Shuler hears citizens’ views on healthcare reform

Published 12:08 pm Tuesday, August 18, 2009

While he said he believes &dquo;it is vital to reform health care,&dquo; he said the law which finally passes must be bi-partisan and one which &dquo;is best for the American people. We have to put down these partisan politics.&dquo;

In answering some 25 questions over about 75 minutes, Shuler said he would like to see health care reform which relies much more upon wellness efforts, disease prevention and disease management to find savings, rather than taxes on the wealthy or small businesses.

Shuler offered as an example the effort by the City of Asheville to promote better health habits by its employees.

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Shuler said The Asheville Project identified diabetes as one disease driving up the city&squo;s health care costs. They asked, Shuler said, &dquo;How can we incentivize people to take their meds, eat right and exercise?&dquo;

A disease management program within the city&squo;s health care insurance group allowed diabetics to go to the doctor for free, to establish individual disease management plans, and at the end of the first year patients had saved an average of $600 to $800 in co-pays, Shuler said.

In addition, the city saved $1,200 per patient and absenteeism from work was down by half.

&dquo;We need to incentivize wellness,&dquo; Shuler said.

Shuler also said, to get his support, the health care reform legislation must deal with the &dquo;waste, fraud and abuse&dquo; in the current Medicare and Medicaid systems.

Shuler further said the current bill does not do enough to curb rising health care costs. He did not like the mandate that small businesses either provide health insurance or pay a tax, and he wanted to be sure that no federal tax dollars go to pay for abortions.

&dquo;We only have one shot at this,&dquo; Shuler said. &dquo;Let&squo;s do it right.&dquo;

Shuler said he was proud of his participation in the Blue Dog Coalition, a group of currently 52 moderate and conservative Democratic Party members of the United States House of Representatives, first formed in 1995. The Blue Dogs promote, among other things, fiscal conservatism and accountability.

Shuler said the Blue Dogs were helping to slow down the process of writing this legislation, and were working for changes to the legislation.

When asked whether illegal immigrants will also be included in the health care reform, Shuler said he favors toughening enforcement against illegal immigration but said it would be immoral to deny someone coming to an emergency room treatment even if that person were in the country illegally.

&dquo;If you look at the current system,&dquo; Shuler said, &dquo;that is why it is broken now &ellip; those who have health insurance are paying for those that don&squo;t have health insurance. But &ellip; if someone is outside the emergency room and they need help and they need care, we can&squo;t turn people down. It&squo;s not about whether they are illegal or not. I just can&squo;t see that we should just turn a blind eye on someone who needs help. What we really need to do is secure our border.&dquo;

Paul from Asheville said he worried about the penalty that the House bill would assess on small-business owners who do not provide insurance.

Shuler agreed, saying: &dquo;We can&squo;t just make mandates on small businesses who are already struggling in our economy.&dquo;

One caller, Eric from Brevard, asked why Shuler didn&squo;t conduct the town hall meeting in person.

&dquo;I want to thank you for giving us a chance to talk to you in some way,&dquo; Eric said, &dquo;but I want to know why we didn&squo;t have an opportunity to see you in person?&dquo;

&dquo;First of all,&dquo; Shuler answered, &dquo;we have an opportunity to reach more people and some of those people who don&squo;t have the opportunity to get out. Those people may be stuck at home.

&dquo;But as you can tell, what has happened is in the news the last few weeks. It has become more political posturing and people trying to get on Facebook or get their picture in the newspaper or on TV, or just shouting matches. (The teleconference) gives us an opportunity to have an open discussion, to answer more questions in the amount of time, and we can listen to people in a very productive way.

&dquo;This is not about town hall meetings. This is actually about health care.&dquo;

Another caller asked, &dquo;how we can add 46 million new people to the proposed health care program without adding any doctors or hospitals and expect better health care?&dquo;

&dquo;That has been the conversation that the Blue Dogs (Democrats) continue to discuss,&dquo; Shuler said. &dquo;We are at a critical level already, especially in the rural communities. We do not have enough primary care physicians to be able to look after the people who are visiting the hospital now. And you add 46 million people to this, we have got to be able to make sure we have the people in place who can service and make sure there is better quality of care. …

&dquo;We have to really think this through and go through this intelligently and very, very carefully before we keep adding people.&dquo;

Another questioner dealt with &dquo;the end-of-life counseling and task force that has been set up in the bill. Obviously the bill doesn&squo;t say they are creating a &squo;death panel.&squo;&dquo;

&dquo;There is no panel,&dquo; Shuler agreed, &dquo;and you don&squo;t have to worry &ellip; You don&squo;t want the federal government telling you when you can go or remain in the hospital. &ellip; You don&squo;t want the federal government doing it, and you certainly don&squo;t want the insurance companies telling you. We need to put that in the hands of the qualified people who understand health care and that is our physicians, our nurses and our people that are in our hospitals &ellip; We have to make sure nobody is pulling the plug on grandma.&dquo;

&dquo;The 11th congressional district is suffering,&dquo; said another caller. &dquo;134,000 are uninsured. Many have had to declare bankruptcy. Will you commit to help us?&dquo;

&dquo;We have to get to the issues at hand,&dquo; Shuler said. &dquo;Twenty-four percent of those in the 11th district are uninsured.&dquo;

But, he said, his problem with HR 3200 is that it &dquo;does not cut the cost curve.&dquo; He said legislation which works to create a healthier population will cut costs and he favors efforts along those lines.

Shuler said he plans a second telephone town hall meeting at 7 p.m. Sept. 1.