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Health Care Questions from Across New Hampshire

Over the past seven months, I have responded to thousands of letters and phone calls on health care. And I have travelled all across New Hampshire talking to small business owners and families who are desperate for help. The following questions are from concerned citizens from across New Hampshire that I have answered during a telephone town hall meeting in early August.

Lowering the cost of prescription drugs

Greg from Keene: I went through a period of extended disability last year and had to take a lot of medication. I was wondering if there has been any discussion about lowering the cost of prescription drugs?

Senator Shaheen: Well, in fact there has been. It’s a significant issue as I’m sure you know based on your experience. It’s an issue that also affects a lot of our seniors. You may have heard or seen stories about the fact that PhRMA has agreed to reduce the costs of prescription drugs by $80 billion so that helps. We had a conversation today among the caucus about the fact that we think there needs to be negotiation for prescription drug prices and also we need to allow the re-importation of safe drugs from Canada and other countries. I think that will also help with the cost of prescription drugs. Hopefully, if everyone has health care then everyone will have access to affordable prescription drugs. That’s one of the important reforms that I think we need to have as part of any new health care package.

The public option as part of health care reform

Tom from Peterborough: My wife and I are both professionals, I own a small business. I provide health insurance to my employees, which I feel an ethical obligation to do. In a nutshell here’s what I come down to: my household income is around $100,000 so I should be solidly, comfortably middle class. However, with the rising costs of health care even I can’t make all my costs add up. And if I can’t make it add up with a $100,000 income we’ve got a really serious problem. This system doesn’t work. So I want to encourage you and let you know that there are folks out here really pulling for a public option.

Shaheen: I think you’re absolutely right, Tom. And as you point out what we’ve got to do as part of a reform is to control health care costs. I have supported a public option, I’ve been a co-sponsor of a resolution that says that needs to be part of what we do so that we have some competition that can help push insurance companies to lower costs. Right now about 75% of people in New Hampshire have one of two insurance companies. So I think it is important to have some competition to help address the costs that people are paying. You know, as you point out, the costs of premiums for family health insurance have doubled in less than 10 years. We’ve got to do something to control these costs and I think having some competition in the industry is one way to do that.

Why we need health care reform.

John from Concord: There are 45 million people apparently without health care in the country, that’s the estimate. And from what I can gather, approximately 30 million of the 45 choose not to get involved with insurance or purchasing insurance although they can afford it. Which would leave about 15 million who truly cannot afford to buy or purchase health care insurance. Can you tell me why you feel it’s necessary to overhaul the entire system for approximately 15 million people?

Shaheen: Well, as you point out there are a number of people who don’t have insurance and who are underinsured, and I think it’s important that we have a system that helps them. But I think perhaps even more important are the stories like the ones we’ve heard earlier from Tom and from Greg out in Keene of people who have health insurance but who are not able to continue to afford the premiums as the premiums go up. Or people who have trouble when they have a significant illness because they’re not able to pay the additional costs. We’ve got to start reversing the incentives in our system so that we incentivize prevention and we incentivize better maintenance of chronic illnesses. That’s going to make us healthier and it’s going to give people lower costs. Right now the average family in New Hampshire who has health insurance is paying about $900 a year in a hidden tax for those people who don’t have health insurance. I think we’ve got to address that because we can’t continue so that by 2040 we are paying a third of our gross domestic product for the cost of health care.

Senator Shaheen on medical malpractice reform.

Kent from Bedford: One of the health care cost drivers there doesn’t seem to be a lot of discussion about is medical malpractice litigation and malpractice insurance. Is there anything that addresses this in the proposed health care reform?

Shaheen: Well again, we don’t actually have a health care bill before us. As we’re looking at the legislation I think we need to consider careful reforms of our medical malpractice laws that can lower health care costs but still make sure that injured patients are compensated fairly. I think there are some good pilot programs around the country and evidence that liability protections for physicians who disclose medical errors to patients has reduced the number of malpractice suits filed. There’s one program in the Midwest where the physicians when something happens have apologized to the patient. What they’ve seen is that that interaction has reduced the number of malpractice suits filed. As you pointed out this is something we’ve got to take a look at as we’re looking at all of the issues around health care reform.

Maintaining your current health insurance coverage.

Emil from Salem: My question is the same concern I believe others have reiterated. I’m retried on Medicare and I also have my private health insurance. If we maintain our own health insurance, will we be able to keep that? Or are we going to be forced in a matter of years into the government plan? If we’re able to keep it, will we at some point be penalized by paying taxes on it?

Shaheen: No, no. My understanding, Emil, is that � and I know this is true of the bill that has come out of the committee in the Senate � if you have health coverage that you like you can keep it. As I said, you may have missed my remarks at the beginning of the call, but one of the things I that I said as a requirement that I have for supporting a bill is that if you have health coverage that you like you should be able to keep that. Now, if you’re someone who has lost your coverage or you’re underinsured or you’ve lost your job and as a result have lost your coverage then I think that public option, which would hopefully be more affordable than the other choices that you have, then that would be a plan that would be open to you. But under ever scenario that I’ve seen, if you have health coverage that you like, you get to keep it.

A single payer system.

Bob from Canterbury: I was wondering if the single payer option has been considered by Congress? I myself am a consumer of healthcare as we all are but I also have to provide health care in my role as the selectman for the town. So we consistently see and fight the cost of health care. And I just wondered why it is that it cannot even be considered. I’m sure there’s no hope. But I certainly do not see our senior citizens fighting to get off Medicare because it’s so terrible. In fact my 81-year-old father has far better health care options than I do.

Shaheen: Well, for those people who are concerned about the public option with health care, we need to remind them that Medicare is a public option for healthcare. For seniors who have Medicare, most people like their health care plan pretty well. I believe there should be competition in our system. I think the system that we haveis fundamentally strong, but we need to make it better. That’s what health care reform is all about. However, I don’t think a single payer system is the way to go. I think it has been discussed�but that it there isn’t the support to change the system to be a single payer. Moreover, one of the things that we’ve just heard from a number of the people on the call is that they like the health care plans that they’re in and they want to keep them. I think that’s what we’re trying to do, start with what’s working in the current system and fix what’s not. So, those people who like their plan they should be able to keep them. I’m being told I need to go vote again so I’m going to turn it over to Mary again.

Health care services for veterans.

David from Penacook: I have a question about taking care of the honorably discharged military people as part of the plan for health care. Also, are we going to do something about a hospital in the state of New Hampshire.

Shaheen: The first legislation that I introduced after I got to the Senate was with Senator Gregg and our two Members of Congress to support a full service veterans’ hospital or equivalent services. I think it’s very important. I’m not going to give up on this until we make sure that that’s available to everybody throughout New Hampshire. We’ve made some progress in that the VA hospital has contracted with Concord to provide full services for people in that central part of the state, but we need to make sure that that’s available for people all over New Hampshire and that’s what we’re working on. I think for all of you who have served the country in our armed forces, who have risked your lives for our safety, we should do what we promised that we would do and make sure that you get the health care that you need.

Receiving medical services in a timely manner.

Amy from Exeter: My question is, with 97% of Massachusetts insured their average delay is 46 days to see a physician. So with health care reform, how will this assist people in getting the care they need in the time manner that they need?

Shaheen: You know, as you point out, it’s one of the challenges that Massachusetts has discovered since they put in their health care plan. That we’ve got to do a better job of training nurses and training primary care physicians to develop that system that I talked about that is focused on preventive care and primary care and so we’ve got to develop the work for that we need to do that. I think that’s got to be part of any legislation that we pass so that we can make sure as we’re providing; as we’re putting more people who are uninsured into the health care system that we’ve also got a work force that can address their health care needs.

Improving the health care system.

Roger from Brookline: What would you say to people who believe that the Federal Government is already too intrusive in our daily lives and giving them control of 20% of the economy is really a big mistake?

Shaheen: Well, I would say to you that the goal of this health care reform is not to give government control of 20% of the economy. One of the issues that I think we’ve got with health care is that right now we’re spending too much of the gross domestic product of the economy on health care and that we’ve got to find ways to reduce that and that’s part of what this health care reform is designed to do. So it’s not designed to give government control of our health care, it’s designed to try and provide more options for people. You know right now 75% of people who have health insurance in New Hampshire only have two carriers. I think maybe if we had some more competition that we would be able to reduce the cost that people are paying for that health insurance.

Medicare and the public option.

Sandra from Raymond: My concern is, just like everyone else who has Medicare, that it will be taken away from us. I’ve also worked all my life putting into the system and now I’m retired, but I had to take jobs in orderto get insurance. So I want to make sure that there’s a public option, not just for myself because I’ll be on Medicare, but I strongly believe that unless we get a public option in there we won’t get anywhere with health insurance reform. It’ll keep the rates down too.

Shaheen: I agree with that. I think what we need to do as we’re looking at our health care system is keep what works and fix what’s wrong. Medicare works for people. It’s been very successful. For those people who are worried about a public option, we already have a public option for people who are seniors and that’s Medicare and it’s been working pretty well for most people. So I support a public option, as I said. I think it’s important to help provide competition in the insurance market. It is a good way to address more choices for people in their health insurance.

The costs of health care reform.

Dee from Newmarket: In the government I notice that we’re talking about spending, spending, spending. We spend to give to the car companies, to all these bailouts, Fannie Mae, Freddie Mac. What about holding people accountable and responsible for the things they do? Why don’t we go after these people to get that money back because if that money were available now these programs could be funded and you wouldn’t have to raise my taxes?

Shaheen: Well I hope we’re not going to raise your taxes. That’s one thing that President Obama has said. I think that one of the things we want to do with our health care reform is to look at addressing costs that we’re paying in our health care system that we should not be paying. We ought to be negotiating better prices for prescription drugs under Medicare Part D. That would save money. We know that if we do a better job on prevention and wellness that we’re going to save money. I’ll give you an example that I heard while I was at the Lamprey Community Health Center down in Newmarket. One of the things they talked to me about is that if somebody comes into Lamprey who has diabetes, that they can treat that person for diabetes if they have an acute episode, they can put them in the hospital and they can get reimbursed for that under our Medicare system and under our current federal system. But they can’t counsel that person on how to stay out of the hospital and prevent those additional costs and get reimbursed for that. That’s the kind of savings that I think we need to be talking about in our system. We need a health care system that says to health insurance companies we need to reimburse for those yearly physicals and check-ups, we need to reimburse for counseling for people with diabetes on how to stay out of the hospital. That’s going to save money in the long run.