"Economic Choices '08"-Iowa Health Care
Monday, November 05, 2007SUZANNE PRATT: With the presidential election just 364 days away, polls show voters want to hear more about the issues and less about personalities. That's our goal as we continue our series, "Economic Choices '08." Darren Gersh visited Iowa to find out what voters there want to see happen with health care.
DARREN GERSH, NIGHTLY BUSINESS REPORT CORRESPONDENT: Kinter Construction has done all the usual things to control its health insurance costs, raising deductibles and switching plans. Now, to avoid a surprise when premiums come due in January, the company is taking a new approach: prevention. Owner Mike Kinter offers $1,000 cash awards to employees who quit smoking. He says he got the idea after he bought life insurance and his agent asked him whether he smoked.
MIKE KINTER, OWNER, KINTER CONSTRUCTION: If I didn't smoke, I got a better rate to buy life insurance. So I thought if the life insurance companies have been on this bandwagon for the last 30-plus years, health insurance carriers ought to start getting on this bandwagon, too.
GERSH: Kinter is also considering chipping in for employee gym memberships. It's the kind of pro-active thinking this staunch independent is looking for in a presidential candidate. With the Iowa caucuses approaching, Kinter wants to hear how Democrats and Republicans plan to inject more competition into the health care system. A good beginning, Kinter says, would be to make prices more transparent.
KINTER: You're not given an opportunity to shop for your -- and I think if that was available, I think that a lot of the carriers or a lot of the providers, would stop and take a look and say, well, you know what? Maybe we can do this a little bit cheaper, because so-and-so can do it cheaper. Let's look at what we can do to cut our costs.
GERSH: Much of the health care debate in the presidential campaign has focused on access to care. But in Iowa, more than 90 percent of the population has some form of health insurance. A key question for many voters here is how to keep their costs under control. Health care costs are a pressing issue for Mike Abrams, both as a business manager and an advocate for doctors. Abrams is executive vice president for the Iowa Medical Society and right now he's trying to figure out how to cover the organization's 22 percent health insurance premium increase.
MIKE ABRAMS, EXECUTIVE VICE PRESIDENT, IOWA MEDICAL SOCIETY: When I look at these kinds of increases, I wonder how long will we have that large portion of our population covered by health insurance.
GERSH: A likely Republican caucus voter, Abrams likes John McCain's plan to allow consumers to shop for insurance across state lines.
ABRAMS: Iowa and many states like Iowa, there is very, very little or no competition under the carrier, so when you get your premium increase, it is what it is and there's not a whole lot of opportunity to affect that.
GERSH: Many Iowans we spoke with are wary of putting too much control over health care in the hands of the Federal government. But they also want to hear candidates explain how to simplify a system that costs a lot and where the payments are hard to track. Independent pharmacist Kim Graziano wants to know why some drugs show up on plan formulary and others don't and she'd also like to see a candidate reduce her bureaucratic nightmare.
KIM GRAZIANO, INDEPENDENT PHARMACIST: And really, the pharmacists don't have enough time to do their profession, which is take care of people with counseling their medications, not trying to figure out what insurance is going to pay for and what it's not going to pay for. It is tying up the physicians and the doctors just trying to figure out how to get someone taken care of.
GERSH: Both Democratic and Republican candidates are counting on better prevention and management of chronic diseases to hold down health care costs. At the University of Iowa, Dr. Paul James worries, in a system which rewards specialization, there aren't enough frontline health care workers to deliver the primary care the politicians are counting on.
DR. PAUL JAMES, FAMILY MEDICAL CENTER, UNIVERSITY OF IOWA: They all want to provide universal access and if not universal access, the choice for every individual to purchase that. But with increasing access, one would logically think costs are going to go up. If everyone gets access to more expensive care, then how are we going to rein in costs?
GERSH: With the caucuses less than two months away, most Iowans seem to agree the nation's health care system is ailing, but they are not sure yet which candidate has the right cure. Darren Gersh, NIGHTLY BUSINESS REPORT, Des Moines, Iowa.
