Tahlequah Daily Press

Features

July 23, 2012

Officials: ‘Rationing’ fears largely unfounded

The second in an ongoing series about the Patient Protection and Affordable Care Act examines limitations on doctor visits and how expanding Medicare affects the state’s bottom line.

TAHLEQUAH — The U.S. Supreme Court has upheld the federal Patient Protection and Affordable Care Act, meaning approximately 200,000 Oklahomans who did not have health insurance will gain access through either Medicare and/or Medicaid.

Under the new law, co-pays for preventive care will be abolished. Theoretically, this would encourage people who previously couldn’t afford doctor visits to seek them, thus allowing doctors to diagnose illnesses early – before they become prohibitively costly to treat.

Given the potential influx of individuals covered under the Medicare and Medicaid, some doctors believe charging a nominal co-pay or limiting visits for minor injuries could ease the immediate stress on doctor’s offices and hospitals.

But mention the word “rationing” in the same breath with health care, and many people fear they won’t get critical treatment, or will have to wait months for life-saving procedures and screenings.

Dr. Paul Hobbs, M.D., of Tahlequah Medical Group, believes preventive health care is still an important part of everyone’s health plan.

“I don’t believe that in towns like Tahlequah, and with partnerships like Tahlequah City Hospital, that patients will not get the care they seek and deserve. Statistics show patients getting the preventive care they need – such as mammograms, prostate screenings, colonoscopies, etc. – will continue to see an improved quality of life as early detection of illnesses are caught. TCH has always been extremely responsive to any emergency situation through its emergency room, and I am sure it will continue to do so.”

Dr. Doug Cox is an emergency room physician at Integris Grove General Hospital. He is also District 5 state representative for Mayes and Delaware counties, and is a Republican. Cox has suggested reducing or eliminating co-pays would only work if controls are placed on the number of doctor visits, preventive or otherwise.

“I fear that not having a co-pay could result in overuse of the system,” said Cox. “People tend to go to the doctor when it’s free for minor things they could handle at home or are self-limited – common colds, minor rashes, minor sprains, bumps and bruises, etc. I see it all the time.”

Cox knows Americans fear “rationing” when it comes to health care.

“We are used to instant access and instant service,” said Cox. “I do not think the PPACA will result in true rationing. What it may do is result in a wait to have non-emergent procedures. I do not call this rationing; many people do.”

Cox is concerned that an additional 200,000 Oklahomans gaining free access to health care could clog the system, and suggests charging a reduced co-pay.

“A co-pay of $5, less than [the cost] of many cigarettes, would amazingly cut down on the number of frivolous physician visits,” said Cox. “And yet, I do not feel that $5 would be high enough to discourage access for preventive care, or prevent those who are truly in need of urgent care from seeking access. Therefore, I feel it would have no ill effect on public health. I really like the stress on preventive health, but would implement the $5 co-pay.”

Sen. Jim Wilson, D-Tahlequah, agrees that a $5 co-pay, or even a $20 co-pay, shouldn’t prohibit people from seeking preventive care. He said since he is a good 10 years older than Cox, he remembers the wild speculation when Medicare was introduced.

“When we passed Medicare in 1965 and it went into effect in ‘66, we had the same arguments,” said Wilson. “People were saying doctors and hospitals would be inundated with people seeking care. [Those in the medical community] were all braced for an onslaught. People don’t come sit in the doctor’s office for the fun of it. It just turns out that people don’t access the system unless they need to.”

The U.S. spends about 17 percent of its Gross Domestic Product on health care. Cox said he has researched the situation, and has found many other countries have better health outcomes and spend only 9 percent of their GDPs on health care.

“[In conducting this research], I have noted they have a few things in common,” said Cox. “First, they have universal coverage, which spreads the expense over the entire population. Non-elective procedures – hernias, elective knee/hip replacements, etc. – take a back seat to urgent procedures, which may result in a waiting period from three to 12 months. Americans have to ask themselves if they are willing to do this as part of a plan to help control costs. Other countries also place an emphasis on preventive medicine, and emphasize personal responsibility. [If you] smoke, you don’t get a lung transplant; if you drink, you don’t get a liver transplant; if you weigh 400 pounds, you don’t get a new knee. Again, some Americans consider that rationing; others call it trying to get the best use of limited resources.”

The Oklahoma Health Care Authority has estimated that, in 2016, when the state is set to take over 10 percent of PPACA costs, the amount will be $26.7 million, and would increase to $32.6 million in 2018, $38.8 million in 2019, and $56.6 million in 2020.

“I feel this is a number we can afford,” said Cox. “Some studies – including those by the Robert Wood Johnson Foundation and Urban Institute – estimate there would be an additional 16,397 jobs created in Oklahoma, which would generate $495 million in payroll dollars. That would generate $52 million in state income from personal tax revenue. That would offset the cost of the program.”

Wilson agreed, saying that by adding the 200,000 Oklahomans to the system, the state would be cutting distributed costs to those who already have insurance. He, too, has done the math, and said between the increased employment and payroll, the state will actually make money.

“Right now, it costs $983 per year, per insured person, to pay for those who are not paying for health care,” said Wilson. “If Oklahoma has a population of 3.7 million people, then $3.5 billion would no longer be cost-shifted. It would save individuals that $983 per year they’re paying to care for others.”

Wilson also pointed out many state legislators have made it clear they want no part of federal money.

“The people who say, ‘Well, if you take federal money, it’s still taxpayer money’ don’t understand the state currently receives $1.35 for every dollar it sends to the federal government,” Wilson said. “It’s insane to say we don’t want federal dollars, and if we want to be esoteric about it, let’s close Tinker AFB. It’s bogus to use that argument. The feds are going to spend the money, and they may as well spend it here in Oklahoma. There are people out there who seem to think we’re better off depriving people of health care. We can afford to give everybody health care. We know we can, because other countries do it.”

Cox echoed Wilson’s statements about cost-shifting.

“We have health care for everyone already,” said Cox. “Many access it and do not pay. The cost of uncompensated health care is presently cost-shifted to those of us who work and have insurance or self-pay premiums. We are paying for the deadbeats. I like the PPACA, because it penalizes those who do not have insurance with a monetary penalty. At least they are going to pay for not being responsible. That’s why I’m not so sure why so many of my [Republican] colleagues are so adamantly opposed to the act; [penalty for irresponsibility] is a pretty Republican idea. It is estimated PPACA would result in a reduction of $324 million in uncompensated care for providers, which cost-shifts to the insured.”

Text Only
Features
  • wherearethey.jpg Padilla enjoys reconnecting with childhood

    As a child spending time at her grandparents’ house, with all her aunts, uncles, and cousins around her, Kerrie (Bosley) Padilla spent endless hours outside playing chase, catching fireflies, or writing and acting out plays.
    In 1987, after her dad got out of the Navy, the family moved here from Georgia to be closer to that family: matriarch Dorothy Monzingo, and maternal grandparents Dorothy and Dwight Allen. Her parents, DeAnna and Steve Edwards – as well as a couple of siblings and some aunts, uncles and cousins – still live here.
    Eventually, Padilla graduated from Northeastern State University, and then its College of Optometry.

    April 22, 2014 1 Photo

  • rf-Dream1.jpg Dream Theatre spotlights songwriters

    Dreams can come true for local aspiring songwriters who seek to gain performance experience.
    For one young musician, Thursday night was an unexpected dream of discovery, as well.
    Two opportunities are available to musicians at the Dream Theatre each month, the new Songwriters’ Showcase which opened Thursday night and Premier Night for musicians who have a few songs or a set, but not a whole show.
    In search of the groove that works for The Dream, Manager Larry Clark is partnering with Blake Turner, Lakes Country operation manager.
    The Songwriters’ Showcase, which will continue the third Thursday of the month in conjunction with Tahlequah Main Street Association’s Third Thursday Art Walk downtown, features seasoned performers who can share some of their personal insights into the how, when and why of their songwriting experiences.

    April 21, 2014 2 Photos

  • Dream, Brewdog’s to host music festivals

    One sign of spring’s arrival is the scheduling of music festivals, and 10 bands will visit a Tahlequah venue May 24, the Saturday before Memorial Day.

    April 17, 2014

  • rf-Zoe-thing.jpg Conference attendees get words of encouragement

    Words of encouragement and door prizes were bountiful Saturday morning at the annual Zoë Institute’s Women’s Conference.
    Ten women shared words of wisdom in areas from happiness to health, and 100 gifts were given out, including the grand prize of gasoline for a year.

    April 16, 2014 1 Photo

  • sp-symposium-art-panel.jpg Panelists discuss impact of Southeastern art

    Until recently, most people had a certain expectation of American Indian art – and it didn’t include images familiar to people in and around Cherokee County.
    “A lot of times, when people think about Native art, they immediately think of Plains art or Southwestern art,” said Roy Boney (Cherokee), Tahlequah artist and moderator of the panel discussion “Southeastern Indian Art: Building Community and Raising Awareness,” held Friday, April 11, at the NSU Symposium on the American Indian.
    Boney and the other panelists are frustrated by the divide between mainstream expectations of Native American art and their need for genuine self-expression.

    April 15, 2014 1 Photo

  • rf-Teacher.jpg Dickerson believes in putting the student first

    As a child growing up in Elk City, Cherokee Elementary teacher Debra Dickerson lined up the neighborhood children and animals to play school.
    “I’ve been a teacher ever since I could talk. My mother always said she knew where I was because she could hear me bossing everyone,” she said.
    The classroom then was a blanket tossed over limbs of her big cherry tree on Eisenhower Street. Recess was spent tree-climbing, running, riding in the bus (her red wagon) and being creative.
    “Those were the days before video games and TV,” she said.
    Dickerson, 2013-’14 Cherokee Elementary Teacher of the Year, believes a classroom should be a safe haven for children, because school is often the best part of their day.

    April 15, 2014 1 Photo

  • kh-trash-pickup.jpg Cleaning things up

    Lowrey was part of the Cherokee Nation’s Career Service Center contingency of 11 volunteers. Other volunteers cleaned up trash along the roadway from the Cherokee Casino to the NSU campus.

    April 15, 2014 1 Photo

  • SR-NinthAmendment.jpg Right to privacy leans partly on Article 9

    While the other articles of the U.S. Constitution’s Bill of Rights are straightforward – at least, enough for Americans to bicker over in court – the Ninth Amendment might cause a bit of confusion.
    It reads: “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.”
    There are no rights enumerated, and it might be difficult to argue one’s Ninth Amendment rights in court, though it has been done successfully.

    April 14, 2014 1 Photo

  • stickball-2.jpg Stickball

    The American Indian Science and Engineering Society and Native American Student Associationat Northeastern State University hosted a traditional stickball game as part of closing cultural activities during the 42nd annual Symposium on the American Indian Friday. Participants included, from left: Nathan Wolf, Disosdi Elk and Chris Smith.

    April 14, 2014 1 Photo

  • green-bldng.jpg City council to discuss ‘green building’

    Tahlequah City Council will hold a special meeting Friday, April 11, at 5:30 p.m. to discuss, among other items, applying grant money to renovate the city’s “green building” at the corner of Water and Morgan, near Norris Park.

    April 11, 2014 1 Photo

Poll

How confident are you that the immunizations for infants and children are reasonably safe?

Not at all confident.
Somewhat confident.
Relatively confident.
Extremely confident.
undecided.
     View Results
Tahlequah Daily Press Twitter
Follow us on twitter
AP Video
SKorea Ferry Toll Hits 156, Search Gets Tougher Video Shows Possible Syrian Gas Attack Cubs Superfans Celebrate Wrigley's 100th Raw: Cattle Truck Overturns in Texas Admirers Flock to Dole During Kansas Homecoming Raw: Erupting Volcanoes in Guatemala and Peru Alibaba IPO Could Be Largest Ever for Tech Firm FBI Joining Probe of Suburban NY 'Swatting' Call U.S. Paratroopers in Poland, Amid Ukraine Crisis US Reviews Clemency for Certain Inmates Raw: Violence Erupts in Rio Near Olympic Venue Raw: Deadly Bombing in Egypt Raw: What's Inside a Commercial Jet Wheel Well Raw: Obama Arrives in Japan for State Visit Raw: Anti-Obama Activists Fight Manila Police Motels Near Disney Fighting Homeless Problem Michigan Man Sees Thanks to 'bionic Eye' S.C. Man Apologizes for Naked Walk in Wal-Mart Chief Mate: Crew Told to Escape After Passengers
Stocks