Wednesday, August 19, 2009

A Doctor's View on the Healthcare Reform

Dr. Winfred Parnell, is not only committed to providing his patients the best of healthcare as a local obstetrician and gynecologist but he is also an advocate for healthcare reform. Speaking Monday as a member of the Community Panel on Proposed Healthcare Reform, Dr. Parnell dismissed the notion reform would lead to "socialized medicine" with assurance, "We will put together a uniquely American program." He also reminded the audience of the importance of getting the right information out, to allow citizens to make a more informed decision regarding which proposal they support.

In fact, Dr. Parnell's concern is the debate derails the reform process and "we do nothing." He challenges those who do not want a public option - fine - bring a solution for the public to consider. Simply saying no is not a solution.

In recent days the idea proposed by Sen. Kent Conrad (R-ND) described as a "nonprofit healthcare cooperative as an alternative to a government insurance plan "commonly referred to as co-ops has gained momentum in the debate. However, Dr. Parnell stated the only successful version of a medical co-op worked well because it operated like an insurance program. Many feel the same issues would persist under a co-op without addressing the underlying problems of affordable access for everyone.

The Community Panel included representatives from Baylor and Parkland hospitals; the business community and Aetna insurance, they all agreed there was a need for healthcare reform. Leading Dr. Parnell to observe, "Doctors want it, patients want it - who is between it?" He feels it is critical political rhetoric be removed from the debate.

Key elements for successful reform will include providing doctors and hospitals incentives to work together according to Dr. Parnell. Stating that what we have now is "sick care" Dr. Parnell advocates providing pay-for-performance incentives. Many have argued by making the public aware of the quality of services provided in the medical community, an informed medical consumer will receive better care.

Dr. Parnell is one of the founding physicians of Carlos Parnell, Jones & Diaz in Dallas, he is an active member of the medical staff at Medical City Hospital, serving in leadership positions on numerous hospital committees, Chief of Staff during the 1995-1996 term.

Receiving his Bachelor of Science from Florida A&M University, Doctor of Medicine from the University of Florida, he completed his internship and residency at Parkland Memorial Hospital and UT Southwestern Medical Center. Dr. Parnell is a member of North Dallas Community Bible Fellowship. He and his wife, Debra, are the proud parents of twins (Winfred and Wendy). He enjoys traveling and skiing.

Health Care Reform Debate Takes Center Stage in Dallas

Although Monday's health care reform town hall meeting in Dallas was moved to accommodate overwhelming public demand for free tickets, the crowd inside was much tamer than it was outside.

In a low-key panel discussion, U.S. Representatives Eddie Bernice Johnson (D-TX) and Pete Sessions (R-TX) presented their opposing ideas on health care reform and fielded audience questions. Each reiterated their parties' positions on the subject and, at times, gave their emotionally charged opinions.

In her opening remarks Johnson described the need for healthcare reform as a "moral obligation to ensure universal access." She said Texas has the highest rate of uninsured people in the United States, with some at risk of bankruptcy due to healthcare costs.

Johnson said she has read each of the three bills currently under consideration in the U.S. House of Representatives, and she favors the public option, which she described as an opportunity for the uninsured to go into a pool and purchase affordable coverage.

Sessions said the public option is a form of "socialized medicine," to which Johnson immediately responded "better than nothing," to the applause of many in the audience.

Johnson, who is a registered nurse, previously worked in psychiatric services at the Veterans Administrations Hospital in Dallas. She is the 30th Congressional District of Texas representative. This includes Downtown Dallas, Fair Park, Oak Lawn, Old East Dallas, Pleasant Grove, and South Oak Cliff, and other areas. Johnson said there are over 220,000 uninsured within the district.

For the uninsured, preventative and primary care is lacking for many because they do not seek medical attention until they are very sick and show up in the emergency room, said Johnson. She said this results in several tests - at a cost to the public - because emergency room professionals have no prior medical history for the patient.

Johnson said she wants health care reform to address quality care and stability for patients despite their income level. Johnson would like to eliminate pre-existing clauses and ensure coverage when there are changes in employment. She said people should not be forced to stay in undesirable jobs just to maintain insurance coverage.

Sessions recognized there is a health care problem, but said he is concerned that the current proposals will provide a huge cost shift to the federal government. Instead of a public option, he proposed actions such as doubling the funding for the National Institute of Health, whose research in recent years has paved the way for significant decreases in deaths due to cancer, heart attacks and high cholesterol

Citing what he considered Republican health care success, Sessions said Medicare prescription reform has led to $4 prescription co-pays. He also said the health savings account, which allows participants to deposit pre-tax monies is a Republican success. And he repeatedly referred to expanding the program by allowing individuals to enjoy the same tax benefits all corporations receive.

Sessions advocates patient controlled coverage, which he said would allow consumers to have insurance portability, allowing them to keep the same insurance provider year to year. He also called for national tort reform to eliminate the $150 billion per year spent in lawsuits.

Sessions believes the current proposals are too ambitious, as they tackle 220 million who have good insurance, rather than simply addressing the 46 million who lack coverage. He said everyone will be heavily taxed, and about 120 million people will be shifted to the public option by their employer, not by choice.

Sessions said patient care will suffer because patients will not be able to choose their doctor as they will be placed in a pool. And he said they will have difficultly seeing a physician there are not enough doctors in place to handle the influx of patients to universal coverage.

Sessions said the Republicans support associated plans offering people the opportunity to band together and buy as a group across state lines, and he cited realtors as an example. Sessions agrees with Johnson that insurance companies must move toward eliminating the pre-existing condition clause.

Sessions and Johnson disagreed on the cost effectiveness of the public option. Sessions said it would "tax the stuffings out of business." When he asked who would pay for it, Johnson said Parkland hospital provided $520 million of uncompensated care last year. She said people visit Parkland because other hospitals will require $500 before you get any care. Johnson said this cost is coming out of taxpayers' pockets.

Sessions changed the tone of the discussion when he dismissed the co-op proposal because he said there is no need to create a new entity. He even suggested many problems are a result of a lack of personal responsibility, citing knifings and drug usage as examples.

"When someone is paying for something in America, they treat it differently," Sessions said.

A stunned Johnson replied, "I don't even know how to respond to that," which was greeted with applause.

She added, "With insurance coverage for everyone at a reasonable cost, we would not have a problem." Johnson pointed out insurance companies charge about the same as each other, eliminating competition in the marketplace.

Johnson closed by saying, "Anything that is for the people is hard to come by."