Roundtable forum examines health care act

MARIETTA – Experts from different walks of the medical industry met to argue the advantages and the concerns regarding the Affordable Care Act on Thursday afternoon for the last event of the Economic Roundtable of the Ohio Valley.

The group, served with the purpose of promoting involvement of the community in social and economic issues, presented a roundtable discussion with a physician, a hospital administrator and a health care official at the Lafayette Hotel.

Scott Cantley, CEO of Marietta Memorial Hospital, Fred Earley, president of Highmark West Virginia, and Richard Cain, a physician at Marietta Memorial, argued the high points and the issues facing the country with the implementation of the government-mandated health care system.

“This system was designed for political gain and because of that it’s full of problems,” Cain said. “Nothing is ‘free,’ because you have to take something from someone to give it to someone else.”

Cain said though he believed the health care system needed reformed, he felt that the ACA was not the right way to go.

“Whether it was this broken start or another broken start, there was no way to reform without bringing pain,” Cantley said, who argued that despite the flaws in the initial enrollment process, he remains optimistic.

Earley, whose company is the only health insurance provider in West Virginia that participates in the government health care exchange, said regardless of how many people sign up, the health care that is provided has to be sustainable.

“West Virginia is near the top in most of the bad categories for health, and it’s not the most attractive risk-based population to sell insurance to, but we are working and offering a robust range of things in the exchange,” he said.

The deadline to sign up for Affordable Health Care was March 31, but those who missed the deadline have to wait until the exchange reopens in November.

Those who do not sign up for coverage in 2014 and who don’t have insurance face a $95 per month fee for an adult and a $47.50 per month fee for a child, or 1 percent the individual’s taxable income, whichever is higher.

As of April 1, healthcare.gov reported that more than seven million had signed up through the enrollment process.

“That’s a significant tax to pay to forgo a service that you could actually get value out of,” Earley said. “People just don’t invest the same in their health as they do with their other assets.”

Cain said he felt like the Affordable Care Act held some problems in that it allowed for abuse of the system and offered no accountability practices.

“It’s appropriate for me to pay to treat a child who is ill because their parents smoke, but it’s not appropriate to have to pay to treat the parent for an illness from smoking,” Cain said. “The Affordable Care Act does not address patient responsibility at all.”

As a physician, Cain said the system suffers when patients leave the hospital and do not continue to take care of themselves, like when he treats a diabetes patient who turns around and breaks a prescribed diet.

Cantley said he felt that though there were always going to be flaws, the health care industry has no choice but to work with ACA, and to use it to improve care, not to backtrack it.

“We have to start investing in those people because that’s the reason they bounce back into hospitals,” he said. “We need to do a better job at reaching into the home and working together.”

Cain said because ACA is a law now there is no choice but to move forward, but said the government could have taken a different option, like making health care services tax deductible.

“Right now, ACA is not paid for, the payment system is not fair, and stakeholders are not getting equal treatment,” he said.