By KAYLEIGH KULP
The Enterprise
Friday, May 8, 2009

Dr. Carol A. Paris spent Tuesday in jail — all in the name of health care reform.

“I interrupt this so-called public hearing to bring you the following unpaid, political announcement: Put single-payer on the table. My name is Dr. Carol Paris, and I approve this message,” Paris said as she was taken out of a congressional public hearing by police for disorderly conduct, as several other protesters with Paris who are part of Physicians for a National Health Program also shouted similar messages.

Paris said she did it because she is sick of seeing patients suffer. It was because she wanted to help them that she became a psychiatrist. But the Leonardtown resident’s remedies only work if people seek treatment, and too many people do not because they are uninsured and can’t afford it, Paris said.

So she’s doing her part to advocate for what she believes is the best solution — single-payer health care. She attended the Senate Finance Committee hearing on health care reform chaired by Sen. Max Baucus (D-Montana) to protest that no single-payer advocate was represented in the roundtable of 15.

Paris’ preferred single-payer health plan care — which she calls Improved Medicare for All — is a system that essentially eliminates multibillion-dollar private insurers in the marketplace. Everyone would get health insurance. It would be financed with money the federal government already contributes to health care through Medicare and other programs, with the help of a new, mandatory employee wage tax. All health care payments would be administered by the government (the single payer). Patients would choose who treated them.

President Barack Obama has promised to reform the health care system since his campaign began and finding the right solution has been a hot topic on Capitol Hill.

“We have tried to do this following the appropriate channels,” Paris said in an interview after the hearing. “We have written letters. We have visited congressional offices. We requested to be invited and we’ve been denied and so we felt that our only recourse was to create a disturbance.”

“We deeply, deeply respect the views of … all Americans … who feel deeply about health care reform, especially those who believe the single pay system,” Baucus said during the hearing. “For those of you in the audience who may be inclined to stand up out of order … I encourage you not to do so … we aren’t going to get the best result here” unless the discussion is orderly.

“I hear from [patients] every single day about their woes … who can’t afford their co-pays,” Paris said in an earlier interview. “It’s fragmented care and inadequate care when all I can do is prescribe medication when they need” a full medical regimen with help of other specialists. As a psychiatrist, she said, she treats patients whose financial stress is causing mental and physical problems.

Over the past eight years, Marylanders have seen their health insurance premiums increase by 64.1 percent while wages during that period only grew by 21.4 percent, according to a statement by Rep. Steny Hoyer (D-Md., 5th). Without reform, the health insurance premiums of Maryland families would increase from 4.7 percent of their income to 9.1 percent by 2016, Hoyer’s data shows.

The federal government estimates that more than 45 million Americans were uninsured in 2008. In Maryland the number of uninsured has grown to 769,007 — 13.8 percent of the state’s population, according to Hoyer’s statement. About $56 billion in uncompensated care for the uninsured is absorbed annually by the health system, driving up the cost of insurance for everyone, Hoyer said.

Reform to lower health care costs, improve delivery quality, increase coverage, and preserve choice of plan and doctors is a top priority for Congress and Obama, Hoyer said in the statement. More people losing jobs and businesses struggling with growing costs of employee coverage has increased demand for action.

“Reform, however, does not mean fixing the parts of health care that aren’t broken,” Hoyer said. “We need to build upon the current system of employer-sponsored care, with a system that provides patients their choice of insurance coverage and their choice of doctors. In other words, if you like what you have, you should be able to keep it.”

Paris, like many other members of her grassroots group, believes insurance companies make inflated profits at the expense of average Americans by unfair practices that limit access to care. Those include denying coverage to people who have pre-existing conditions, providing inadequate coverage, jacking up costs and paying doctors and hospitals low reimbursements that barely cover expenses.

On some weekdays and on weekends, Paris travels to meet with Capitol Hill lawmakers, trying to convince them that single-payer financing would actually lower medical costs because patients would regularly seek primary care and catch problems before they became catastrophic and expensive. People’s access to health care would be secure even if they lost their jobs. Small business could be relieved of the rapidly increasing health care coverage costs for employees. And doctors could focus more on helping people than on deciphering convoluted medical billing codes and fighting with insurance providers for fair payment, Paris said.

But some say there are better ways to fix those problems. “The concept of single-payer has been around for a long time,” said Jon S. Frank of Jon S. Frank & Associates, an employee benefits consulting firm in Prince Frederick. “I don’t really know how that would contain costs … Wouldn’t it just drive demand for services and if we drive demand for services, doesn’t it just exacerbate [the need] for services?”

Frank said health care reform must combine elements of personal responsibility and government subsidies for those who cannot afford care. “I can’t envision single-payer working. We have a lot of people covered by health insurance in this country. What would it be like to make the transition into some other kind of model? It would be impossible,” he said. But he believes everyone must enter into a system to lower overall costs and government regulation of the industry may be in order. For example, many young people who could get lower premium costs because they are in good health do not buy in because they don’t see the benefits of insurance.

“I think the more you earn the more you have to pay into the system,” he said.

“We strongly believe that we need to reform the health care system this year … [as] rising health care costs are hurting families … The American people have made it clear that they prefer a public, private approach to health care reform. But the reform should build on the types of things that are currently working to improve patient care. [Single-payer] would turn back the clock on innovative programs to improve care,” said Robert Zirkeobach, spokesman for America’s Health Insurance Plans, a national association representing nearly 1,300 health insurance companies that cover more than 200 million Americans.

Zirkeobach said AHIP advocates new market rules and stronger consumer protections, and reform can be accomplished without a “government takeover of the entire health care system.”

Justin Britanik, a spokesman for Greater Baden Medical Services, which operates a low-income clinic in Nanjemoy, said the organization has seen increased numbers of uninsured and publicly insured patients over the last year.

He called the reauthorization of funding by Congress this year to expand Medicare coverage to 11 million children, including 150,000 in Maryland, a “step in the right direction.”

Congress also passed an economic recovery plan that provided relief to states for Medicaid services and provided temporary subsides to help families maintain their health coverage after a job loss in the federal budget.

Margaret Flowers gave up her pediatric career in Maryland and joined Physicians for a National Health Program, a grassroots organization. “It came down to having to make a choice,” she said. “What do you do if your whole thing is taking care of people and you can’t take care of people?”

Flowers and Donna Smith, an activist who went bankrupt because of medical expenses, work with Paris to lobby federal legislators. On a recent Friday, the three shared coffee in the Hart Senate Building in Washington after meeting with legislative staff from the office of Sen. Benjamin C. Cardin (D-Md.).

“What they don’t want is for the government to mandate private insurance and subsidizing it because the industry is losing premium dollars every day as people lose their jobs and reduce coverage,” Flowers said.

As the debate goes on, Paris will continue to fight for the single-payer cause, she said, traveling to Capitol Hill, speaking at church and civic organization events, and preparing for her May 26 court date. “It’s just another bailout,” Paris said. “Congress is asking us to bail out the private health industry and call it universal health care, which it’s not. Health care must become the civil rights movement of this decade.”

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kkulp@somdnews.com

To learn more

To find out more about Dr. Carol A. Paris’ reform efforts, call her at 301-997-1494. Go to the Physicians for a National Health Program Web site at www.pnhp.org. America’s Health Insurance Plans has developed proposed solutions to promote coverage, raise the bar on quality and make health care services more affordable. These proposals are available at www.AHIPbelieves.com or www.americanhealthsolution.org.