Carson doctors: Health reform not a cure-all

After President Barack Obama signed a landmark health care reform bill into law last week, local doctors expressed both positive and negative opinions about the most significant piece of social legislation passed in decades.

Doctors are concerned over the law's estimated $938 billion price tag over a decade and said they thought the law doesn't do enough to address the costs of malpractice lawsuits.

But others were supportive of reforms to the insurance industry, especially a ban on denying coverage to people with pre-existing conditions, among other provisions.

One opinion was consistent: It's still too early to know how the law will impact their practices and the lives of their patients.

Matt Vazeen, who performs eye surgeries in his Carson City practice, said he is concerned the law could stifle medical innovation, but added that a country as wealthy as the United States should be able to provide care for all of its citizens.

"I'm kind of split down the middle," Vazeen said. "I think being an advanced society we should be able to provide health care for everybody - that's the ultimate goal. The problem is resources."

Another problem Vazeen cited is the rising cost of health care in the United States, a problem proponents in Washington say the bill will address over the long run. The nonpartisan Congressional Budget Office reported that the reforms included in the law will cut federal budget deficits by $143 billion over a decade.

Still, Vazeen said there is only one sure way to cut health care costs: Perform fewer surgeries.

"There's no magic bullet out there," he said. "The only way you're going to cut costs is lowering the number of procedures you do."

Sandra Koch, an obstetrician with the Carson Medical Group, said the law includes benefits for women, especially an equity clause to address the fact that women on average pay more for health coverage than men.

And while she approves of the extended coverage to an estimated 32 million Americans and a mandate that would require insurance companies spend 85 percent of their revenues on medical costs for enrollees or give them a rebate, "I'm very concerned about the costs," she said, adding "I'm not exactly sure what the impact will be."

Regardless, Koch said she thinks health care is a right and the bill moves the country in the right direction.

But Tim Gentner, a family doctor with the Carson Medical Group, said he largely has a negative opinion of the reforms enacted into law last week.

His deepest concern: "None of us know what's in it."

"I don't think anybody has read the whole thing," Gentner said. "I don't like bigger government and more government control of things, but I do think the insurance industry does need some monitoring, something needs to be done there."

He added the costs of the legislation will also affect Americans for generations to come, adding people may have a "warm and fuzzy" feeling about some of the provisions now, but "they're not looking down the road."

"Democrats are saying that they really know what's best for us, and we don't," he said. "What gets ignored are the people who are happy with their medical insurance."

Ole J. Thienhaus, the dean of the University of Nevada, Reno School of Medicine, said he agrees with the mandate to require all Americans to obtain health insurance by 2014 or face a penalty, which could relieve pressure on hospital emergency rooms that often treat patients seeking medical attention for non-life-threatening ailments because they lack health coverage - a cost often lobbed onto the backs of taxpayers.

But he still has concerns over how that mandate will be enforced.

"If someone does not buy insurance then they have to mark that on their tax returns, but if this is a person who doesn't pay taxes, then I'm not sure how this will even be noticed," he said.

The doctors interviewed also agreed that the national debate over the health care bill was not helpful.

Thienhaus called it "pretty miserable."

"A lot of that debate degenerated into sound bites, death panels, socialism," he said. "There's no perfect solution to making quality health care accessible to all. Whatever anyone comes up with will have flaws."

Still, the law "will be an improvement over the mess that we're dealing with at this time," he said.

Koch said the debate left a lot to be desired.

"It's just an unbelievable amount of misinformation out there about the health care system," she said. "The two party system is so fractious, both sides are having a polarizing effect on our system."