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The High Cost of Health Care (Part 5)

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The High Cost of Health Care (Part 5)

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We continue our 5-part series on the high cost of health care in America.

We continue our 5-part series on the high cost of health care in America.
Friday, August 7, 2009

MAUREEN CAVANAUGH (Host): I'm Maureen Cavanaugh, and you're
listening to These Days on KPBS. Now we don’t usually have a These Days
program on Friday but we thought after the response we’ve had this week
to our series of shows on healthcare reform that we needed one more
hour. That’s because the number of calls we’ve gotten on this subject
has been overwhelming. Since we were talking with a number of guests,
patients, doctors, healthcare policy experts, politicians, and we were
trying to find out answers to questions like why is healthcare so
expensive and what reform plans are on the table, we just didn’t have
enough time to take the volume of calls we were receiving. So today
we’re opening the phone lines at 1-888-895-5727.

This is your show. Now if you’ve been listening this week, you’ve
heard the arguments for and against various healthcare reform
proposals. Some of our guests have said that government can’t run
healthcare or that it should be left to the states or that the
proposals on the table are too expensive. Other guests have said we
should get rid of the insurance companies, expand Medicare to cover
everyone or have a mix of public and private plans like many government
workers do. And we’ve also heard people talk about how not being able
to afford healthcare has affected their lives, like Norah Schwartz, our
guest on Monday. She’s a breast cancer survivor but she’s already used
up her benefits for the year and now any treatment she gets, she’ll
have to pay for herself.

NORAH SCHWARTZ (Breast Cancer Survivor): Well, apparently or I’m not
going to get it. I mean, I just can’t afford – I can’t afford to see my
doctors, and I’m afraid to see my doctors because I don’t know what the
tests are going to say. At this point, I don’t know if I have cancer
again. I haven’t seen my oncologist yet. I don’t know about my bone
health. I haven’t had a – I need a bone density scan. My thyroid
health, I mean, all of these are side effects of the treatment. I don’t
know how much that’s going to cost me.

CAVANAUGH: If you have a story, a comment, an opinion on healthcare
reform, call us now. How would you like to see access and payment of
healthcare changed? Should it stay the same? How do we keep healthcare
costs from rising 15 to 20% a year? This is a special edition of These
Days on KPBS. Let’s go to the phones. Let’s hear from Ellen in La
Jolla. Good morning, Ellen, and welcome to These Days.

ELLEN (Caller, La Jolla): Thank you. Would you like my comments?

CAVANAUGH: I would very much.

ELLEN: So I’m a physician and a family doctor. I live – I work in –
here in California. I come from Canada. My parents became elderly and
stayed in Canada. I grew up there and worked there. I just absolutely
believe in a single payer system, and I feel the nation, our nation
here, the United States, we need to mature. We need to not be – A sign
of a mature nation is that there’s a right to healthcare. And I fear –
And I feel in our fear a loss of freedom. We’ve – We don’t take social
responsibility and we – they don’t under – and we don’t understand.
We’re so afraid to take social responsibility and people don’t realize
that we’ll gain freedom. As a physician, as a person, as a daughter, as
a parent, I always felt so much more free in the healthcare system in
Canada. So I – makes me really sad. And even with all that’s happening
and right now in the arguments, it’s going to be so wasteful whereas a
single payer system would be so much cheaper and so much freer and I
wish for our country to become more mature and I – I’m happy to answer
any question if there’s something you’d like to ask me.

CAVANAUGH: Yes, I would, Ellen, because…

ELLEN: Yeah.

CAVANAUGH: …we hear – You know, critics of healthcare reform have a lot of criticism of the plan up in Canada.

ELLEN: Right.

CAVANAUGH: The national health plan in Canada.

ELLEN: Umm-hmm. Yes.

CAVANAUGH: They say that time, wait – people are waiting a very long time.

ELLEN: Well, time is the biggest issue, right. Right.

CAVANAUGH: Yeah, and that there are not enough MRI machines.

ELLEN: Well, there’s an answer to that if I could share it…


ELLEN: …if you’d like. Sure. The issue is, is that in Canada – So
right now Canada pays about, I think it’s 9% of their GNP towards
healthcare. In America 17% of our GNP is – we pay. But we have 47
million people here. Like there’s no way – Like we have to recognize
that we have a 47 million people line in America, and there’s no way to
get to the front. So until we have that line addressed and then the 108
million people that need dental care, until we get to the front – to
get people that can get to the front of that line, you’re talking
apples and oranges. Now the other issue with the lines in Canada is the
reason is, is because these liberals, who are like the Democrats,
brought in the healthcare system in Canada. But let’s say you’re the
Republicans in Canada, which is like the conservatives, you don’t want
the system but you know that if you say we want it out, you’ll never
get reelected because Canadians love their system. So you undermine it
from within. And what I would do is that if we ran – if we had a
Canadian self-healthcare system, I would say that no less than 13% of
the GNP could go to healthcare so that a particular four-year
government couldn’t undermine it from within and say no more MRI
machines in Saskatoon and therefore you end up with this situation that
it seems like the structure is falling and it’s simply because you need
to just have another machine.

CAVANAUGH: It’s underfunded. Well, thank you, Ellen. Thank you so
much for your call. We are taking your call. It’s open phones on this
special edition of These Days. The number is 1-888-895-5727. Let’s hear
from David calling from San Diego. Good morning, David. Welcome to
These Days.

DAVID (Caller, San Diego): Hello. How are you today?

CAVANAUGH: I’m quite well. How are you?

DAVID: Good. I’m not a doctor but my wife is a doctor here in San
Diego, okay. And the first comment I’d like to make about government
running things, the military is run by the government, okay? And that’s
something that no one seems to mention. And also, our economy is kind
of run by the government so like I think our government actually does a
good job running things. Number two is the military has an insurance
called TRICARE. It’s a government run healthcare system. Every retired
military and active duty military is under TRICARE, and this is the
first time you’re ever going to hear about TRICARE in the nation, right
this morning. I’ve never heard anyone talk about TRICARE, the
government run healthcare of the U.S. military. And for example, my
wife, we take – about a third of our patients here in San Diego are
TRICARE and it’s one of the best insurances we accept and I don’t know
why no one’s talking about TRICARE.

CAVANAUGH: Let me ask you, David, this is different from the V.A. system?

DAVID: It’s TRICARE. It’s the TRICARE system. It’s basically a
government run healthcare that every single, you know, active military
and retired military has. So I’m not sure why you guys never talked
about it. I’m just not sure why Barack Obama’s not talking about it.
But it’s there, it’s a great system. We get paid, you know, on time. We
actually get paid better than most private insurance companies. So,
like, I don’t know why that’s not in the discussion. It’s the first
time I’ve ever heard it and it’s the first time anyone’s ever hearing
it on the radio.

CAVANAUGH: I don’t know why it’s not under discussion either. I
haven’t heard about it before but let me ask you something about
something I have heard. You talked about the military running – the
government running the military, the government also runs the V.A.
healthcare system, which, you know, according to some people, is one of
the – is a really, really good healthcare system. What do you think
about that?

DAVID: You know, I’m not so familiar with the V.A. system. I mean,
you know, of course my grandfathers and, you know, people in my family
have gone through V.A. but, you know, it’s – I think it can probably
have some improvement but I know that the company that runs the
military’s insurance is TRICARE, T-r-i-dash-c-a-r-e. Anybody – You can
ask any military person, they’ll tell you about TRICARE. And…

CAVANAUGH: Well, we’ll try to find out more about it, David. Thank
you for that call. This is open phones on a special edition of These
Days. The number is 1-888-895-5727. We’re taking your comments on
healthcare reform. Bobbi is calling from La Jolla. Good morning, Bobbi.
Welcome to These Days.

BOBBI (Caller, La Jolla): Thank you so much, Maureen. This has been excellent.

CAVANAUGH: Thank you.

BOBBI: I – I used to work for a hospital. I was Director of Public
Affairs and Public Relations for a hospital in the Boston area before I
moved here 13 years ago. And I thoroughly believe, and I haven’t worked
for a hospital since then, but I thoroughly believe that the problem is
not excess charges from hospitals, they’re pinched because of Medicare
and Medicaid and I understand why some of them are concerned about this
healthcare reform because if they keep getting paid too low, they’re
going to be in trouble and also, they have to endure the cost of free
emergency care. And it’s not the physicians. I mean, the primary
physician, average salary is $120,000 and the usual – the average cost
of the going to medical school is $140,000. But as a public affairs
director in Boston of a hospital, I had volunteers who worked for us, I
had seven volunteers who worked for our department and one of them in
particular was a wife of a healthcare executive. Now what she did –
what she told us about just absolutely amazed me. She and her husband,
her husband was an insurance company exec, had tickets to the Olympics
in Russia, whatever year that was. The women all got fur coats, and the
family all got leather luggage as well as first class tickets and
deluxe accommodations. And I thought to myself, you know, people are
struggling to pay their healthcare bills and these insurance company
execs are so over compensated. I don’t understand what the value added
insurance companies provide. There’s – If they were supposed to make
things easier for hospitals and doctors to provide care, that’s not the
case. Every doctor you can talk to today and every hospital you can
talk to today will tell you that the red tape for – that provided by
insurance companies—and every patient—is horrendous. So as far as I’m
concerned, they are the main culprits.

CAVANAUGH: What would you like to see done with healthcare reform, Bobbi?

BOBBI: Well, I would love a system that allows some people who are
happy with their healthcare, they probably have really great
healthcare, keep what they want, but I also do very much agree that we
need a healthcare system that is run by the government efficiently and
effectively, and I think that’s quite possible. Aside from the low
reimbursements for Medicare and Medicaid, they work. And as the caller
before said, a lot of things work. And as the caller from Canada said,
there are other countries that have these options that are doing much
better than America is. I’d like to see that kind of option here for

CAVANAUGH: Thank you so much for your call. A special edition of
These Days right now, and we’re taking your calls about healthcare
reform. The number is 1-888-895-5727. Next on the line is Aaron. He’s
calling from Carlsbad. And good morning, Aaron. Welcome to These Days.
Hi, Aaron, are you there? I think maybe we should go to Jack in San
Diego. Good morning, Jack. Welcome to These Days.

JACK (Caller, San Diego): Oh, good morning. I also am a Canadian.
Actually, I’m a dual citizen. I’ve lived in both countries. I’ve
experienced both medical systems. But I think – Well, there’s two
issues that catch my attention. One is they keep talking about this
thing called choice. If you go through the Canadian medical system, you
simply go into any clinic or any doctor, give them your name and you
give them a number, and you’re treated. If you have to go to a higher
level, to, say, to a specialist, you get transferred on. Again, you
just simply give your number and your name. All the billing goes
directly to the government. You never see any billing. You never see
any, you call them co-pays or insurance, whatever it is, you never see
any of that. You just never – There’s never money transferred in any
portion of your medical system. Everybody gets the same system. As far
as lineups go, well, I mean, you can exaggerate anything you want but
the simple fact is that if you need something immediately, you get it
immediately. If it’s something that’s going to take a little bit
longer, well, you might have to wait a few days.


JACK: Umm…

CAVANAUGH: Yeah? Go ahead, Jack. I’m sorry.

JACK: I – I just don’t -- I just don’t understand what the confusion
is, as the other physician had mentioned. The gross amount of money
that they spend in the government – country of Canada per person is
less than what it is here and it’s – You can almost – there (audio
dropout) that amount of money to the fees and the benefits and the
profits that the individual corporations get from it. It’s – Sorry.

CAVANAUGH: No, that’s okay, Jack. Thank you so much. I think you put
it very well. That was Jack calling from, I think, San Diego. And we
have to take a short break. When we return, we’ll continue to take your
calls. First, though, before we take a break, I want to hear – I want
to play a clip from one of our guests, Dr. Jeoffry Gordon, from the
shows that we’ve had this week. He is a member of Physicians for a
National Health Program, and he talked to us about our present – his
ideas about our present health insurance plans.

DR. JEOFFRY GORDON (Physician): When the congress people stand up
and say everybody loves their health insurance, there are two kinds of
people who love their health insurance, an insurance plan that, by
accident, gave them a good doctor who they love. They love their
doctor. They don’t choose their health plan; their employer does. They
happen to have good medical care from a good physician. Secondly, the
people that like their insurance have never used it. Everybody who uses
their insurance is now running for their wallets and finding their
wallet isn’t big enough.

CAVANAUGH: Give us a call with your comments when we return. The
number is 1-888-895-5727. You’re listening to These Days on KPBS.


CAVANAUGH: Welcome back. I'm Maureen Cavanaugh. You're listening to
a special edition of These Days. We’ve opened up the phones so more
people can get a chance to let their voices be heard on the issue of
healthcare reform. Our number is 1-888-895-5727. All this week, we’ve
been talking about guests (sic) about various aspects of healthcare
reform. One aspect that’s developed just about over the past week is
that we’ve been seeing angry crowds at healthcare town hall meetings
that are being held by congressmen in their home districts. The
protestors are expressing outrage against healthcare reform and many
are questioning whether the outrage is actually being fueled by
rightwing organizations and special interests. And I’d like to know, do
you think these protests are genuine? And, really, the deeper question
is, what are people afraid of about healthcare reform? Are you
concerned about the changes you’ve heard proposed? Give us a call,
1-888-895-5727. Let’s take a call from Bob in San Marcos. And good
morning, Bob. Welcome to These Days.

BOB (Caller, San Marcos): Good morning.

CAVANAUGH: Yes, how – What is your comment?

BOB: Well, I’ve been a Republican all my life and I have to say that
I’ve worked for big business, I’ve been a small business owner, and I,
just in the last year and a half, converted to MediCal, Medicare and
Social Security. And I find it works fine so far.

CAVANAUGH: So – And you thought maybe it wouldn’t?

BOB: Well, I was concerned because, you know, there are additional
coverages that you can buy and I’m still not 100% satisfied. They’ve
got me in the donut hole now and I’m on a medication that’s a
maintenance drug and I’ve been paying the co-pay and the pharmacy nine
dollars and forty dollars and thirty dollars and now all of a sudden I
find out I’m in the donut hole…

CAVANAUGH: Oh, I – That donut hole where you have to pay for your own prescriptions.

BOB: My drug is now a thousand dollars.


BOB: Just turning over. So I think – I’ve been in big business. I’ve
seen the way companies try to provide for their people. I’ve been a
small business owner and I’ve tried to persuade people to get coverage
and be covered. And I’ve been a Medicare, MediCal, Social Security
person that, for the last year and a half, has been involved in that
part of it. But my suggestion would be – I think the Republicans have
abandoned – they’ve abandoned the citizens, to be sure, because they
haven’t said anything reasonable in the last six months since our new
president’s involved. And I didn’t vote for him but I think we owe him
the courtesy of letting him get on with the job.

CAVANAUGH: I want to thank you so much for your call. And I also
want to remind our listeners that we have been talking about healthcare
reform all through the week. And we did talk to a small business owner
who also happens to be a member of the Regional Chamber of Commerce,
Vince Mudd, we talked to him on Wednesday. And he told us why
healthcare is important to him as a small business owner.

VINCE MUDD (Small Business Owner): I pay 100% of the healthcare for
my employees and when my kids are in school, I want to make sure the
child they’re sitting next to doesn’t have tuberculosis and that
they’re going to the hospital and being taken care of. So I’ve come
down on the side of saying that I believe that life, health, safety
issues in our country are things that should be provided for for our
citizens. We should be able to take care of that. How we do it is
what’s up for debate. And on the single payer question, just so we’re
clear, as a business guy, I don’t – single payer means different things
to different people. I’m not prepared to say we’re going to put all the
insurance companies out of business. I think that if you don’t provide
a benefit to people, you shouldn’t exist, so some insurers don’t
provide any benefit so they don’t exist. What I don’t want to do right
now – What I’m doing today as an employer is I’m paying healthcare to
my work – through my health insurance premium and my auto insurance and
my homeowners insurance, my general liability insurance. I’m paying
healthcare in about 25 different places, and I’d like to only have to
pay it in one place. And so that one place could be my primary premium
that I’m paying currently to my insurer but the answer to your question
is where I’ve come down as an individual is that healthcare is
something that I want to make sure everyone in this country is healthy
enough to sit next to my child in school.

CAVANAUGH: That was Vince Mudd, one of our guests. He’s from the San
Diego Regional Chamber of Commerce. He was – joined us on Wednesday to
talk about healthcare. We’re taking your calls and asking for your
opinion about healthcare. 1-888-895-5727 is the number to call. Let’s
take a call from Larry in Del Mar. Good morning, Larry, and welcome to
These Days.

LARRY (Caller, Del Mar): Good morning. Thank you.

CAVANAUGH: You’re welcome.

LARRY: I had a – my thought comes that if the government pays for
the physician’s professional liability insurance and takes care of
that, then they won’t be practicing defensive medicine and ordering all
these extra tests for people who want one for their mother who’s got a
bump on her hand every, you know, every two or three weeks. That would
be one step in taking down the cost of healthcare for tests that don’t
need to be run.

CAVANAUGH: And have you experienced rising healthcare costs?

LARRY: Absolutely. Everybody has. You have to live under a rock not to have seen that.

CAVANAUGH: I remember one of our guests this week was talking to us
about the fact that if we did, indeed, require people to be covered by
healthcare, that he thought that would immediately drive down the cost
of healthcare and curb healthcare premiums. Have you heard about that?
What do you think about that?

LARRY: Well, when you put everyone in the pool, it smooths it all
out and you don’t – I don’t know how that would work. I just know that
the cherry picking that goes on with the insurance companies is leaving
a whole lot of people uninsured. And you judge a coun – you judge a
people by the way they treat their old and their infirm, and we’re not
doing a very good job at this point.

CAVANAUGH: I want to…


CAVANAUGH: Oh, I’m sorry. Go ahead, Larry.

LARRY: And I think those people who are banging the drum that this
is the wrong thing to do need to look into their hearts and decide what
they would do if it was a member of their own family who was uninsured.

CAVANAUGH: Thank you, Larry, for your comments. You’re listening to
a special edition of These Days. Our number for – our call-in line
number is 1-888-895-5727. Holly is calling from Poway. Good morning,
Holly. Welcome to These Days.

HOLLY (Caller, Poway): Good morning. I wanted to – and thank you for
taking my call. I wanted to say that recently there’s been a lot of
polls showing like declining support. I think even NPR had one for
health reform. And I find that a little hard to believe. Like it
doesn’t say, the polls that I’ve heard, don’t – don’t ask specific
questions. Because everybody I meet is either unhappy with the cost of
healthcare, they’re having trouble getting coverage, they’re having
trouble seeing a doctor. So I really can’t believe that people don’t
want these improvements in cost and access to care and so I think maybe
the polls aren’t asking the specific enough questions. And, really, I
think that the – everybody does want at least a public option that’s
not a single payer plan. And I think when the midterm elections come
out that the Representatives that don’t support what the people want
will be voted out.

CAVANAUGH: Thank you for your comments, Holly. I really appreciate
it. The number is 1-888-895-5727. The report that Holly mentioned, I
believe she was talking about a report by Liz Halloran earlier this
week and it was titled “The Public is Baffled by the Healthcare
Arguments.” And the polling listed in it was when pollsters ask
straight-up questions about whether people support favor – or whether
people favor or oppose revamping healthcare, there is little more
opposition than support. In other words, there’s a little more
opposition than there is support for the plan. But when the surveyors
asked more specific questions about what the plan might include, then
there is remarkably consistent support in the 55% range. So I guess it
does matter what questions are asked to find out how many people
actually do support healthcare reform. We’re taking your calls at
1-888-895-5727. And Lamise (sp) is calling from San Diego. Good
morning, Lamise. Welcome to These Days.

LAMISE: Yes, good morning.


LAMISE: Thank you for taking my call. I would think, first of all,
fear and dependency comes to my mind regarding health and things that
would help decrease that, and we do want freedom, is probably
preventive care, education and empowerment. So, you know, like these
kind of things. And President Obama did mention that aspect and I think
like in schools, programs, things that would help in the long run to
bring the health costs down and teach people on how to take care of
themselves, how to eat properly, how to exercise, right from grade
schools through and that would, in the long run, help us. And then in
the immediate, it’s education, even for those who are dependent on the
system, to show them and support them, spend more time to show them on
how they can be – take care of themselves and, you know, prevent some
things and stuff like that.

CAVANAUGH: You know, Lamise, we just heard those sirens in the
background. It’s interesting we’re talking about healthcare and there
could be ambulances driving around your neighborhood. I’m wondering,
you’ve heard the debate over healthcare reform, where do you come down
on this? What proposal do you support?

LAMISE: If I’m – I don’t know about the detail of the proposals but
I think the preventive aspect of the proposal so – And then they can –
I think that the – whatever they will propose will have to be changed
in time depending on how we do it. It’s not – It shouldn’t be like a
rigid thing that they decide on and that’s it. And that’s what we do.
We decide on something and a system and then it stays fixed. It should
be a process that is continually changing as we’re improving. That’s my

CAVANAUGH: Thank you for your call, Lamise. You know, Lamise’s
opinion was quite similar to an opinion of one of the guests we had on
our show this week. Dr. Mimi Guarneri is a cardiologist and Medical
Director of Scripps Center for Integrative Medicine, and she talked a
lot, when she appeared on Tuesday’s show, about the kind of healthcare
system we already have and what we need to change it in terms of
preventative care.

DR. MIMI GUARNERI (Medical Director, Scripps Center for Integrative
Medicine): I would just like to take a step back and be as bold to say
that we don’t have health care in this country. We have disease care.
We have a ‘we will fix you when you break down’ mentality. And for many
years, that’s what we have been doing. The end result of that is no
focus at all on prevention, and when we think about chronic disease—and
I agree with you, Mike, this is the key—most of the healthcare
expenditure is going into chronic diseases like heart disease,
diabetes, all the results of obesity and so on. What do we do to
prevent these diseases?

CAVANAUGH: And that was Dr. Mimi Guarneri. She was a guest on
Tuesday’s show. She’s Medical Director of Scripps Center for
Integrative Medicine. We are taking your phone calls on healthcare
reform at 1-888-895-5727. Let’s hear from Alan in North Park. Good
morning, Alan. Welcome to These Days.

ALAN (Caller, North Park): Good morning. Hey, you may remember that
back in the spring of 1994, thousands of volunteers in the State of
California helped to gather more than a million signatures to put an
excellent single payer healthcare plan on the ballot here. But in the
fall when the election came around, the insurance companies used their
money to frighten the public with really misleading advertising and,
unfortunately, the vote was lost. Now this time around, we, the people,
don’t even get to vote. It’s in the hands of congress. And I kind of
think that the insurance companies can pretty easily badger and bully
enough members in congress to really water down any kind of genuine
healthcare reform. So what we need to do as the general public is to
really educate ourselves, our neighbors, our coworkers, our friends,
and learn what single payer is really all about. It eliminates the
bloated profits that the insurance companies make. It takes that
savings and uses that money to make sure that everybody gets the
healthcare that they want, that they need, and it just sets up a system
where a single agency does that process for far less overhead and
paperwork, and it would be a wonderful thing for our country to have
such a system that we could all have universal healthcare for all of us.

CAVANAUGH: Now, Alan, as I suppose you know that single payer plan
is not even on the table as congress tries to make up some sort of
healthcare proposal but a lot of other changes are on the table like
pooling health insurance plans and coming up with a public option and
eliminating the need for preexisting conditions. And I’m wondering, is
that, anything you’re hearing coming out of congress, is that something
you might be able to support?

ALAN: There are some things that are coming out of congress that
will be greatly beneficial and will be helpful but I think we have an
opportunity now, as a citizenry, to ensure that we put the pressure on
congress to come up with a reasonable, good single payer healthcare
plan, a universal plan that provides something for everyone in an
equitable way so that we can have a good healthcare system in this
country, which we all deserve.

CAVANAUGH: Thank you for your call. I appreciate it, Alan. We’re
taking your calls at 1-888-895-5727. This is a special edition of These
Days to let your voice be heard on the healthcare reform issue. Peter
is calling us from Point Loma, and good morning, Peter. Welcome to
These Days.

PETER (Caller, Point Loma): Yeah, thank you so much for taking my call.

CAVANAUGH: You’re welcome.

PETER: Actually, I have my wife on the line and (audio dropout) question.


PETER: Dana.

DANA (Caller, Point Loma): Yes, hello.


DANA: Hi. I just – my husband just called and patched me into your
radio show. I am an emergency physician assistant. I work throughout
various ERs in the state of California.


DANA: And I just want to state that I would say close to 60% of my
patients that I see in the emergency rooms are illegal immigrants whose
bills are paid by Medi-Cal, which means that you and I, as taxpayers of
this state, are subsidizing the healthcare for illegal immigrants.
These are people that are not – do not have medical emergencies but
come to the emergency room for non-emergent medical care, particularly
for their children. One of the reason there’s a disparity in the cost
of healthcare, at least in the state of California, is because we, as
taxpayers, have to pay higher premiums to subsidize this care. Why this
situation is not addressed is an absolute mystery to me. And I can tell
you there are days when I work in the ER that I never speak a word of

CAVANAUGH: Well, I wonder, as the healthcare debate goes on, there
are about 50 million U.S. citizens who don’t have healthcare insurance
and could wind up in emergency rooms as well. What do you think about
that, Deana (sic), the proposals that are being talked about, changing
the healthcare system? And perhaps we can address the illegal immigrant
issue later. The actual healthcare proposals for U.S. citizens, what do
you think of those?

DANA: Right, well at this point, because of the illegal immigration
population, I don’t know if you can really parse out the two
situations. I think they’re intertwined at this point because whatever
single payer plan you propose, you’re going to have to address the fact
that illegal immigrants are also going to benefit from a single payer.
Having said that, I do agree that there needs to be some kind of
overhaul of the United States healthcare delivery system, although
nobody who comes to an emergency room is denied healthcare, nobody.

CAVANAUGH: Okay, well…

DANA: But as far as making it equitable, I do think there needs to
be some changes but you have to factor in the tremendous burden of the
illegal immigrant population who is skewering the costs, the cost ratio
of a legal versus an illegal U.S. citizen. I think that has to be

CAVANAUGH: And you have. And I appreciate the phone call. Thank you
so much, Deana. We will continue our special edition of These Days,
taking your calls on healthcare reform proposals, 1-888-895-5727. We
have to take a short break. We will return in just a few moments.


CAVANAUGH: Welcome back. I’m Maureen Cavanaugh. You’re listening to
a special edition of These Days. We’re taking your calls about our
series of programs on healthcare reform and we’re opening up the lines,
hearing your voices about healthcare reform. What do you think will
happen if congress does nothing? Will private insurance companies in
the free market fix the rising costs of healthcare? How many uninsured
Americans can fall through the cracks before the rest of us all – we
all start feeling the pain? A guest on Tuesday’s show was Victor Fuchs.
He was professor emeritus on economics and health policy and research
at Stanford University. He told us what he thinks will happen if we
don’t do anything.

VICTOR FUCHS (Professor Emeritus, Stanford University): Costs will
continue to increase at about 3% per annum, faster than the rest of the
economy. The first big explosion will be when the Medicare trust fund
runs out of money but sooner or later there will be a real medical care
crisis. Alice Rivlin, a very distinguished economist, put it very well.
She said long run fiscal policy in America is health policy. If we
don’t get our health policy right, we won’t have our economy in the
correct position.

CAVANAUGH: We’re taking your calls at 1-888-895-5727. And let’s hear
from Susie in El Centro. Good morning, Susie. Welcome to These Days.

SUSIE: Hello. I’m here. I wanted to talk about a situation that
happened three and a half years ago, well actually longer than that. My
husband had to have a liver transplant which, curiously, was necessary
because of a transfusion in 1968 where he got hepatitis C. There’s two
things, one, we had to travel frequently from the Imperial Valley to
San Diego and that was costly. We do have good insurance. However, the
associated costs meant that we had to borrow from a pension fund and
because we had that option, then we were able to do that. And the other
thing is, the inequity of the system was really evident because in
qualifying for a transplant, one of the items that is assessed is your
ability to pay for your prescriptions after the operation.

CAVANAUGH: I didn’t know that.

SUSIE: And if you don’t have good insurance, then you’re not going to qualify at the same level as someone who does.

CAVANAUGH: May I ask you, Susie, how expensive was it for you? How much did you have to draw out of your pension?

SUSIE: $10,000.00.

CAVANAUGH: And that was over and above the health insurance that you had.

SUSIE: Right, because we had to stay in San Diego for two months. We
had to commute back and forth from time to time throughout the very
first year. I mean, we had to see the doctor at least once a week
initially and then once every two weeks and so on and so forth. And, of
course, we had to have meals over there and all of those sorts of
things because we live, you know, in the Imperial Valley, and that’s a
two-hour drive.

CAVANAUGH: I’m wondering, Susie, what would you like to see changed in our system of healthcare?

SUSIE: I want to see a public option. I want to see us all level and
I think that’s going to reduce the cost for everyone and it’s also
going to provide the kind of care that we really ought to have in this
nation. We ought to have healthcare for every single person.

CAVANAUGH: Susie, thanks for the call. I appreciate it. The number
is 1-888-895-5727. Larry is calling from San Diego, and good morning,
Larry. Welcome to These days.

LARRY (Caller, San Diego): Good morning. Thank you. I also would
like to address the cost of insurance and I think with another
government option, or a public option, it certainly would drive the
cost down. My situation, briefly, is I’m self-employed. My wife lost
her job two years ago and we had health insurance through her company,
which put us onto the California COBRA plan. The California COBRA plan,
two years ago, was $1200.00 a month. Last year it went to $1500.00 a
month, and now I’m paying $1800.00 a month, $23,000 a year for health
insurance. I’m in that donut hole, I guess if you call it, because I’m
62, I’m not eligible for Medicare, I’m a Vietnam era veteran but I make
too much money so I can’t use the V.A. system. So I think with the
government option, it would drive the cost of health insurance down for
everyone and I think – I think anyone who opposes that is, you know, is
– they’re not thinking of the healthcare system. They’re just thinking
of themselves. They’re selfish personalities, I guess. And I wish I
could’ve got through to Mr. Bilbray yesterday because I would like to
know how much money he’s taking from the pharmaceutical lobbies. So
that’s kind of my comment.

CAVANAUGH: Well, Larry, I appreciate that comment. And we heard from
a retired San Diegan who had also dealt with healthcare issues during
our show on Monday, Alan Bennett, and he talked to us about what a
government run healthcare plan would look like that he would like to

ALAN BENNETT (Surgical Patient): I want that system. I want a V.A.
system. It’s the highest rated on 294 point criteria. They are the
highest rated medical delivery system in the United States. And I think
one of the reasons why they are so well respected and families love
them is because they have a well system. They’re – they have their
patients for life, not cut off at 52, so they take care of people
before they get sick and that really holds down medical care. I’d love
to see single payer universal healthcare like our congress and Senators

CAVANAUGH: We’re taking your calls at 1-888-895-5727 on this special
edition, this Friday edition of These Days. Let’s hear from John in La
Jolla. Good morning, John, and welcome to These Days. John, are you on
the line? Okay, let’s try to hear from Katherine in San Diego. Good
morning, Katherine. Welcome to These Days.

KATHERINE (Caller, San Diego): Good morning.

CAVANAUGH: Yes. How can we help you?

KATHERINE: I was interested in saying that Obama’s first words on
healthcare were that a single payer was the only way we were going to
pull national costs down. I thoroughly agree with that, and I’m
distressed that it’s not even on the table. I do feel that in terms of
what must be in the bill that he actually ends up signing, and he’s got
to sign a bill, there’s just no two ways about it, we have got to
control costs in this country. It’s crazy.

CAVANAUGH: Katherine, I’m sorry. I don’t mean to interrupt and I
want you to finish what you wanted to say but it sounds to me as if
you’ve been following this whole healthcare reform issue very closely.


CAVANAUGH: I’m wondering, what do you think about the disruptions
that are going on at the town hall meetings that you’ve been seeing on

KATHERINE: Oh, I think it’s just a whole lot of people who are being
paid to be there or something. I don’t know how they’re getting all
those people there but they’re just a complete betrayal of, you know,
public access to the Senators and congress people that are trying to
hear from their constituents. And I’m sure the healthcare money is
behind it. We’ve got to get that – I mean, the insurance money. We’ve
got to get insurance money out of public healthcare, that’s the other
thing. We must cover everyone. There is no excuse for this country not
having every single person covered, and we must get the healthcare – I
mean, the insurance companies out of the public money because their job
is to make money for their company; their job is not to cover human
beings and take care of them. And that’s so clear with what’s going on.
I was in the hospital for three days. My bill, when I checked it, was


KATHERINE: …and my health insurance people—this is when I realized
how broken we were—my health insurance company settled for $4800.00,
that bill. So that means that people who are covered are…

CAVANAUGH: Pay less.



KATHERINE: And the people who are not covered are left with the
$43,000 bill and losing their homes and going bankrupt and it’s just so
inequitable. It’s just not fair. And I know that’s my healthcare and I
have good healthcare…

CAVANAUGH: Well, thank you.

KATHERINE: …but it’s not fair.

CAVANAUGH: Katherine, thank you so much for your call. I really,
really do appreciate it. Let’s take another call. Hugh is calling from
El Cajon. Good morning, Hugh. Welcome to These Days.

HUGH (Caller, El Cajon): Good morning. You just had a call a couple
of minutes ago from a doctor who states that she works in emergency
rooms throughout the county.

CAVANAUGH: Right, a nurse.

HUGH: And part of her statement – Oh, a nurse?


HUGH: Well, anyway, part of the statement was that everyone has
access to healthcare because everyone can go to an emergency room.
That’s nearly malpractice, that statement. I’m a nurse. When you go to
the emergency room, you don’t get healthcare. You are treated for an
emergent situation. Healthcare is being able to see a primary
physician, is being able to continue treatment, after the visit, with
medication. People who go to the emergency room don’t have insurance in
– to follow up with medication past being in the hospital or past being
in the emergency room, so that’s not the same thing as healthcare. And
in matter of fact, having access to an emergency room and not having
access to healthcare is exactly part of the reason that causes people
to not get healthcare because they continue to go back to the emergency
room. So you have an emergent problem, they go in, they get their heart
treated that day. Two weeks later, they can’t get more medication,
another week later, they’re back in the emergency room. It’s a cycle
that continues to cause people to visit hospitals and get the most
expensive care available as opposed to getting healthcare. And this is
part of – of course, part of the problem and why we need to have a
single payer system where everyone has access to healthcare, not access
to an emergency room.

CAVANAUGH: Thank you for your point, Hugh. Thank you very much for
that call. And let’s hear from Jerry in La Jolla. Good morning, Jerry,
and welcome to These Days.

JERRY (Caller, La Jolla): Thank you so much for taking my call. I’m
going to pull over now because I’m on my way driving to my doctor.

CAVANAUGH: Okay, that’s a good idea, Jerry. What did you – what kind
of comment did you want to add to our discussion on healthcare reform?

JERRY: Here I am. I’m the co-founder of the San Diego Coalition for
Single Payer. And I really appreciate the program that you’ve been
running all this week, and it’s been excellent. In view of the fact
that so many of your callers, your people that called in, are looking
for some sort of public option or single payer, I have news that
doesn’t seem to have been on the program at all and that is that we
have now a small window of opportunity to get single payer. Now I’m not
talking about Obama’s plan, I’m not talking about HR-3200 (audio
dropout) …bill that has been a convoluted compromise that the Democrats
have come up with. I’m talking about HR-676, the true (audio dropout)
bill which gives Medicare for everyone. Now that’s going to be on
(audio dropout) …congress. It’s going to be voted for within three or
four weeks. And it’s very important that people call their congress
people, their congress representatives, and to call Henry Waxman and
call John Conyers’ office. We need to have this bill scored by the CBO,
the Congressional Budget Office. It would…

CAVANAUGH: You know, Jerry, I have to stop you because your
connection is not really terribly great. But let me just make sure
you’re talking about HR-676?

JERRY: Yes, we are.

CAVANAUGH: Okay, I’m going to have to end it there with you, Jerry.
Thank you so much for calling in. And you got that message out. I think
we’re going to be taking Luis in Yuma calling us now. Good morning,

LUIS (Caller, Yuma): Good morning. Thank you for having – I just
want to say – I actually drive 30 minutes out of town because I don’t
get your station…


LUIS: …and I actually drive to a rest area out of town to listen to the station.

CAVANAUGH: Well, thank you for that.

LUIS: Yes, I heard a gentleman call earlier about how he would like
to have the whole V.A. system for everybody and as a three-time Iraqi
war vet, I am currently going through the V.A. system to get my health.
I have several health issues resulting from the war. And I’ve been out
of the service now for a year and a half and they are just now getting
my case and they are just now getting me the emergency specialist care
that they’re – they’re calling me. So if that’s what the country’s
going for, for that kind of waiting time, then I don’t think this new
program would work. I don’t think any of the new proposals would work.

CAVANAUGH: Okay, you know, thank you for that, Luis. Thank you for
driving to hear us. We really do appreciate it. And thank you for
calling us. We have been conducting a special edition of These Days and
we’ve been taking your calls and comments. We’ve been talking about
healthcare reform all week. And if this week of shows on These Days has
gotten you involved in the healthcare reform debate, there are some
other things that you can do. First of all, if you’d like to, you can
listen to the series again or you can read the full transcripts at our
website,, and we invite you to add your comments to
those already posted there. I know there are some people on the line
that I’m not going to be able to get to today. Please go to, post your comments. They are read by us and by
interested people. You can also e-mail and call your Senator and member
of congress and even the president about how you feel about healthcare
reform. I think we have all learned this week that reforming the
nation’s healthcare system is too important to leave it to the people
with the loudest voices and the biggest bankrolls. I want to thank all
of our guests and, of course, all of our callers who participated in
our special series this week. Tonight on San Diego Week, they’ll
continue this discussion on how to reform healthcare in America. That
is 7:00 p.m. on KPBS Television. I’m Maureen Cavanaugh. You’ve been
listening to a special edition of These Days on KPBS.