Experts discuss ‘Obamacare’ at USD

Dutch health care expert Freek Lapre discusses health care in the Netherlands as associate professor Mike Myers and assistant professor Brian Hensel look on at an International Forum held in Farber Hall at the University of South Dakota Monday. (Photo by David Lias)

According to one health care specialist, the response of the European medical community to the United States Patient Protection and Affordability Care Act (PPACA) otherwise known as Obamacare is simple.

Welcome to the civilized world.

Dutch health care expert Freek Lapre relayed this opinion to the audience at the International Forum held in Farber Hall at the University of South Dakota Monday.

Brian Hensel, assistant professor of health services administration at USD, said that while some provisions of PPACA addresses the issue of cost, it is at heart an access bill.

The punchline is that the congressional budget office projects that 32 million more of the currently uninsured will be covered by insurance, he said.

Hensel said that estimates indicate there are approximately 50 million uninsured persons living in the United States today.

Under PPACA, income eligibilities were increased so that more people will be eligible for Medicaid.

There will be something called the insurance exchange put in place including in South Dakota (where) the private insurance companies will compete in a virtual marketplace, and they will have apples-and-apples benefit packages. Youll know exactly what youre getting for each level. The idea is, it will foster competition.

There also will be reductions in future Medicare increases through an advisory board, the actions of which can only be overridden by two-thirds vote in both the Senate and the House, Hensler said.

Lepre discussed some of the criticisms that have been leveled against universal health care, such as that the very idea is Communist, that it is more expensive and that the quality of care provided is less than that which is currently available.

He pointed out that most of the countries that offer such a health care system are not Communist.

As for expenses, he said, If you look at the expenses of health care around the world, you can see the United States has the highest cost of health care per capita.

While 20 percent of insurance costs go toward administrative fees in the United States, that number is an average of 5-8 percent in Europe, Lepre added.

Lepre also said the quality of care afforded by universal health care may be illustrated by the fact that citizens in most countries operating under such a system have higher life expectancies than residents of the U.S.

Europeans do not understand the argument that says the government should not tell its citizens what they should and should not buy, he said.

You cannot walk naked in the streets, so you have to have clothes. You have to buy clothes, Lepres said. You will be jailed if you let your children starve because they dont get food, so you have to buy food. So, there are many things where the government is dictating that you have to buy a particular product.

Hensel said that despite most criticisms, public support for universal health care is remarkably stable.

According to a Gallup Poll taken in 1938, 81 percent of respondents said the U.S. government should be responsible for providing a system of health care. The results of a similar poll taken in 1991 put the number at 80 percent.

The total usually stands around 50-60 percent, Hensel said.

Its not a huge majority, but it is a majority, he said.

Mike Myers, associate professor at the USD School of Law, currently is involved in a lawsuit with the Yankton Medical Clinic.

He said that a Nebraska man took his wife to the clinic so she could undergo a mammogram. The couple told the receptionist at the clinic that they did not have Medicare Part B, but did have Medicare Part A.

The words were, Dont worry, Myers said. So that guy thought, Theyre going to accept Part A.

However, he said, this was not the case.

They get a bill and they cant pay it, Myers said. His income is $1,011 a month, hers is $890. Right around two grand a month. They dont have the money to pay, and (YMC wants) $866.

The issue with the bill was assigned to Credit Collection Services. Myers said he tried to resolve the matter with the owner of that company, but could not make any headway.

As a result, a countersuit has been filed on behalf of the couple, as they were told not to worry at the clinic.

What that person at the desk should have said was, Since you dont have Medicare Part B, you will be charged and we will expect the sticker price $866 instead of the $240 that Medicare Part B pays, Myers said. Were going to contend that that was a breach of contract and that theres something called the fiduciary duty between doctors and patients.

Myers suggested that this information should be posted at clinics so patients can be aware of what they will be charged under their respective plans.

I would suggest that even the doctor ought to have some awareness as to the financial implications of the treatment that he or she is providing, he said.

Benno Wymar, forum moderator and professor emeritus of economics at USD, said charts outlining plans doctors will and will not accept currently are available in Germany, his home country, and elsewhere in Europe.

Lapre said this is similar to the fact that under universal health care, patients will not be admitted to emergency rooms for non-emergencies. For this reason, general practices have been incorporated into most European emergency rooms.

(That way), youre not sending someone away. Youre sending someone to someone else, he said.

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