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Group eyes big changes in health care

December 29, 2008|By KATE S. ALEXANDER

CHARLES TOWN, W.Va. -- Judie Marshall of Bunker Hill, W.Va., sells health insurance for a living. But not everyone who walks through her door qualifies for coverage.

Mary Ann Baird of Charles Town is on Medicare. But the federal health insurance program won't pay to replace or repair the faulty electric wheelchair that she needs for mobility because of her heart condition and carpal tunnel syndrome.

Sham Albers of Charles Town has an HMO insurance policy through his employer. But he can only get a five-minute appointment at one clinic in Frederick, Md., when he needs to see a doctor.

Karen and Dane Spurrier of Charles Town have been paying $800 per month for COBRA to supplement Karen's Medicare coverage since Dane was laid off two months ago. But even with Medicare and supplemental insurance, the co-payments for many of her medications are so high she cannot afford them all.

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"Clearly our health care system needs to change," Karen Spurrier said. "The question is how."

For nearly three hours on Sunday, a group of concerned West Virginians sat in the back of Jumpin' Java in Charles Town and debated how to fix what they see as the faulty health-care system in America.

The Spurriers hosted the discussion group as part of the Obama-Biden Transition Project, which encouraged citizens across the county to meet between Dec. 15 and Dec. 31 to debate the hot-button issue.

The small group gathered at the coffee shop consisted of individuals who all have personally struggled within the status quo. Yet despite their diverse viewpoints, all were hopeful that not only could change happen, that it would happen.

"We need open enrollment, no matter if you have a disability or not," Marshall said.

Drinda Franzen of Harpers Ferry, W.Va., said it is important for Americans to realize that when it comes to health care, citizens are not independent, but rather interdependent.

"True insurance should pull us together as a group," she said.

Everything from mental health, profit-driven companies and Medicare to premiums, tort reform and co-pays hit the floor for discussion.

"Health care means caring about people, yet in this country it is a business where people are treated no different than objects," Albers said. "You can insure a boat, you can insure a person. Either way, to the insurance companies we are nothing but commodities."

Baird argued that the root of the problem was inherent in the way America views health care and those who need it.

"There is a mindset in America that health care is a business and those who are not well are a burden (on the bottom line)," she said. "To make profits, the companies make it too cost prohibitive for many (people) to function."

As Marshall took notes on the discussion she noticed a theme: reducing the cost of care and coverage.

"There is a lot of talk of cost, but if we are going to talk about cost we need to talk about capping liabilities for doctors," she said. "Health care reform needs to have tort reform as well."

By the end, the group of six drafted a nine-plank platform that expanded benefits to include mental health coverage and preventative care, replaced the profit-driven model of insurance with a care-concerned model, implemented checks and balances on government insurance programs, and distributed the risk in the insurance industry equally among all Americans by creating an income-based sliding scale of premiums.

As the discussion came to an end, Dane Spurrier said there is one question, that as long as people still need to ask it, the system is not fixed.

"Do I buy food or do I buy health insurance?" he said. "No one should have to make that choice."

Karen Spurrier said the group's platform together with answers to a three-questions survey will be returned to the Obama-Biden Transition Team as feedback.

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