Wednesday, January 22, 2014

EDITORIAL >> Time to fix health care

If you want to know what’s wrong with health care in the U.S., read an in-depth article in last Sunday’s New York Times. Much of the article is about a professor at the University of Central Arkansas who underwent an expensive procedure at the Arkansas Skin Cancer Center in Little Rock to remove a small cancerous spot on her cheek.

The story is online at

Since the Little Rock newspaper ran about half of the article, readers missed the comments at the end from a UAMS dermatologist who questioned the need for such an expensive procedure.

Professor Kim Little, who teaches history at UCA, underwent an expensive Mohs surgical procedure that ran the cost up to more than $26,000. The operation involved a dermatologist, an anesthesiologist and an ophthalmologist who is also a plastic surgeon.

The UAMS doctor told the reporter the Mohs procedure was unnecessary and the operation should have been done for much less.

But when you’re told you have a cancerous spot on you cheek, who’s going to do comparison shopping?

Although Professor Little has insurance, she has a huge deductible and wasn’t happy about paying several thousand dollars for the operation out of her own pocket. She finally negotiated her portion of the bill down to about $4,500, which should have been the cost of the entire procedure.

Multiply Professor Little’s experience by several million and you can see why we spend an astonishing $2.7 trillion a year on healthcare.

As medical bills keep rising, it appears the Arkansas Legislature, rather than addressing the problem of high health-care costs, is determined to defund the state’s short experiment with the so-called private option, which insures thousands of Arkansans with the help of federal subsidies at no cost to taxpayers.

The state legislature last year narrowly ap-proved the private option, which was crafted by Sen. Jonathan Dismang (R-Searcy), House Speaker Davy Carter (R-Cabot) and others. It was a smart move that other states are emulating. The program is completely funded through Medicaid, which will cover all costs for the next several years and as much as 90 percent after that. Hundreds of millions of federal dollars will insure thousands of Arkansans. As a result, dozens of hospitals in our communities will stay open and will no longer have to write off billions of dollars in uncollected debt.

But legislators like Rep. Joe Farrer (R- Austin) hope to kill the private option, which will create a huge deficit in the state budget if they succeed. Thousands of Arkansans will lose their insurance and hospitals like North Metro Medical Center in Jacksonville, where Farrer is a physical therapist, could close. North Metro, like almost every hospital in Arkansas, depends on Medicare and Medicaid reimbursements. If Farrer gets his way, those funds will go to poor states like West Virginia and Kentucky, where hundreds of thousands of people are being insured for the first time.

When you’re in the legislature, people like Farrer are eligible for government insurance, but for less fortunate Arkansans, the private option is critical. Unfortunately, a two-thirds majority is needed to reapprove funding for the private option. That’s a high hurdle as more Republicans are leaning against it. One key Democrat, Sen. Paul Bookout of Jonesboro, who supported the private option, has been replaced by a Republican following Bookout’s resignation for ethics violations.

“The Arkansas private option has become a national model for states seeking flexibility under the Affordable Care Act,” Gov. Mike Beebe said in his radio address last Saturday. “It has already brought insurance coverage to more than 77,000 Arkansans, with tens of thousands more soon to qualify. It has attracted younger people to our insurance exchange, a necessity to keep insurance affordable in the future. The anticipated influx of federal funds will save an estimated $89 million for our state in the next fiscal year.”

“If the private option fails,” Beebe warned, “many Arkansans will lose their health care and tough cuts will need to be decided for other state services, as well.”

The governor, along with Speaker Carter and Sen. Dismang, cannot let that happen. Let’s hope they can persuade their colleagues to do the right thing. The private option will provide coverage for those who need it and keep our hospitals open, so Joe Farrer can continue working as a physical therapist and will never have to turn away a patient without insurance.