Ted Kaufman - United States Senator for Delaware

Delawareans cheer extending coverage, but remain wary of reform plan's details

Source: The News Journal

By RACHEL KIPP

December 25, 2009

President Barack Obama lauded the Senate's historic Christmas Eve passage of the health care reform bill as the most important piece of social legislation since Social Security.

Delawareans were a bit more skeptical.

They cheered the proposed extension of coverage to millions of uninsured Americans, including an estimated 105,000 in the First State, as a significant step forward in the nation's history. But many wondered what the legislation would look like after what are expected to be arduous negotiations to reconcile the House and Senate versions.

"There's a potential for it to be the biggest thing since Social Security; obviously it's the biggest thing since Medicare and Medicaid," said Wayne Smith, president and CEO of the Delaware Healthcare Association, the trade group that lobbies for the state's hospitals. "After this, there should be less uninsured, that's a good thing just morally and we're a compassionate nation."

Octavio Sanchez, 37, an industrial mechanic who has been out of work for about six months because of a back injury, hopes it will help uninsured people like him receive medical care while between jobs.

There are so many Third World countries that do a better job at insuring their people than we do, he Other key stakeholders, such as physicians, hospitals, insurance companies and pharmaceutical manufacturers -- are approaching the proposals with trepidation.

They know the broad outlines of the bill -- that the government for the first time will require nearly every American to carry insurance and that the insurance industry will no longer be permitted to deny benefits on the basis of pre-existing medical conditions. But the rules and regulations of how the overhauled system would work are unknown. So are the effects of reduced payments to insurance companies, doctors and hospitals that treat Medicare patients.

"What you saw in Massachusetts, which has had a form of this for four or five years, is that when you give people more insurance, utilization of the health care system goes up dramatically," said Smith, former Republican state House majority leader. "The concern is that there are not enough physicians, nurses and physician's assistants to handle what will be the initial surge of folks seeking medical services."

Doctor sees help for working families

A practicing physician for 13 years, Dr. Jo Ann Fields has seen patients left "high and dry" after being denied coverage by insurance companies due to pre-existing conditions. She also sees patients with no insurance because they make too much to receive Medicaid but not enough to pay for coverage on their own.

"These are people who run pest control companies, day care centers, small contracting businesses, small trucking businesses and people who are self-employed," said Fields, a primary care physician in Kent County. The bill "will help them get more affordable health insurance. A lot of them right now are taking their chances with not having insurance coverage and that's playing Russian roulette with their bank accounts and with their health."

Fields was disappointed the Senate bill omits a government-run insurance option, which she thinks would help to control and contain the escalating cost of health care and insurance premiums.

She stressed that the final version of the legislation must include methods of funding the proposed health care subsidies, such as a tax on "Cadillac" insurance plans and a minimum medical loss ratio or the requirement that insurers spend a certain percentage of premium funds on medical care rather than other expenses or profit.

"If we don't contain rising health care costs the system is still going to be unaffordable," Fields said. "It's going to go up every year and the government is not going to be able to continue to subsidize people if premiums keep going up.

"At some point, you've got to contain the increases to health care costs. Otherwise, the whole package that was just passed, 10 years from now is not going to be the answer."

'Jury is still out' on final product

She said about 25 percent of uninsured Delawareans are eligible for Medicaid but are unaware of it, or unwilling to sign up. Also among the 105,000 are young adults who could get health insurance from their employers but choose to pocket the money they would pay for premiums.

"Large groups of [unhealthy] people coming into the system would have an impact on costs but, going back to loss ratios, I think now having a flood of healthy people coming in is going to create more of a balance," Stewart said.

AstraZeneca, which has its U.S. headquarters in Fairfax, issued a statement Friday saying the company "is committed to working with the administration and Congress to help enact comprehensive health care reform that promotes market competition, ensures patient safety, expands coverage for the uninsured and fosters innovation while protecting intellectual property."

Del. senators call bill 'historic'

The Senate bill passed with a 60-39 vote presided over by Vice President Joe Biden. Fifty-eight Democrats, including Delaware Sens. Tom Carper and Ted KAUFMAN, and two independents voted "yes." Republicans unanimously voted against the legislation.

"Today's vote was historic," KAUFMAN said. "We took a critical, monumental step toward ensuring the long-term well-being of our nation and citizens."

Carper agreed, saying that "the American people have waited too long for affordable and accessible health care."

Biden said the Senate vote brings health care reform a step closer to reality.

"This bill includes the fundamental, essential change that opponents of reform have resisted for generations," he said. "Now, 30 million uninsured Americans are one step closer to access to affordable health care coverage and soon enough, insurance companies will no longer be able to deny coverage to those with pre-existing conditions or drop coverage when people get sick. I join President Obama in congratulating my colleagues in the United States Senate for their historic vote."

But Delaware Republicans echoed national party leaders in deriding the bill as ill-conceived and politically motivated.

Rep. Mike Castle, who is running for Senate, said some states were given millions in federal funds to continue Medicare or Medicaid programs while others -- including Delaware -- received no additional money.

"Exempting certain states while putting an additional burden on the remaining states is simply unacceptable," Castle said. "Every legislator is expected to fight for the interests of their state. However, the basic merits of legislation should be the determining factor.

"Instead, the focus on lowering the cost of health care insurance coverage and services for all has been neglected in favor of individual state buy-offs."

State Republican Party chairman Tom Ross predicted that, if signed into law, the bill would lead to less coverage and higher prices for most Americans.

"Would they, for the first time in over 100 years, be voting on Christmas Eve if this was something to really be proud of?" Ross asked. "Wouldn't they take the time and explain to all of us exactly how it's going to work?"

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