Synopsis of the Nevada County Health Care Forum

Aug 31, 2009 at 7:00 p.m. ~ Madelyn Helling Library Community Room, Nevada City CA

About 60 people attended this Health Care Forum. 

Moderator: Welcome and opening remarks by Maureen Shepard. 

This event is presented by the Sierra Foothills Chapter of Organizing for America, a non-partisan group. It is one of two forums this week, the other is a town hall meeting with Representative McClintock on Friday. We would like civility and respect to be shown by all participants at both events.

Speaker: Dr. Christine Newsom. 

Dr. Newsom spoke on health care systems around the world. She presented information from T.R. Reid author of “The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care” (see www.brightsightgroup.com). There are 4 basic types of health care systems:

   Beveridge Model: Publically financed, publically delivered – UK, Spain, Italy, New Zealand

   Bismarck Model: Privately financed, privately delivered – Germany, France, Japan, Switzerland. Although these are private systems, insurance companies are highly regulated. They must accept everyone and premiums are controlled.

   Single-payer Model: Publically financed, privately delivered – Canada, Taiwan

   Non-developed World: You get what you can pay for.

   In the US, we have a combined system of all of the above. The VA and Indian Health Service are publically financed and delivered as in the Beveridge Model. Most US citizens are covered by private insurance with health care privately delivered as in the Bismarck Model, except that we lack the tight insurance company regulation. US Citizens over 65 are covered by a Single Payer system: Medicare. And 47 million are uninsured.

Speaker: Dr. Alex Klistoff

   We pay more for our health care, yet we’re not as healthy as people in other countries.

   Competition is good. Doctors and hospitals should compete on quality of care. You should have more choice to choose a doctor based on how good a doctor he or she is, not by what network your insurance allows you to choose from.

   Dr. Klistoff told stories of patients with diabetes and high blood pressure. They are not able to afford health insurance, not able to afford necessary medication, not able to afford needed cancer treatment. This is just not right.

Speaker: Dr. Jonathan Pierce

   The Bismarck Model might work best for us. Switzerland has a good basic plan that includes vision and dental. Everyone has to be signed up for a plan, and the price is the same regardless of which one they choose. In Switzerland, insurance company profits are limited to 3-4% and there are no exorbitant salaries - employees make middle class incomes. The Capitalist system only works when there are no monopolies. There are big insurance monopolies in many regions of our country now. The Swiss love their universal health care system, and wouldn’t consider giving it up.

Questions for the doctors

   How can we pay for this? There are lots of inefficiencies in the system. The Mayo Clinic is a good example of how higher quality care can be given for less money. Now doctors have incentives to order lots of tests and to own their own clinics and test machines. Also ER care for the uninsured is costly and those costs are now shoved onto you. Young people would have to buy insurance, even though their use is low, which would be a net income to the system. Insurance companies are now taking too much in profit. See Dr. Atul Gwande’s article in the New Yorker comparing the incentives for physicians in El Paso TX and McAllen TX. The incentives to send patients for more tests and to more specialists increased the cost of care in McAllen to about double of what it was in El Paso.

   We’re eating a diet that makes us sicker and what about corruption in medicine? There is corruption in every industry and some doctors don’t put their patients first. However, our recommendations are based on scientific results.

Speaker: Christa Darlington, Chair, Sierra Foothills Chapter of Organizing for America

   Handout from the Kaiser Family Foundation comparing the Senate HELP Committee bill “Affordable Health Choices Act” and the House Tri-Committee bill “America’s Health Choices Act of 2009 (H.R. 3200)” 

  Christa explained the important features of these 2 bills currently under consideration.

   Handout from GOP Health Care Solutions Group http://bit.ly/CqOpI .

   To get involved in support of Health Care Reform , see the Sierra Foothills Chapter website http://www.ofasierrafoothills.org/ or email Paul Goodyear at Paul.Goodyear (at) wavecable.com.