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Doctor points to insurance for woes

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Chicago’s Orris speaks to area health consortium

By Rick Miller
Olean (N.Y.) Times Herald, March 6, 2015

OLEAN — The U.S. health care system is more costly and less effective than many other developed nations, a Chicago physician told members of the Cattaraugus County Healthy Liveable Communities Consortium on Thursday.

Dr. Peter Orris, a professor at Rush University and Northwestern University’s School of Medicine specializing in occupational and environmental medicine, told the audience at Bethany Lutheran Church that many health care shortcomings in the U.S. are the result of insurance companies.

Believing that a quasi-market approach to health care was the best way to go, the Affordable Care Act, or Obamacare, relies on for-profit insurance companies.

“Many of us have been critical of that for some time,” Orris told about 50 members of the Health Liveable Communities Consortium. “There is a disconnect between the cost of disease and the profits of providers and hospitals.”

A lack of controls and a lack of balance drives up costs. Health costs in the United States are about $9,160 per person per year, Orris said. That’s $3,000 above the cost of other developed countries, and often the results are not as good, he claimed.

Health insurance adds 30 percent to the costs of health care, Orris said.

Today’s market-defined health care is a far cry from the black bag and home visits by a doctor up until the early 1900s, Orris said.

“Most decisions are being made 500 or 1,000 miles away” nowadays, he added.

Insurance companies, he said, “make their money by holding on to your money.

“Every day they don’t have to pay a reimbursement to a hospital is money in their pockets,” he explained. “They get to hold the money for another couple of weeks.”

Hospitals have learned to increase their revenue by accurate billing and maximizing revenues, according to Orris. Money is being put aside instead of going into health care.

“There is a built-in overhead in the system,” he said. Orris expressed concern that despite higher health care spending, the United States had higher infant and maternal mortality than many countries.

The availability of medical health insurance under the Affordable Care Act should help the formerly uninsured and underinsured who might otherwise delay medical diagnosis and treatment.

However, Orris warned of high‑deductible health plans that could have the same effect on beneficiaries, who could delay treatment due to costs. With high-deductible policies, “most everything” comes out patients’ pockets, Orris said. People can delay treatment if they can’t afford it, he added.

The Affordable Care Act is providing health coverage for millions of families who did not have health insurance previously.

“It left the fox sitting at the henhouse,” Orris said.

In Canada, where there is national health insurance and a single-payer system, health care costs are 11 percent of the economy, while in the U.S. the amount is 18 percent.

Because of the quasi‑market approach of the Affordable Care Act, leaders “are unable to move ahead with logical changes in the health care system,” Orris said. What is needed to change the health care system locally is for patient organizations and organizations representing doctors and hospitals to get together and demand changes from insurance companies, according to Orris. One of the ways the Affordable Care Act is seeking change is by tying hospital reimbursement to scores from patient discharge surveys.

“Those answers, for the first time, will be affecting rates of reimbursement,” Orris said.

Orris was introduced to the group by Dr. Kevin Watkins, Cattaraugus County public health director, who knew him when he still lived and worked in Chicago.

The Cattaraugus County Healthy Liveable Communities Consortium, which meets four times year, was created to help county residents lead healthier lives by making good life choices.

In another development, John Eberth of Southern Tier Health Care Systems said the group is offering training for first responders and friends and family members of heroin addicts in the use of Narcan, which blocks opiate receptors in the brain and is used to help someone recover from a heroin overdose.

“Narcan saves lives,” Eberth told the group. The heroin antidote was recently used to save a local 13‑year‑old, he said.

Police officers, firefighters and family members of heroin users who want training in administering the drug can contact Southern Tier Health Care Services in Olean.

Contact reporter Rick Miller at rmiller@oleantimesherald.com. 

http://www.oleantimesherald.com/

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