How much medical care is enough? Town-hall meeting takes up debate
| Wednesday, Jul 01 2009 06:46 PM
Last Updated Wednesday, Jul 01 2009 06:46 PM
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Debate over who should control access to the U.S. health-care system figured heavily into a panel discussion Wednesday that local organizers said could help shape reform efforts in Washington.
While the gathering at Bakersfield Memorial Hospital examined many challenges facing the industry and consumers, the more impassioned statements focused on who should decide how much medical care is appropriate -- the patient, the government, health plans or hospitals and doctors.
Several but not all of the panelists expressed skepticism that the government could efficiently administer a single-payer health-care system or, alternatively, improve market competition by creating a federal health insurance plan -- a proposal now gaining momentum in Washington.
But there was consensus that some form of change is due, evident by escalating costs and what some described as insufficient preventive care as well as excessive use of life-prolonging measures for terminal patients.
A question that repeatedly came up was how to create financial incentives that would promote responsible, quality health care.
Dr. Ravi Patel, of Bakersfield's Comprehensive Blood and Cancer Center, noted that 20 percent of patients account for 80 percent of the nation's health-care spending. He and others advocated greater personal responsibility on the part of patients.
Dr. Michelle Quiogue, head of the Kern chapter of the Academy of Family Physicians, suggested giving doctors more responsibility for their patients' health, which she said would force them to keep closer tabs on their patients and reduce unnecessary procedures. She also called for greater communication and transparency among the physician community.
The panel's biggest proponent of more government involvement in health care was Steve Schilling, CEO of Clinica Sierra Vista, a Kern-based system of medical clinics. Although he said the nation was not "prepared emotionally" for a single-payer system, he asserted that people should not "be afraid" of a larger government role in health care.
But panelist Sean McNally, vice president of human resources at Grimmway Farms, all but wrote off government involvement.
"I don't trust the government to come up with a solution better than what's out there now," he said.
Panelist Dr. Les Burson, an emergency department physician at Bakersfield Memorial, said that eventually patients will have to get used to the idea that they cannot get unlimited care.
Burson told of a patient who requested an expensive medical test when a painkiller was all that was needed.
"People have to come to a realization that, at some point, this (idea of unlimited) health care has to stop."
About 100 people were present for the event; some of them asked questions that were addressed by panel members.
Bakersfield Memorial said its parent company, Catholic Healthcare West, would summarize points made in the discussion and forward them -- along with summaries of similar meetings at its other hospitals -- to the White House and Congress.
Panelist Jim Costa, a Democratic congressman, said the House of Representatives and the Senate would likely pass versions of health-care reform next month, then work to iron out differences between their plans as soon as October.
