A look at the health care reform debate: Dingell explains legislation. What do you think?

Check out some stories about health care reform coming out of Michigan here and here.

Here’s a look at a recent conversation about the health care reform bill between AnnArbor.com and Dingell before Congress went into its recess at the end of last month.

Q: How would the health care reform legislation that’s been introduced in Washington impact people in the 15th district - more specifically in the Ann Arbor-Ypsilanti area?
A: There’s one person who’s very much affected by it - he’s been working on this thing for better than 50 years, and his father before him worked on it for 20 years. So if it goes well, there will be great celebration in the Dingell family. … We are closer to accomplishing this than at any time during my service … and we have learned, I think and I hope, from the mistakes of before … There’s more public support for this than I have ever seen before, and it is heightened by the economic downturn, which I think gives us more arguments to move vigorously forward than we would have without this downturn.

Q: How does this area stand to uniquely gain from legislation like this?
A: Eighty-three thousand uninsured individuals, they’re going to get high quality affordable health insurance and interestingly enough, they are going to have their choice and hopefully their choice not only between a number of private plans but also at least one public option. There’s going to be 11,500 small businesses that are going to receive tax credits and that will provide coverage to their employees with the government picking up through the tax credits about 50 percent of the cost. 2,700 seniors are going to avoid the (Medicare Part D) donut hole, which is an important matter. Nine hundred and fifty families are going to escape bankruptcy … We’re hoping to get up to 97 percent of all Americans, which is good … Uncompensated care is a major problem, and health care providers in just this district provided $330 million in uncompensated care. That’s a big item and if you take a look we have a bunch of great hospitals, we’ve got University of Michigan and St. Joes … Those numbers are only going to go up if we don’t address it. The nice thing about it is, it’s fully paid for.

Q: How?
A: Half is going to come from efficiencies in Medicare and Medicaid and half from the surtax on the income of the wealthiest individuals … There’s only going to be about 2,300 households in the district that are going to get hurt by this. And those are going to be folks who will have better able ability to sustain it and afford it. So 99.2 percent are not going to get a tax increase at all.

Q: What would this do to address the ultimate problem of enormous waste in the healthcare system?
A: There are all kinds of provisions we’re putting in there to bring out efficiencies and get rid of inefficiencies. For example, it will do several things I think are going to be important. The most important of which is it’s going to essentially standardize a lot of the forms and a lot of the bureaucracy in the billing system. When you go by your doctor's office, you walk in you see all these wonderful people running around in white uniforms and you say, ‘My, look at all these health care professionals they’re looking after me, this is wonderful doctor.’ When you get right down to it, health care professionals so far as their handling billing, there are literally thousands of different billing problems that are handled in different ways. There’s a real question about whether the doctor spends more time worrying about your health care or filling out the damn forms. So we’re building a bunch of efficiencies in to the system that will reduce waste, reduce cost and overlap and duplication.

Q: In Washtenaw County, the county health insurance plan Washtenaw Health Plan has closed enrollment due to high demand. That’s left a lot of people here unable to get any insurance and safety net providers have said the county is being strained from health care costs.
A: That’s exactly the same problem everybody’s got. Wayne County’s got a similar situation and of course Monroe has got the same problem. But all three counties have particular problems with low income and un-served or underserved areas and we’ve put in there a significant amount of help with the states in terms of Medicaid. But we do something more and that is we fund increasingly, community health centers, including mental health centers, to see to it you can get availability of services and high quality health service of the kind that these community health centers provide made available to our people and those are tremendous resources.

Q: What is working in the health care system right now?
A: We’ve got great medicine, great health insurance, great physicians and all kinds of great providers from laboratories, to hospitals and nursing homes. And then you’ve got the problem of paying for it. Our problem is not that we don’t have the best medical care available. It’s just people can’t get it because they can’t afford to pay for it. That’s the real thrust of this legislation.”

The Associated Press contributed to this report. Contact reporter Tina Reed at tinareed@annarbor.com.