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Shirley Menasco, an Elk Grove real estate agent, turns 61 next month and will see her insurance premium jump from $520 to $660 a month.

These days, she and her husband are fretting over the rising costs of health care in America. To save money, Donald Menasco dropped his own coverage, opting instead to rely on Veterans Affairs doctors to care for his Vietnam War injuries.

“I want reasonable premiums for reasonable care. That’s what I want,” Shirley Menasco said.

The prospect of overhauling the nation’s health care system, Menasco said, ought to open a path toward taming the rising cost of medicine, enhance the quality of care and figure out how to cover 46 million uninsured Americans — nearly 7 million in California.

But the broad strokes being discussed in Washington, D.C., are not translating well for average American consumers like Menasco, who are scratching their heads as they sift through details — many still undefined — they hope will yield results for a troubled health care system.

“President Obama goes on television and says we need better health care. What does better health care mean?” Menasco asked. “There’s so much jibber-jabber about it.”

These are high-stakes times for consumers, hospitals, physicians, insurers and the rest of the health care industry.

Menasco and Sacramento-area health care professionals wonder who will end up caring for the uninsured, who will pay for that coverage and how it might preserve or alter coverage many people now have.

Cost-cutting companies are eliminating health plans or expecting workers to pay a greater share of premiums. Meanwhile, premiums are rising.

In 2007, the health care industry accounted for $2.4 trillion in spending, about 17 percent of the country’s gross domestic product, according to the National Coalition on Health Care. By 2017, health care spending is expected to reach $4.3 trillion if costs aren’t contained.

Hospitals, clinics and doctors complain about inadequate government reimbursement rates for such programs as Medicare and Medi-Cal.

In the Sacramento region, the safety net of health care providers — from public clinics to nonprofit centers — is so thin it can no longer carry the load of the uninsured, poor and medically underserved.

Health care proposals in Washington, D.C., now pose too many unanswered questions, said Robert Caulk, chief executive officer of The Effort, a Sacramento nonprofit clinic.

For example, “where are you going to find the capacity to accommodate the 46 million people who aren’t in the system now?” Caulk asked.

“We are encouraged by talk in Washington that clinics will be part of an expansion of primary care,” he said. “For the first time, there will be a solid base for compensation for that service.”

Government-funded clinics in the region have closed because of budget cuts. Nonprofits such as The Effort have attempted to respond: Earlier this month, The Effort reopened a shuttered county health clinic in Oak Park.

Meanwhile, with nowhere else to go, more of the uninsured are heading to hospital emergency rooms.

“We’re trying to cobble together a system that will increase the capacity of clinics like mine,” Caulk said.

“We’ll have to see what they come up with.”

Critics of the U.S. health care system have long complained about what they call a broken system.

Gov. Arnold Schwarzenegger attempted his own fix in California but could not muster adequate support.

At center stage are three major pieces of legislation, two being drafted in the U.S. Senate and one in the House.

Until a final draft is written, what will survive remains politically murky as policymakers, lobbyists and consumer advocates attempt to find common ground.

“I’ve been following the news stories, but a lot of the stories are focused on the political ins and outs,” said Dr. Richard Pan, a pediatrician and associate professor at the UC Davis Medical Center.

“When we’re talking about reforming health care, we want to recognize that our eventual outcome is health,” Pan said.

“A lot of the discussion has been focused on money and financing,” he added. “It’s too easy for people to say health care is too expensive, and we need to cap spending and cap costs.”

Incentives for good medicine should be strengthened, he said.

Doctors are compensated by insurance companies based on visits and medical procedures. But doctors spend a lot of their time processing paperwork and coordinating care once the patient leaves, Pan said.

On another front, health insurers support expanded health coverage. But a government-sponsored plan has risks, according to Patrick Johnston, president of the California Association of Health Plans.

“It’s important that everybody has insurance coverage,” Johnston said. “We should figure out how to fill the gap of those not covered. — Medicare deficits are serious. Medicaid costs continue to rise.”

Johnston contends a public plan that pays providers the same rates as Medicare and Medi-Cal will raise concerns.

Consumer advocates argue that Americans need more choices, not today’s array of choices, limited because of spiraling costs.

“This legislation is about giving consumers more security, more choices into the future,” said Anthony Wright, executive director of the advocacy group Health Access California. ” — Consumers shouldn’t be left all alone at the mercy of the insurance industry.”

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This entry was posted on Friday, July 31st, 2009 at 12:35 pm and is filed under Dental Care & Health Care. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.