Local doctor wants reform, but has concerns

An Iowa City physician, tired of seeing patients who are squeezed by the current health care system, says he and his colleagues are also concerned about the specifics of health care reform.

“Every day I see the real problem of the uninsured — and that group does not only encompass the destitute,” Dr. Timothy Kresowik said during a press conference at U.S. Rep. Dave Loebsack’s office last Wednesday. “There are people who are working but don’t have health insurance, perhaps at a small business that doesn’t offer coverage or maybe self-employed. These are people who are suffering in the current system, and that’s what physicians are committed to change. We need accessible health insurance and health care for the entire population.”

Speaking with The Iowa Independent after the press conference, Kresowik said that many health care professionals — especially those in Iowa in similar states — are concerned about doctor and nurse shortages and federal reimbursement rates.

“Unfortunately, just as misinformation is out there in the public, it is also present within the medical community,” he said. “Physicians are a diverse group. They cover both ends of the spectrum. … I think you have a lot of physicians who are generally supportive, but don’t necessarily want to be seen or viewed as supporting everything that is being discussed.”

While all Americans will be impacted by reform, physicians and other health care professionals are unique in that they will be impacted both as consumers and as providers.

“Right now, unless something is done about Medicare reimbursement formulas, we are headed for a cliff,” Kresowik said. “The fear about the public option is that if the reimbursement rates are at the same levels of Medicaid and Medicare it is not sustainable. This is especially true in a state like Iowa where, because of these crazy geographic adjustments that have nothing to do with what it costs to practice medicine but focus on things like [office] rent. … We are already at the bottom of the barrel in terms of reimbursement for exactly the same service. So, [physicians] worry that if those rates are simply continued then they simply won’t be able to afford to maintain their practices.”

Another concern, according to Kresowik, is the creation of broad policy on a federal level that may or may not fit the one-on-one interaction required in health care delivery.

“A lot of the health care stuff happens between individuals and should happen at the local level,” he said. “Anytime you get the government [involved], you tend to have a lot of broad policies that don’t fit the individuals. What we have to do is create a system that provides the right incentives, but still allows individual patients and their physicians to make decisions without a lot of bureaucratic oversight.”