Opinions on health care ruling vary in Modesto [The Modesto Bee, Calif.]

June 29--MODESTO -- In Stanislaus County, with its 90,000 residents who are uninsured, Thursday's Supreme Court ruling on health reform got a strong reaction from patients, business owners and the people who provide medical care.

Most agreed the nation's costly health care system needs to change, but they disagreed about whether President Barack Obama's ambitious plan is the right course.

"I want everyone to have insurance," said Laura Hinton, a Modesto restaurant worker who was without insurance for a year after her husband lost his job in 2009. "People think they won't need it, but one day they will."

In a county with a jobless rate above 15 percent, others are concerned that individuals will have a tough time buying insurance and the mandates on business owners could kill the recovery.

Keith Shepardson, who sells health insurance, said the law will take away profits from valley businesses that employ seasonal and lower-wage workers. He predicted many will be forced to find loopholes.

"If the mandate is to insure people who work 30 hours a week or more, they will employ more people who work less than 30 hours," he said. "I think it will absolutely bankrupt employers, if they don't play the games so they don't have to provide the benefits."

The president and immediate past president of the Stanislaus Medical Society spoke favorably about the historic ruling, although the 750 active doctors in the society hold various opinions about the law.

Dr. Amarjit Dhaliwal, a Modesto oncologist installed as president of the society last month, said Obama's reforms would have faltered without the requirements for individuals to buy insurance.

"Everybody will have insurance, so the costs will come down as a whole," Dhaliwal said. He predicted the changes will be good for patients, physicians and hospitals, as well as the local economy as investments are made in health care facilities.

Representatives of Doctors Medical Center and Memorial Medical Center, both in Modesto, deferred to their parent organizations when asked for comment.

Supporters of health reform believe it will provide a better option for uninsured people who resort to seeking care in hospital emergency rooms. About 43,000 patients without insurance used emergency rooms in Stanislaus and Merced counties during 2010, roughly 16 percent of all ER visits, according to the Statewide Office of Health Planning and Development.

Obama's program will raise the eligibility ceiling for Medi-Cal, moving tens of thousands of Stanislaus County residents into the state health coverage. Medi-Cal will absorb many of the adults in the county's indigent health program, giving them better access to pharmacies and specialty care, officials said.

The county health centers and other community clinics will need to expand their clinic space and staffing, and change their models of care, to serve the increase in patients.

Dr. Del Morris, medical director for the county clinics, said the court ruling "clears the air, because everyone was waiting to see what was going to happen. Now that we have more certainty, the county might be able to come up with more concrete decisions."

Morris said the Central Valley has about 70 percent of the primary care doctors it needs and perhaps 50 percent of the specialists needed. "We have a shortage of providers and that can't be fixed in two years," he said.

Michael Sullivan, executive director of the nonprofit Golden Valley Health Centers in Stanislaus and Merced counties, saw the Supreme Court uphold the kind of reforms he has awaited throughout his career. He retires today after leading Golden Valley's safety-net clinics for nearly 40 years.

"It's good for Americans, it's good for those that want to improve our very broken health care system," Sullivan said.

Since the reform act was signed into law in 2010, Golden Valley has received millions of dollars in funding to build a senior health and wellness center in Merced, expand care in Modesto and Patterson, and start a school-based health clinic in Riverbank.

Additional funding is expected to pay for hiring physicians and nurses to meet the influx of patients in 2014.

Dr. Peter Broderick, head of the Valley Family Medicine Residency, also was pleased with the decision. The physician training program was awarded almost $10 million over five years from the Affordable Care Act, but the funding could have been cut short if the court had overturned the law.

Even though the national reforms promise to broaden access to medical and dental care for tens of thousands of county residents, plenty of people have serious questions about such a sweeping change to the health system.

Jeremiah Williams, who has a cabinet business in Modesto, said the requirement to buy insurance could be a burden for self-employed people who have battled the economic downturn.

"I appreciate (Obama's) attempt to try to help his fellow Americans to have the health care they deserve; however, I think there are other ways he can go about making a difference in our health care system," he said.

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or (209) 578-2321.

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McClatchy D.C. Bureau: Reaction outside Supreme Court

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Modesto residents react to news

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