Transcript for the Piece Audio version of Why Single Payer, Part 1: We are all paying for a broken healthcare system!

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MILES

Healthcare! We hear a lot about it, but what do we really know other than we keep paying more and more for it? I?m independent producer Miles Eddy, and I spoke with three healthcare professionals in an effort to try and understand what the current system is, why it is considered ?broken,? and what some solutions might be.

Doctor Rocky White is a proponent of a single-payer healthcare system believing that it will help businesses remain competitive in a world market.

DR WHITE
I?ve been invited to the Rotary today to speak on this issue of universal healthcare, because healthcare, although it affects all of us in various insalubrious (???) ways, it affects business in a very particular way, because small business and large business are carrying the burden of healthcare on its shoulder

RUSS JOHNSON
I?m Russ Johnson. I?m the CEO for San Luis Valley Regional Medical Center.

MILES
Russ Johnson will give us an administrative point of view, and Dr. Beth Kinney will chime in from the perspective of an Emergency Room doctor.

DR KINNEY
I love the ER. One never knows what one is dealing with next.

MILES
We begin this series with some comments on the current healthcare system.

DR WHITE
In this nation, we spend close to $6,000 a year per person. The next closes nation to us in terms of healthcare spending is somewhere between three and four thousands and then it goes down from there. And yet are health outcomes are some of the worse.

RUSS JOHNSON
Most hospitals in the United States are 501(c)(3) hospitals. The reimbursement done for a private corporation like the PC use to be, the doctor/client use to be, was a fee-for-service. You have a contract with a variety of manage care organizations, or you except Medicare/Medicaid, which you don?t negotiate with, they just tell you what they are going to pay, and it?s usually significantly below what commercial insurance is. The hospital doesn?t have that. What really changes for this model financially with the hospital is that revenues that come out of those cliental services we use to supplement, frankly, the losses we take on having them just practice medicine. So we loss money on our client side and make it up, hopefully, on the hospital side.

DR KINNEY
CHC in general pays for doctors office visits and can help pay for prescriptions. However, when a person goes into the emergency center, Community Health Center does not pay anything. There is a lot of free care given away in this country, un-reimbursed by specialist and primary care doc?s alike, in order to take care of these people. However, there are many, many people with CHC who need to see specialist and basically they can. And so the patient and their primary care physician kind of struggle through and try to do the best they can with the resources that they have available which is not very many.

MILES
So what does the federal government propose to fix the system?

DR WHITE
The five major steps that Washington is trying to do to promote healthcare reform: We?ll set deductibles higher so people can put money into health savings accounts; We?re going to provide tax vouches to people who are the lower working income individuals so that they can help subsidize buying insurance; Thirdly we?ll expand Medicaid; Fourthly we?ll lower Medicare eligibility so that we can put more people on Medicare; and then allow small business to buy into these sponsored plans. And if we do that, supposedly and theoretically then we can get most people covered with health insurance. The problem is that all the emphasis is on health insurance. The cumulative effect is grater than 10% healthcare inflations when our national growth is only going on at about 3%.

MILES
So what is the effect on hospitals for those who don?t have insurance? CICP is the Colorado Indigent Care Program.

RUSS JOHNSON
The amount of services that we provided through CICP has gone up significantly.

MILES
Why and you also mentioned that the money received from them is going down?

RUSS JOHNSON.
Fewer and fewer people have health insurance, and so as employers earn less they cut their benefits down and one of them is often health insurance. At the same time, the state budget has been shrinking, so their pool of money allocated for indigent care is actually going down even thought the number of people who are falling into indigent care qualifications is going up.

MILES
Dr Kinney is a salaried employee of the Alamosa Hospital.

DR KINNEY
I know for fact that board certified emergency room doc?s can go to the city and earn up to twice what their making in the emergency room here.

MILES
So why would they work here?

DR KINNEY
Because they like working in a rural area.

DR WHITE
Let me tell you about what it means to have good insurance in this company. How many of you guys have had problems getting into seeing a doctor last time you wanted to get in? You had to wait two or three weeks! When clients start going broke, physicians are going to start leaving the rural communities, they?re going to start leaving the inner city areas and they?re going to leave these places because they can?t do it any more. What that means to you who has good health insurance, it means fewer doctors are going to be around for you to see.

MILES
In the next part of this series, we?ll continue our conversation with Dr. Rocky White, Mr. Russ Johnson, and Dr. Beth Kenney, and take a look at the role of insurance and pharmaceutical companies in our current healthcare crises.

Reporting from Alamosa, Colorado, and produced in the studios of Midi Age Productions, I?m Miles Eddy.

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