insurance in Natchez, said he certainly isn’t ready to join in on the landmark negotiations.

“I don’t think the industry has been deeply involved in negotiations,” Stephens said.

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“From what I understand there are closed negotiations in the House and Senate, but who knows what our future will be in that market.”

The Senate health care bill, estimated to cost $871 billion over 10 years, will cover 94 percent of legal residents under age 65. Government subsidies to help buy coverage would start in 2014.

Fees on insurance companies, drug makers and medical device manufactures would pay for the system overhaul. In addition, a 40 percent excise tax will be placed on insurance companies, keyed to premiums paid on health care plans costing more than $8,500 annually for individuals and $23,000 for families.

Cuts to Medicare and Medicaid are necessary to fund the overhaul, according to the Senate bill, as well as a Medicare payroll tax increase to 2.35 percent on income more than $200,000 for individuals and $250,000 for couples. Finally, a 10 percent sales tax will be charged to patrons of tanning salon, and individuals who fail to purchase coverage will incur fines. Employers with 50 or more employees must provide coverage or face financial penalties.

The House health care bill, estimated to cost $894 billion over 10 years, will cover 96 percent of legal residents under age 65. Government subsidies to help buy coverage would start in 2013.

Placing new income taxes on single people making more than $500,000 and couples making more than $1 million would pay for the system overhaul, as well as more than $400 billion in cuts to Medicare and Medicaid, a 2.5 percent excise tax on medical device makers, expected to raise $20 billion, $13 billion from limiting contributions of flexible spending accounts and other corporate taxes and fees.

The House bill penalizes individuals and employers who fail to purchase coverage.

Both bills would extend coverage to 30 million uninsured Americans, create opportunities for individuals to shop for insurance and halt practices such as refusing insurance to people with pre-existing conditions.

The House bill would create a national exchange to purchase insurance, while the Senate bill prefers a state-based exchange.

Stephens said sweeping changes to the health care delivery system are especially detrimental in small communities like Natchez that are often overlooked by Washington lawmakers.

“At last count, we only have 45 doctors here in Natchez. We need more access to health care and I hope the bill will provide for that,” Stephens said. “We need to provide incentives for doctors to locate in smaller markets like Natchez and provide financial incentives for them to do so.”

Stephens said he is uncertain what the future holds for insurance providers once Congress reaches an agreement. Whatever the result, Stephens said lawmakers should make cost control a top priority.

“I haven’t seen a lot of cost reduction aspects that would reduce the cost of health care,” Stephens said. “If we can cover more people effectively at a lower cost, that’s what we’re all about. The insurance industry would embrace those changes.

“These sweeping changes could have an impact on all types of insurance — auto, liability, workmen’s compensation — all those types of coverage are likely to increase in cost because I can’t think of a single project Washington has provided that has been on time, on budget and efficient. The delivery is not always as promised, but I hope this is an exception.”

Dr. Kenneth Stubbs, an internal medicine physician in Natchez, said his biggest concern regarding the bill isn’t health care, but rather the federal government’s management of the system.

“There isn’t anything the federal government does for you that doesn’t takes away from someone else,” Stubbs said. “It’s bothers me there’s this attitude — we can do any program we want, and I don’t think that’s true.”

Stubbs said he fears the health care overhaul will be another bureaucratic nightmare, and he is wary the government will not enforce adequate administrative supervision.

Stubbs said there are some aspects of the bills that will benefit his practice, such as reimbursements for arranging physical therapies and medical home projects for which he previously has never received compensation.

Despite the silver lining, Stubbs said the overhaul would be financially carried on the backs of hard- working Americans.

“I might actually get paid for some things I’m not getting paid for,” Stubbs said. “It’s going to be OK for me, but it’s not going to be OK for this country.”

Like Stephens, Stubbs agrees cost-saving measures aren’t detailed in either bill, and he urges Washington lawmakers to closely review dollars and cents.

“(The government) is not able to pay for what they’re currently doing,” Stubbs said. “How are they going to pay for an expanded system? Tax more and cut existing programs. Be prepared to pay more for your health care as this moves forward. It’s just scary they’re going to do all this.”

Still, Stubbs said it’s too soon to tell what the final legislation will entail.

“We don’t know what (the bill) is going to be. Right now it’s all speculation,” Stubbs said. “Until a final bill is actually hammered out between the two legislative branches, we don’t know what we’re going to have.”

House members return from a holiday recess this week and Democrats will meet Tuesday to discuss their strategy. President Obama plans to meet with House Democrats later this week.

The Senate will not return to Washington from its holiday break until Jan. 20.