2 local doctors, 2 views on dying health care bill

Blame for the death of health care legislation in Congress can be placed at the feet of both political parties and at those of President Obama, said a Grand Junction physician who has urged that the system be changed.

“This is a chapter I wasn’t expecting,” said Dr. Michael Pramenko,  a universal-coverage proponent.

Had President Obama shown leadership, he would have taken the measure that passed the Senate to the House and won approval, Pramenko said.

“We would have had the Senate-side bill four months ago,” said Pramenko, a general practitioner. As it was, health care legislation “was derailed by the wings of both parties. I fault both sides significantly.”

The failure of the legislation is not necessarily a bad thing,  according to another Grand Junction doctor, who has opposed the efforts in both houses of Congress.

“I’m pleased there was a roadblock. If the bus was headed toward a cliff, I’d rather there be a blowout that sent it into the ditch,” said Dr. James Schroeder,  a pediatric cardiologist.

The health-care ball now is in the Republican court and Pramenko said the GOP should not squander its opportunity.

“If Republicans truly want universal health care, this is their moment to show it,” Pramenko said.

They also can win restrictions on medical malpractice suits and cost-control measures, he said.

Any of the 41 GOP senators now “is just as powerful as Ben Nelson was four weeks ago,” Pramenko said. “They said they wanted relevancy. Now they’ve got it.”

Nelson, a Democratic senator from Nebraska, supported legislation in the Senate in exchange for favorable treatment for his state. That sparked angry complaints about back-room deals from both sides of the political aisle.

The health care debate stopped dead last week when Massachusetts Republican Scott Brown defeated Democrat Martha Coakley for the Senate seat left vacant by Democrat Ted Kennedy, for whom the health care legislation was named.

“The weight is on her shoulders of 31 million Americans who don’t have health insurance,” Pramenko said.

Health care legislation is struggling in the polls and in Congress. The reason, Schroeder said, is lawmakers are asking the wrong questions and getting the wrong answers. Costs are not necessarily out of line, Schroeder said.

“I think utilization is all whacked-out” because patients can insist on services that they won’t pay for.

Payment is at the heart of the debate, Pramenko said.

If all Americans are to be covered for their health-care costs, then it’s imperative all Americans purchase coverage, he said.

Costs can be cut by using comparative effectiveness measures, or evidence-based health care to determine the best and least expensive treatments, he said. Republicans are in a position to move that effort forward, he said.

Given the sharp split in the country on health care, Schroeder said, Congress would be best advised to take no action.

If Congress does move ahead, it will have to act in a big way, said Reeves Brown, executive director of Western Slope lobbying and promotional organization Club 20. Otherwise, he said, legislators will opt for a piecemeal approach, such as prohibiting insurance companies from denying coverage because of pre-existing conditions, allowing portability of insurance, and other measures.

Without a comprehensive approach, Brown said, “I’m afraid we’re going to wind up pursuing politically popular things with huge price tags and no way to pay for them.”

Club 20 came out two years ago in favor of an individual mandate to buy health insurance.


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