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Health care’s ills worry leaders


– The short-term prognosis for health care providers is gloom and doom.

Costs are high and rising. Incomes are falling. Fewer students can afford medical school or want to become primary-care physicians. The federal government is botching its oversight of private health insurance and reducing its reimbursements to doctors.

Those were among views expressed Wednesday during a group discussion led by two lawmakers who are also physicians.

Unless medical providers become more engaged in the politics of health care, “we’re going to get run over by a truck – by Washington, D.C., by CMS and by the rest of the government,” Rep. Larry Bucshon, R-8th, warned at the gathering at Lutheran Hospital. CMS is the U.S. Centers for Medicare & Medicaid Services.

Bucshon, who represents southwest Indiana, and state Rep. Tim Brown, R-Crawfordsville, visited Lutheran Hospital as part of their two-week Hoosier Healthcare Tour.

Brown, chairman of the Indiana House Ways and Means Committee, is an emergency physician. Bucshon is a cardiothoracic surgeon from Evansville.

The dozen people taking part in the Fort Wayne session included local doctors, health administrators, an insurer and Allen County Commissioner Nelson Peters. Some spent much of the 90-minute meeting lamenting requirements and costs of the federal Affordable Care Act, also known as Obamacare, which stipulates that people must obtain health insurance or pay penalties.

Bucshon has voted many times to repeal the Affordable Care Act. But he said he does not want to return to letting insurers deny coverage to people with pre-existing medical conditions.

“The good parts of the law that are there, and there are some, OK, are going to sustain in the long term. … And the parts of the law that are clearly not working will be repealed and replaced with something different,” Bucshon predicted.

For one thing, care providers should offer more pricing information to consumers, the second-term congressman said.

“We are going to have to show that we provide value,” he said.

“As a provider, I’m not afraid of that. Some are.”

He said the federal government should give states and medical providers greater flexibility for administering health programs.

“We want some innovation; we want some patient ownership in those plans,” Brown said, citing the Healthy Indiana Plan, the state’s response to a federally recommended expansion of Medicaid.

In the meantime, Dr. Todd Rumsey said physicians have seen “a tremendous explosion” in unpaid bills because patients cannot afford insurance deductibles of $5,000 and more.

“Your local physicians are going to eat that, because they are going to give them the care,” said Rumsey, an obstetrician. “They’re not going to put a lien on (a patient’s) house. They’re going to do what’s right for the patient.”

He described uncollectible bills as “another tax for those who are providing care.”

Dr. Matt Sutter, an emergency physician, said medical school costs of $40,000 a year at some colleges are prompting more students to become highly paid specialists rather than general practitioners.

“I’m worried about how primary care is going to survive that,” Sutter said.