By The Record-Eagle, Traverse City, Mich.
McClatchy-Tribune Information Services

June 29--TRAVERSE CITY -- Jeanne Lee knows health insurance can be expensive, after she took on the burden after years of being covered through her employer.

Lee, of Wellston, is among the northern Michigan residents, health care providers, insurers, businesses and others weighing the impact of Thursday's landmark U.S. Supreme Court ruling that upheld much of the federal health care law. Locals offered a wide range of reaction to the long-awaited decision.

"I have my own now, so I know what it's like to carry your own. It's very expensive," Lee said. "I ended up taking a huge deductible just so I could get something that was affordable to me."

Lee said it's important for everybody to have access to affordable insurance, but she wonders who's going to pay for it.

"There are lots of people whose poor lives get ruined over one illness," she said. "I think there are parts of (the law) that are good, but I think taxes are a big part of it. The money has to come from some place."

Jerry Kadrovach, of Traverse City, also is concerned about who will pick up the country's health care tab. He said it's unfair for people who take care of themselves to pay for those who don't.

"Everybody's entitled to health care, but I disagree with the fact that everybody's going to pay for it," he said. "You can go into the medical centers and watch people that are getting free care who are just abusing themselves. They're sitting there in a wheelchair, and they can't move but they're sucking down a two-liter of Mountain Dew."

Kadrovach hopes requiring people to purchase health insurance prompts them to take better care of themselves.

The region's business community is still sorting through the ramifications of the Supreme Court decision.

"I don't know any of our members that want to say 'yeah' today," said Doug DeYoung, vice president for government relations at the Traverse City Area Chamber of Commerce. "What we are hearing from our members is the uncertainty of what comes next. How will the health insurance exchanges be laid out and what will be the true cost on business?"

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Bonnie Alfonso, president and CEO of Alfie Embroidery Inc., said it would be great if the health care legislation works and reduces costs for small business, but she's doubtful.

"Health care is a huge cost factor for small business," Alfonso said. "I will be curious to see what happens next, and I'm not convinced this is the best plan. I think it will be just shifting who pays for that cost."

Traverse City attorney Michael Senger said he's not bothered by the government's intervention in the health care industry.

"What bothers me is that the health care business has become a business. And it's a huge, huge business," Senger said. "The only people who can deal with that business is the federal government."

Senger also said the decision sends an important message about the judicial branch.

"It helps us believe again that the court can make decisions based on their analysis of the law rather than their analysis of the politics," he said.

College-aged residents were relieved that the law will help them maintain coverage through their parents' health care plans.

"I like the stability it provides, not having to worry about it right after college," said Jason Kuck, 19, of the Ann Arbor area, who's taking a class at Northwestern Michigan College this week.

Traverse City native Clarence Drilling, an NMC student, agrees. College students already have plenty of financial burdens, he said.

"I think that's a pretty good deal," he said.

First District Congressman Dan Benishek has been a vocal critic of the federal health care law and said he's "disappointed" in the court's ruling.

"I was hoping it would be struck down," said Benishek, who's a physician.

Benishek, a Crystal Falls Republican, said there are parts of the law he favors, including expanded insurance for dependent children to age 26 under their parents' coverage and insurance for patients with pre-existing conditions.

But he called much of it "bad policy" that doesn't address rising health care costs.

"I don't see where we're going to see any cost savings on this," he said. "I see it as more of a rationing situation."

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Benishek said he doesn't have specific solutions to improving health care access and lowering costs. But he supports more competition among insurance companies and health care providers as a way to improve the system.

"I don't know the best answer to all these things," he said. "But we've taken the cost away from the patient -- they're not involved with how the money is spent."

But others were elated with the decision. Filmmaker Michael Moore, whose 2007 documentary "Sicko" was about the health-care industry, said he's "still pinching myself" about Thursday's ruling.

But, he said, "there's still a ways to go."

"It's not a victory, but a challenge," said Moore, who has a home in Antrim County. "We need to take control of our health care system out of the hands of big insurance companies. And we still need to take care of the 26 million people who aren't covered by (the Affordable Care Act)."

Still, Moore said it's a clear sign that the U.S. is moving toward universal health care coverage.

Ed Ness, president and CEO of Munson Healthcare, based in Traverse City, which is northern Michigan's largest health care provider, said he's glad the ruling finally came down as the ongoing legal battle created uncertainty in the health care sector.

"This is some much-needed clarity," Ness said Thursday from a Michigan Health & Hospital Association conference in Lansing.

Ness said Munson continues to brace for a $100 million reduction in government reimbursement to Munson for health services over the next decade, and putting more emphasis on preventive care and reducing patient re-admittance. Those would be priorities regardless of how the Supreme Court ruled on the health care law, he said.

"A lot of the key principals are going to be the same," Ness said.

Ness said it's a "good thing" to have more people covered by basic health insurance. But the federal law still doesn't guarantee that patients can find access to primary care physicians to treat acute or chronic health problems, which remains a problem particularly in more-remote areas like northern Michigan.

"Frankly, this doesn't address that," Ness said. "We're still going to have that issue, especially in rural Michigan."

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Insurance companies have also closely followed the long-winding health care debate.

Tom Ingold, owner of Devette & Ford Insurance Agency Inc. of Glen Arbor, doesn't expect much impact to the industry from the ruling.

"The industry has changed their policies to meet what the new law is and the Supreme Court ruling doesn't change anything, so there isn't anything for the insurance industry to change at this point," Ingold said.

Barry Riske, owner of Riske Brown & Associates, said he's always considered the health care act as a Medicaid bill. The tax penalties for not obtaining insurance, $150 for an individual, aren't really enough to force people to buy insurance that may cost them $1,100 a year, he said. But it will raise money to help support Medicaid.

The uncertainty contributes to people's disdain for the law, Riske said.

"It's big, it's complex and they don't understand it or understand how it will affect them because it's not clear," Riske said. "Now it will start to evolve because there is a lot more clarity with this ruling."

Some look at the change negatively but Riske contends "change is good.

"Maybe you have to roll the dice and try a new idea," Riske said. "America was a new idea. Let's try it. We can always change it if it doesn't work."

Record-Eagle staffers James Russell, Brian McGillivary, Art Bukowski, Jodee Taylor and Bill O'Brien contributed to this report.


(c)2012 The Record-Eagle (Traverse City, Mich.)

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