Discussing health care
June 29, 2009
Tim Leeds Havre Daily News [email protected]
State Sen. Jonathan Windy Boy, D-Box Elder, heard about a variety of problems and issues Friday when he held a forum on reforming health care. U.S. Department of Health and Human Services Secretary Kathleen Sebelius appointed Windy Boy and 29 other state legislators from across the country to a group to provide information on health reform from a stategovernment perspective. Windy Boy held the Havre forum to gather information for that group and for the Montana Legislature, he said. “What we were tasked to do is assist in gathering information,” Windy Boy said when he opened the meeting, adding that the information will be used to help the White House prioritize issues in the push for health care reform. That ef fort , spearheaded by Montana's senior senator, Democrat Max Baucus, is now being written in Congress. President Barack Obama has said he wants to see legislation passed by October. Representatives of the health care and insurance industries and the Native American community opened the meeting with prepared remarks, and then the forum was opened to questions and comments from the audience. Audience member Chuck Grant told the group he believes the people who need help with health care the most have been forgotten in the discussion on reforming health care. There are two Americas, Grant said, one where people already have health insurance and receive health care,Another where people do not. Grant said everyone in the community knows someone who has lost their home due to medical expenses. He added that no one should have to see a child die because of lack of care, saying that he knows of a 9-year-old girl who died of appendicitis because her father couldn't afford to take her to the hospital and delayed finding her medical attention when she started having pain. Something needs to change, and many people can't wait until October, Grant said. “It can be done. It's done all over the world,” he said. Havre attorney Phillip DeFelice said the problem in the U.S. system comes from what he called an “unholy alliance” between medical providers, insurance companies and drug companies which all “feed off of each other.” The six-member panel at Windy Boy's forum discussed different aspects of health reform. One topic was the need in Indian Country in Montana. Panel member Bum Stiffarm, the chief administrative officer of the Fort Belknap Indian Community, said the federal government is under obligation by treaties to provide health care for Native Americans, but the government has not lived up to that obligation. “We're very unhappy with the services provided by Indian Health Services,” he said. Part of the problem is attracting and keeping health care professionals, Stiffarm said. Fort Belknap has one dentist for 3,500 people and doesn't have an optometrist. He said people are transported to Havre for some care, with individuals getting on a bus at 5 a.m, then having an appointment from 8 a.m. to 8:30 a.m. and then waiting all day until the other individuals complete their appointments. Some people can't afford to make special trips for specialized treatment, he added. “So many do not go, and they die,” he said. Audience member Alvin Windy Boy, former chair of the Business Committee at Rocky Boy's Indian Reservation, said he recently attended a meeting in Washington and was not impressed with the progress or lack of it in the five years he has been out of government. He said he doubts any change actually will happen. For Native Americans, improving the programs on the reservations is key, he said. “For some of us, that's the only game in town,” he said. Audience member Tracy King, a member of the Fort Belknap Tribal Council, said another problem is having too many agencies. Military veterans on the reservations often are shuffled back and forth between agencies, such as Indian Health Services and Veterans' Affairs, delaying or preventing their care, he said. One of those people is his own daughter, a veteran of the war in Iraq, he added. King likened the situation to a tennis match with Venus and Serena Williams, with the government taking veterans and “batting them back and forth.” He said the situation leaves veterans homeless, war heroes dying on the street. “I'm tired of the government looking at people as road kill,” King said. “Those people who die are somebody.” Dave Henry, chief executive officer and president of Northern Montana Hospital, said one solution might be simplifying the systems, like providing a Medicaid card to all of the people now served by different agencies. “Instead of creating a new insurance company, how about expanding what we have?” Henry asked. Havre optometrist Gary Stremcha, a member of the panel, spoke primarily as a representative of small business. He said Havre Optometric Clinic does not offer health insurance to its employees, primarily due to the high cost. Most of the employees at the clinic have health insurance through their spouses, Stremcha said. Employees have left their jobs as their situations change and they need to have employer-offered insurance, and the clinic has been passed over by some potential workers because of the insurance issue, he added. “I'd kind of like to know if we are in the majority or in the minority in this area,” Stremcha said. Joe Uhl, director of rural services for the Center for Mental Health in Havre, said the center does offer insurance, but the rates are climbing every year. “Many employees still can't afford their own piece of that insurance,” he said. He said most of the people who use the center's services have government insurance such as Medicaid. The time needed to process that is a major problem, Uhl said. “We still have a room full of people who work for us who do nothing but billing,” he said. “It's kind of a nightmare.” Havre insurance agent Steve Mariani said he can remember when buying dental, vision and medical insurance cost $50 a month. The situation has changed immensely. “I've never seen this kind of complexity in an issue to deal with,” he said. He said several principles need to be followed in reforming health care, including making sure it is affordable and available, with accountability and primary care a key to improving the situation, as is educatingpeople about options and healthy living. Mariani added that a key to any changes made is making sure the changes are sustainable. Lori Henderson, administrator of the long-term care facility at Northern Montana Hospital, said the people writing the reform also need to make sure that care is not forgotten. There seems to be an emphasis on shifting toward in-home care, but that will not work for all people, Henderson said. Some people cannot live by themselves, and not all can afford 24-hour in-home care, she added. For some people, going to a home is the best option, Henderson said. “The plan must acknowledge that these people exist,” she said. John Flink, vice president for governmental affairs for the Montana Hospital Association, said he sees things from a statewide perspective. It is a major issue, he said, adding that Montana hospitals provided $140 million in unpaid care last year. Flink said the association supports many parts of health care reform, including ensuring that all Americans have access to health care, increasing wellness and preventative programs, and paying special attention to rural and sparsely populated areas. Windy Boy said the information collected would be sent to the U.S Department of Health and Human Services as well as being available at the state legislative offices in Helena.