Updated, 7:17 a.m.: Copy edits
NORWALK, Conn. — Democratic elected officials heard about Norwalk health care and discussed their hopes for the future at a forum held Friday at Norwalk Hospital.
The hour-long round table, attended by Sen. Chris Murphy (D-Conn.), Rep. Jim Himes (D-Greenwich), and State Sen. Bob Duff (D-25), often referenced the Affordable Care Act (ACA), also known as “Obamacare”. Murphy and Himes touted the ACA and heard from health care providers regarding the law’s local impacts.
Video by Harold Cobin at end of story
A woman who identified herself as working with the Open Door Shelter told the panel that when the shelter’s clients have access to healthcare they are more likely to keep their jobs and less likely to return to the shelter.
“We have found working with our healthcare partners that emergency room visits have dropped by 65 percent (due to the Affordable Care Act) because they have been able to get the care they need, when they need it, in the way that is most appropriate for them,” she said.
Personal bankruptcies have been cut in half over the last six years, Murphy said. Before the ACA more than half of bankruptcies were caused by medical debt, he added.
“It’s not that there is no one who goes into bankruptcy because of medical debt but we have lopped 750,000 personal bankruptcies off of the court system,” Murphy said.
System ‘requires some tweaks’
“Healthcare continues to be a very, very important issue to all of our constituents … and it causes a fair amount of stress,” Duff (D-25) said. “… Those of us who are legislators know, when you do such a large piece of legislation, and especially the Affordable Care Act, it takes such a large part of the economy, that it requires, conversations, it requires some tweaks and some changes, and unfortunately we have not seen that because there has been some gridlock, as we know.”
A woman commented that there are illnesses that don’t respond to pills but respond to lifestyle changes, and a system is needed to create a successful approach.
The Obama Administration was working on that but President Donald Trump’s former Health Secretary Tom Price “pulled apart the work for reimbursement systems” that would have supported holistic health work, Murphy said.
Norwalk program seeks cost reductions
Norwalk Hospital has a program that follows frequent visitors to the Emergency Room, said Eileen Kardos, High Risk Navigator at Western Connecticut Health Network.
“We have definitely kind of adopted the mentality that if we are really going to reduce our health care costs it is really going to come down to changing the definition of health, from being the absence of medical systems and disease to really incorporating health to address all of our social determinates,” she said, speaking of socially and medically complex patients.
By “stabilizing them socially, we have ended up reducing the amount of patients coming to our emergency room,” Kardos said.
“I think the idea of ‘what is healthcare?’ is a fundamental question that we are not equipped to deal with at this point,” Murphy said. “So, we will pay for all of the consequences for not getting the healthy meal which can be in the millions of dollars per person, but we won’t pay for the couple of bucks a day it might cost to get that person access to food, it doesn’t make sense.”
Hopes for the future
“We are in interesting moment… when it comes to things like Medicaid and the way people actually get their healthcare, in a city like Norwalk, it is very much a shared responsibility, shared resources, shared oversight and jurisdictions between the state and the federal government. Medicaid in particular is that way,” Himes said, noting that his 10 years in Congress have been defined by a debate around healthcare.
“I really do feel like we’ve made a lot of progress but we obviously have a long way to go,” Himes said. He added that the G.O.P. “got a little dose of reality” when it tried to repeal Obamacare and found out how “complicated and important it is to people.”
The country is now at “a point where we can open a discussion,” Himes said.
“I am a little less optimistic than Jim is about the ability to try to suck some of the political venom out of this issue come next January, in large part because the president seems to every week come up with new and creative ways to try to destabilize the existing health care system,” Murphy replied. “It’s kind of hard to figure out what the root causes are of his crusade… other than he’s mad that the system has President Obama’s signature on it, and though he promised to repeal it, because as Jim said, of popular backlash to the repeal, that he wasn’t able to get it done.”
A participant asked the legislators to talk about Medicare and negotiated prices for prescriptions.
When Medicare was expanded to include the drug benefit under the Bush administration, the “big ugly negotiation” resulted in a “bit odd” commitment to not to use the power of bulk buying to negotiate better prices, Himes said. This, he said, is why drugs are less expensive in Canada, and the net effect is that Americans subsidize prices in other countries.
“Republicans spend a lot of time lecturing the country about running government like a business… This is an example of a restriction on the government that you would never ever foist on a business, the inability to use your bulk purchasing power to try to drive down the costs,” Murphy said.
Thoughts from Republicans
Duff, Himes, and Murphy are seeking reelection this year. They join Democrats nationwide in campaigning on healthcare issues.
Murphy’s Republican challenger is businessman Mathew Corey, who addresses the ACA in a statement on his website:
“We all agree health care cost is on the rise. We should allow the purchase of health insurance across state lines. We also need tort reform. Doctors are under tremendous strain and rising costs of performing their job. There should be no discrimination on purchasing health care with preexisting conditions which the states should subsidize through cost effective Medicaid programs. The health care exchanges are in place. Let the free market compete in these exchanges so the American people can get the best rates. We also need to create large pools so individuals can get the best rates available. This should include creating policies to cater to individual needs to get more people to sign up.”
Himes’s Republican challenger is investment analyst Harry Arora, who states on his website that healthcare has become unaffordable since the ACA was passed, and premiums, deductibles and copays have increased.
The ACA “broke the insurance market by including non-insurable risk,” Arora’s statement says. “The correct solution is to create a separate pool for those with pre-existing conditions and subsidize that pool. As a result, those with preexisting conditions would still be able to buy subsidized insurance without penalizing the remainder of the pool.”
“The ACA prohibited lower cost plans,” according to Arora’s site, which also contends that the ACA “made insurance costs prohibitive for many Americans.”
“The correct solution is to offer a variety of plans. These plans should have offered different coverage levels at various price points with CLEAR and CONCISE DISCLOSURES.”