In congress' hands

On Monday, the Political Science Honorary Society, Pi Sigma Alpha, along with the Public Affairs Club, Masters of Public Administration Student Organization and Omicron Delta Epsilon (economics honorary), organized and presented a panel of health care officials to speak with students about the current reform bill before Congress.

Issues The first question the panelists were asked was whether or not they believed a public health care option would lower the costs of health care in North Dakota. Dwight Thompson, CFO of Obligated Group and Affiliated Corporations and Altru Health System employee, expressed his doubt saying, "It's hard to imagine taking care of 35 million more people and lowering costs. I just don't see it happening." Panelist Rod St. Aubyn, who previously served on the Human Services Committee of the ND Legislature and current director of Government Relations for Noridian Mutual Insurance Company (Blue Cross Blue Shield of North Dakota) echoed his opinion when he talked about reimbursement rates for North Dakota being significantly lower than most states. Because the federal government has not kept up with the costs, it has shifted to private insurance. If the private sector lowers its reimbursement rate to that of a public option, St. Aubyn fears the area will lose specialists and facilities. Tim Sayler, COO for Altru Health Systems has been with the company since 1983, agreed, saying, "Overall costs will increase because someone has to pay for it."

Joshua Wynne, interim vice president for Health Affairs and interim dean of the UND School of Medicine and Health Sciences and practicing cardiologist, explained to the audience that 45 million people in America currently are uninsured. 10 million of those are disregarded since they are not US citizens, leaving 35 million uninsured people to work with. Of those, one quarter choose not to be insured. The other three quarters are assumed to either be too poor or too sick to have health insurance. Alvin Boucher, a lawyer specializing in senior health care and medical insurance shared that it's beneficial to society to figure out a public option, because the increasing number of individuals who are unemployed are not being productive, contributing members of society. He also said tying the reimbursement rate into the Medicare rate would devastate North Dakota, because it's just too low. St. Aubyn joined in again, saying initially Medicare was established with the intention of being the prevailing rate. Now it's much lower.

Some people fear this would happen with the public health care option.

Another question was whether or not opening state lines to purchase health care in other states would be beneficial. St. Aubyn explained that different states have different mandates.

The more mandates a state has, the higher the cost of premiums. North Dakota has the lowest premiums. "Insurance companies contact providers to work out a fee schedule in order to give members discounts. Allowing people from New York to purchase health insurance in North Dakota where premiums are lower would result in either the consumer having to pay more, or the premiums going up so someone could pay for it."

The third question was why Medicare reimbursement rates are lower in ND than other states. Wynne began explaining this one, saying that if the cost of labor is less in Grand Forks, they are able to meet their costs easier with lower reimbursement rates.

Thompson added, "Yes, but cardiologists come from a national market and demand being paid the same in Grand Forks as they do in New York. The index does not always recognize that." St. Aubyn added that there is a political aspect as well. "It's hard to take money from one area and give it to another, especially when there are a low number of congressmen for North Dakota compared to other states."

Next, the panel was asked whether or not there would still be uninsured people after healthcare reform. Dr. Wynne said the House and Senate's pending bills are regarding health insurance reform, not health care reform. "The goal is to get most people insured, but the question is how to do that." He explained the theory is it would be better for the country to pay for primary health care for individuals than to wait until they reached the point of an emergency. Then citizens tax dollars go toward emergency room visits.

Boucher added that there would be a tax penalty for those who choose to remain uninsured. St. Aubyn agreed that while this is true, the current pending bill has the tax penalty at $750. He said the problem arises when young, healthy people chose to pay the $750 fee and then purchase $200+ a month health care once they get sick, dropping it again when they become healthy. "The penalty is too weak," he said. "It's a joke." He also added the bill proposes allowing parents to claim children on their health insurance until they are 27 years old starting in 2013. This will allow for better health coverage for those attending graduate schools.