GREENVILLE, Ky. (8/6/13) – U.S. Senator Rand Paul (R-KY) made a surprise stop at Muhlenberg Community Hospital (MCH) in Greenville Tuesday, August 6th, to discuss the future of healthcare in America with John Countzler, MCH Chief Executive Officer. There was no big fanfare, no campaign-type hand shaking around the hospital. The two men simply found a quiet room and sat face to face discussing the current state, and future, of healthcare in America.
SurfKY News was exclusively allowed to sit in on the meeting. Showing his infamous dry wit, before diving into the complex issues of healthcare, Senator Paul asked if the reporter had any questions.
After mentioning to Senator Paul that Secretary of State Grimes was campaigning in Muhlenberg County last week, he asked, "Did she say anything nice about me? She didn't say anything nice about me at Fancy Farm. She said I was in Iowa. Just for the record, I was not in Iowa. I was in Bowling Green at my son's soccer match." Paul said.
Then the two men sat down to focus on more serious issues. Senator Paul, a strong opponent of Obamacare, is the son of former U.S. Representative and physician Ron Paul. Senator Paul is a former practicing ophthalmologist with over 20 years’ experience. So, to say the least, agree or disagree with the man, there's no debate in that he knows the intricate ins and outs of healthcare.
Trying to get a grasp on the needs and concerns of hospitals across the state, as the Affordable Healthcare Act continues to fall into place, Paul started with the basics of local medicine.
"How many family doctors do you have in the county?" Paul asked Countzler.
"Around eleven, and I'd say two of those are independent. The rest are associated with Baptist Healthcare in Madisonville." Countzler replied.
"So do those doctors bypass your hospital and take patients to Madisonville?" Paul continued.
"Well, some of the time." Countzler said.
Paul continued, noting that he "worked at Graves Gilbert Clinic in Bowling Green for about 11 years, and then I finally started my own practice. My wife asked me, 'Why did you spend all this time and money, and buy all this equipment... and then run for office?’ I told her, 'Well, honey, I didn't think I was going to win." Paul joked.
Paul said he had mixed feelings on the computerization of medical information.
"I like the fact that it gives you a template, so if a number of people come in with the same symptoms you know where to start. But now even the government is complaining because doctors are taking such complete notes. Everything is documented. It sort of loses sight of the most important thing. 'You can tell me everything about the patient including his shoe size but does the patient have appendicitis or doesn't he?"
Countzler agreed, noting, "We did see a drop in our ER productivity but it's now back to where it was."
Countzler brought the discussion around to what both men were concerned with...what will happen on January 1st, 2014, when large portions of the healthcare act take effect.
"We're watching to see what Kentucky is doing. You've talked about Medicaid expansion, and Kentucky hasn't quite figured out what they are doing with the exchange," Countzler told Paul
"Well, Congress is a part of that too. My own insurance will be through the exchange, and we have no idea what it will be." Paul admitted.
Getting to the core of his argument against the Affordable Healthcare Plan Paul noted that "the hard part is, and this is where I think it can be counterproductive, let's say you work in a fast food job and make $20,000 a year. And the insurer has maybe 30 workers. You are mandated to buy insurance. You couldn't afford it before and you still can't afford it. If you make $20,000 a year, what if the policy costs $20,000 per year, which it very well could. Or maybe the cheap plan is $15,000. It's just ridiculous. So we haven't helped anybody, except that this poor person trying to get started in the workforce now has to pay a penalty for not buying insurance because they can't afford it. So I really think there is going to be a lot of unintended consequence to this."
Turning to Medicaid, Paul said, "The other problem with Medicaid is that in the short run it might help, but also, if those were paying patients, who don’t get converted to Medicaid, it's going to make it more difficult for the hospital to make a profit, and somebody has got to pay for it, through taxes."
"It's a pretty big increase. If you think about something in your business that increases a couple of percentage points, that's one thing. But you usually don't look at Medicaid increase by 50%. I'm worried about, when the bills come due, who's going to pay for them?" Paul added.
Countzler noted that, "We have been looking at our own hospital employees' health insurance. From a benefit standpoint we're set up very well. I think we're okay as far as the premium share."
Paul noted that one of his biggest concerns is "young healthy people, who make the decision not to buy insurance now. That's less people in the pool, so the pool becomes the sick people, and everything becomes more expensive. Because, what if I'm 25? I would buy insurance because I don't have a pre-existing condition. But with the new plan, now I can buy it at any time. So I wait until I get in a car wreck, I'll buy my insurance as they are wheeling me in on the gurney. But for the ten years, or maybe forever, that I don't get sick, I don't buy any insurance, and I'm outside the insurance pool. If that happens in a big way, insurance will become more expensive for everybody."
Paul then turned to the Obamacare worst case scenario for businesses. "So what if you have a thousand people working for your business," Paul used as an illustration. "And your competitor doesn't insure their employees, but you do? Then you have an incentive to drop your employees, in order to compete."
Countzler replied that "I'm still not sure where I come down on the delaying of the employer mandate. I have mixed feelings about that."
Senator Paul's take on the subject?
"Well, it's not fair to the individual. However if you think it's a bad thing maybe it's good to delay it. The point is we all need to figure out if it's good or bad, and decide. I think they (the Democrats) are delaying it to get beyond the next election. I think the biggest worry the Democrats have is how much is this stuff really going to cost. Mandating that insurance has to have more things in it, it's got to be more expensive. If the cheapest plan is 12 thousand, or 15 thousand, it really doesn't do anyone any good that doesn't get their insurance through their employer. Even if you make as much as $40,000 a year, $12,000 is too much. You really need to do the opposite, to mandate less, and have a higher deductible. But I don't think those will be sold under the exchange."
Senator Paul will be back in Muhlenberg County Thursday, August 15th, for a "Meet & Greet" at 3:45 pm, at the Greenville McDonalds. The senator has said he will welcome questions from those who would like to discuss any issues or concerns.
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