June 29--A decision by the U.S. Supreme Court that requires Americans to buy health insurance upholds a benefit that comes with a cost, local health professionals and insurers said Thursday.
The law that the court upheld tells Americans to buy insurance by 2014 or pay a tax, but also requires insurers to sell policies to people with pre-existing conditions such as diabetes that require long-term care.
"As I see it, it allows people to get insurance who could not get insurance," Dr. Robert Childs, a pediatrician in Hazleton, said.
Hospitals should benefit, too, Childs said, because patients entering the emergency room will have a way to pay, whereas some patients now lack insurance and their bills go unpaid.
James Edwards, the chief executive officer of Hazleton General Hospital, said it's hard to argue against insuring everyone.
"I think that's a real plus to the bill," he said while offering caution.
"This has to be paid for somehow," Edwards said. "I find it hard to imagine that somehow this isn't going to come out of the payments that hospitals and physicians are receiving now."
When required to buy health insurance, people will use their coverage, especially if they postponed treatment while they were uninsured.
Edwards used the example of patients who "gritted their teeth" and limped on sore knees that they will have surgically repaired or replaced once they are insured.
He has heard estimates that 30 million people or more -- including about 1.37 million Pennsylvanians -- lack health insurance.
"Add that many people to the system and say it's going to bring down the cost? Intuitively, I find it hard to believe that," Edwards said.
Adding people to insurance rolls will level the cost of premiums, in theory. Some new customers will be in excellent health and need little care, whereas others will have chronic diseases and their care will cost more.
Before Thursday, insurance companies feared that the court would require them to insure people with pre-existing conditions without requiring everyone to buy health care.
The court, however, upheld both provisions.
"That was a positive reaction to us," Kimberly Kockler, vice president of governmental affairs at Blue Cross of Northeastern Pennsylvania, said.
Whether insurance rates will increase is difficult to predict, both Kockler and officials of Geisinger Health System said.
At Geisinger in Danville, Drs. Thomas Graf and Duane Davis said the act rewards caregivers who find better ways to deliver and finance health care. They spoke during a telephone news conference.
Kockler said the Patient Protection and Affordable Health Care Act levels the field for insurers by requiring all companies to insure patients with pre-existing conditions.
While Blue Cross is preparing for more customers, Kockler believes doctors and hospitals might be hard pressed to care for new patients.
"Are there enough doctors, enough nurses, enough technicians to be able to serve those patients?" Edwards wondered.
At Hazleton General, the hospital has been spending money to recruit physicians in under-served specialties. Integrating serves for inpatients and outpatients gives the hospital flexibility to treat more people, too, he said.
"Does that mean seeing an extra 100 patients or an extra 500 patients a day? Obviously, that's a significant difference," Edwards said.
Childs, who believes the law shifts the burden of paying for health care from taxpayers to insurers, said practices won't change much in his office in Hazleton.
"I see whoever, whenever. That's always been my philosophy. However, the health industry as a whole has not done that," Childs said. "Now it's time for the insurers and health industry to work together to provide that.
John Keegan, owner of Heights Terrace Pharmacy in Hazleton said the law might work against independent pharmacists like him.
Insurers, he said, might require customers to purchase medications by mail rather than at local pharmacies, he said.
The law also could entice large corporations to drop health insurance for their employees, Keegan said.
Companies with 50 or more employees that don't offer health insurance pay fines of $2,000 per employee. The companies might discover that paying fines is cheaper than providing insurance for their workers, Keegan said.
Congress, he pointed out, has the power to change the law, which also factors in the presidential race.
President Barack Obama supported the law, which has been dubbed Obamacare, whereas Republican Nominee Mitt Romney said he will work with Congress to repeal the law if he is elected.
The debate also plays out in the local contest for Congress.
Republican Lou Barletta, the incumbent in the 11th District, wants to repeal the law, whereas Democratic nominee Gene Stilp supports it.
"Today's decision is a victory for big government and a defeat for individual freedom," Barletta said in a statement. He said the law discourages small businesses from hiring more employees and takes money from Medicare, the program that insures senior citizens.
Stilp said Congress should accept the court's decision. Rather than try to repeal the law, he said Congress should shift attention to bolstering the economy and Social Security.
"Today is a good day for the people of the 11th District who have pre-existing conditions, who fear losing their insurance if they change or lose their job, who have had their benefits limited, and whose children have not been able to gain coverage," Stilp said.
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