by David Flint
On Monday afternoon Congressman Scott Murphy brought his Congress-On-The-Corner to the Roaster’s Whim Café in Nassau, just across the line from West Stephentown. With health care reform the hot topic, the parking lot was filled to capacity with the vehicles of the media and constituents.
Murphy wanted to talk about other things as well, such as the steps he’s proposing to help area dairy farmers who are being crushed by falling milk prices. But most of the questions posed to him had to do with health care reform.
Several people, such as Martha from Poestenkill and a man from Glens Falls, wanted to know if a public option is made available, what would stop their employer from dumping the health insurance they carry now and sending their employees to the public option which might very well not be as good as what they had. Murphy responded that the current House bill includes a penalty for doing that. The employer would have to pay a fine into a pool. Companies would also be under some competitive pressure, not wanting to lose good employees to another company.
Lynne from Clifton Park said nobody seems to be talking about tort reform or illegal aliens in conjunction with health care reform. Murphy agreed that nothing in the House bill addresses these issues, but he and others are looking at ways – for example an evidence based system or loser pays provisions – to provide justice when people are harmed, but to do it in a more sensible and efficient way. He said there is no intent to provide illegal immigrants with free medical care but the whole question of illegal immigration needs to be reconsidered.
A man from Glens Falls wanted to know why the government is getting involved in end of life care. Murphy responded that the House bill proposes only that doctors be reimbursed for their time if they sit down with a family and have a conversation about planning end of life care and help them to make decisions. Mandatory counseling, he said, would be “a horrible idea.” Murphy added that there is nothing in the bill about rationing health care. The intent is just to keep costs contained.
Stephan Sell, a retired physician residing in Stephentown, asked if the single payer system was now off the table, and he questioned that with many people now afraid to go the doctor for fear of going bankrupt, why not take the profit motive out of health care or at least expand Medicare to younger people. He also suggested that nurses and other paraprofessionals might be given more responsibilities to reduce costs. Murphy noted that not all hospitals or all insurance companies are for profit. He agreed that nurses and physician assistants could be doing more because, “You don’t have to go to the doctor for the sniffles.” He said there are some provisions in the bill for this but not enough. Regarding the single payer system, he said that most Americans apparently want some choice and, “single payer is not where we’re going right now.”
Several people appeared skeptical that the government could do a good job with a health care public option, pointing to the fiscal irresponsibility displayed in the Social Security and Medicare systems. Murphy agreed that funding for those programs should have been better handled but pledged, “We’ll do a better job with the public option.” It would have to be self funded, run like a private insurance company and actuarially sound after some startup money has been supplied. If it does a poor job and costs go up, people can still choose MVP or Blue Cross.
Murphy asked for a show of hands regarding people’s preferences about health care reform. Some wanted no government involvement at all; some wanted reform but without a public option; a larger group wanted the public option and a group of about the same size wanted a single payer system. But apparently nobody thought that no change at all was a good idea.
