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Pained bewilderment – that’s a pretty common expression when the phrase “health-care reform” comes up. It’s a politically polarizing topic that few seem to want to talk about in a public forum. From small business owners to beauticians, pharmacists to physicians, the Shelby County community seemed forgivably lost and a bit apathetic about trying to understand the massive, daily-changing legislation that is health care reform in Congress. And some people, especially those in the medical profession, seemed afraid of alienating patients or customers by sharing their opinions. Family physician Dr. Ron Waldridge, Sr., who has been practicing for more than four decades, was one of the rare extroverts. “My gut is, we’re going to get something whether we want it or not,” he said. “We do need to tweak the system, but we don’t need to start all over.” Waldridge recognized the multifaceted problems related to bringing health-care costs down and proving coverage to all Americans, the two main goals of reform. When it comes to providing affordable health insurance, Waldridge, himself a diabetic, said pre-existing conditions should not exclude you from coverage, but you should have to pay more. And health insurance should be treated like life insurance. “Somehow we have to be put into the system in some way that we all have to be accountable for our health care,” he said. Waldridge said he sees an attitude among patients of one, a denial that major illness could happen to me, and two, an unrealistic expectation of medical care keeping people alive. He said he treats many Medicaid patients, both in his daily practice and as a medical director of both Shelby County’s nursing homes. A little co-pay, currently not required, could go a long way in deterring people from unnecessary treatment. “People think, well if it’s free, everybody’s going to abuse it,” Waldridge said. “Well some will and some won’t.” Waldridge said he had read that the majority of Medicare and Medicaid money is spent in the last six months of a person’s life. “My philosophy as a physician is to treat a person’s mind,” he said. “Once you lose your ability for cognitive function, [but still elect for] repeated hospital visits and feeding tubes...that costs a lot of money.” He does, however, believe that the government should subsidize poor people and take care of them. This view was shared by two health care administrators who see a lot of people without health insurance. Need seen here The Mercy Clinic on Washington Street is a free clinic relying on private donations and volunteer doctors and nurses. Clinic Administrator Jill Baldwin said not accepting federal funding allows for more freedom in providing free services to patients. She has followed the health care reform to some degree. “I don’t know how it will affect our patients,” Baldwin said. “Even after it kicks in, there are people who are not going to be able to afford insurance. I would like to see free clinics somewhere in this bill, as even able to apply for federal funding and some recognition.” This year, she said, free clinics have served some 4 million people across the United States. The Mercy Clinic, too, has seen an increase, seeing as many patients (1,250) in one quarter this year as in all of 2007. “We’re busting at the seams,” Baldwin said. “We’re pretty much booked all the way through January for accepting new patients.” The Shelby County Health Department has seen similar growing need. Kentucky has more than 654,000 residents without health insurance. “Of course we accept health insurance, but we also don’t turn anyone away,” Administrator Renee Blair said. “We’re seeing more and more indigent because they’ve lost jobs.” Blair has also kept up with facets of the legislation, and said she sees the positives proposed, like preventative services for the elderly, helping seniors afford prescription drugs and making insurance affordable to those who otherwise “fall through the cracks.” Making medical records electronic are something she’s very much in favor of. “It will mean more time for physicians and nurses to spend with patients,” Blair said. “I feel Kentucky is getting left behind by not using that.” Providers’ concerns Changes to the proposed health-care legislation come out of Congress daily. The Senate recently added the concept of offering Medicare to people starting at age 55. This creates a major concern for health-care providers, including Jewish Hospital Shelbyville. JHS CEO Michael Collins said the government paying for more services would spell less money for doctors and hospitals, as the government doesn’t negotiate prices like insurance companies do. “Medicare already pays hospitals less than cost,” Collins said. “What that’s likely to make happen is to create access problems for Medicare folks. That concerns me.” And that gets to the heart of what people are worried about: access. It’s indisputable that Americans want the best care, Collins said. “Do we have the money to pay for it? Will they [providers] be able to continue to provide the array of services they currently do?” Collins asked. He said he has been closely following the debates, as he sees the problems associated with access and payment every day. And Collins points out nearly half of all hospitals in the U.S. are operating in the red. Still, a considerable difference could be made in health care if his goal of 97 percent of people had insurance. “We see patients who do not establish relationships with our physicians, and they’re using our emergency room. That’s not a good way to establish care,” Collins said. Information flow Though individual citizens weren’t jumping to talk with The Sentinel-News, they are reaching out, and being sought, in political circles. Fielding Ballard, chair of the Shelby County Democratic Party, said he has talked with a good number of people about health-care reform, who, if Democrats, are predictably in favor of reform. Maybe a few Republicans are, too. “I’ve talked to more than a few people in the other political party but who work in the health care field. They see the problems that persist in getting care and paying for that care,” Ballard said. “It depends on how well-informed people are as to their opinion,” he added. “Some people are close-minded. The people who realize the facts are in favor of [it].” But those facts are mired in political spin, 2-minute media sound bites and scare tactics, all which seem to do a disservice to the American public. No wonder people appear to throw up their hands in despair. Ballard does offer a keen suggestion, one that can certainly be non-partisan: Educate yourself by seeking the answers to your questions.