Local observers weigh in on medical care, describing hopes or fears about reform

As the debate over how to restructure the health care system meanders to some sort of conclusion, the result still appears not much clearer than when the debate started several months and dozens of Sunday morning talk shows ago.

Questions abound. Will any bill come in shorter than 2,000 pages? Will anyone understand it, whatever its length? Has the idea of general reform of the health care system been stranded by the focus on overhauling the insurance system? Do the cost estimates, either over or under $1 trillion, have any connection to reality? Will the public option be in or out? What is the public option? How long before lawyers and lobbyists begin massaging obscure sections and finding loopholes to suit their clients?

Rather than attempt a play-by-play that may have a shelf life of only days, or even hours, the Business Press contacted a dozen experts in the local health industry to solicit their priorities. The opinions listed above span the spectrum, explain why health care reform has become so complex and why it has frustrated would-be reformers for decades.

For example, Dr. Sherif Abdou, CEO of HealthCare Partners of Nevada, with 22 clinics in Las Vegas, favors a payment system that would emphasize team work, which he admits would put small groups or sole practitioners at a disadvantage. But Dr. Annette Teijeiro, president of the Clark County Medical Society, which has a large number of small groups or sole practitioners, has warned of assembly line medicine eroding or destroying the traditional patient-doctor relationship.

Alan Feldman, senior vice president of public affairs for MGM Mirage, believes Medicare has generally worked well and shows that a public option could work.

Attorney Andrew Brignone, on the other hand, recently read about one bill that included reimbursement for spiritual healing.

"If ever there was an example of why you don't want the government in health care, there it is," he said.

Perhaps the only sure winners will be the political junkies who enjoy the process and intrigue. Speaking to the Nevada Health Care Forum last month, K. Meredith Taylor, director of congressional affairs for the Healthcare Information and Management Systems Society, predicted, "If something does pass, there will inevitably be bills for the next two years to amend or correct it."