SHERRI TAYLOR
Journal News Editor

"I need to go to the doctor today," said the young woman working in a discount store. "But I don't have insurance and I can't afford to pay for a doctor's visit."

That's a common problem in Louisiana where 984,000 citizens have no access to health insurance and many of them work.

"People in America have a basic right to have adequate health care, yet we have 42 million in this nation going without health care coverage," stated Stephen Wright, CEO at Christus St. Frances Cabrini in Alexandria, Louisiana. "We might compare this problem to having 42 million hungry people in this country. How can we allow this to continue when children are affected?"

Not all those suffering without care are children. Arlette Peel of Quitman, Louisiana just learned she has an aneurism along a major artery. Surgery is her only hope. She's been told that in addition to the surgery, she will spend 24 hours in intensive care and five days in the hospital.

"I told the doctor I have nothing but Medicare and it won't nearly pay for everything," she told the Piney Woods Journal. Although confident that her doctor will successfully solve her health problem, she worries constantly about the medical bills she will probably pay on for the remainder of her life.

Some people in Louisiana have solved their problem of receiving medical care by using the state operated hospitals like the ones in Shreveport, Monroe, Pineville, and New Orleans.

"We go to Conway (now LSU Medical Center) in Monroe," said Rachel Beaubouef of Jonesboro. Her husband has a good job as a housing contractor but they have no insurance. "I trust my doctor there in Monroe and we get good care."

She admits there are drawbacks. For one thing, she has a long wait before she can get an appointment.

"I'd love to see the doctor when I'm sick rather than wait," she said. Mrs. Beaubouef states her only option when extremely ill is to access the emergency room at LSU Medical Center in Monroe.

"There needs to be a more reasonable way to get health insurance for everyone," Mrs. Beaubouef said.

Most people agree with her. Changes must be made. The question raised continues to be "What can be done?"

"We need to think about this seriously," said James Emerson, a pharmacist in Winnfield, Louisiana. "There's no free lunch. Somebody is going to pay whether through sweat and toil or through their pocket book. We always have to pay the piper."

Dick Gephardt, a candidate for the office of President in 2004 has presented a plan calling for every employer in the nation to be forced to provide insurance for their workers. He proposes a 60% tax break to employers for doing so. Almost everyone in the medical field and in other professions, believe Gephardt's plan will not work.

"Two things will happen," said Donald Carpenter of Winnfield. "Companies will be forced to raise prices on their customers to pay for insurance and the Federal government will raise taxes to pay for the rebate returned to businesses." A third thing destined to occur under Gephardt's plan might be the closing of small businesses unable to pay for insurance.

Others believe socialized medicine to be the answer. Canada and Britain already have free healthcare for everyone. However, the wait for non-emergency care is long, even months for some elective surgeries.

"We need to be careful," said Wright, in Alexandria, speaking about the institution of socialized medicine. However, he went on to say even if the United States does decide to allow the Canadian form of healthcare, he feels there will be two layers: one for those unable to pay and another for those willing to pay higher prices to get the care they desire.

"Who will take the brunt, if the nation goes to a national healthcare plan? The doctors and the hospitals," said Bobby Jordan, CEO at Winn Parish Medical Center in Winnfield, Louisiana.

A few of the problems facing healthcare today appear to be unanswerable. For instance, frivolous lawsuits force reliable, honest physicians to spend $100,000 each year on liability insurance.

"No one would say that some of those lawsuits are not justified," said Wright. "But many are not."

Also, the Louisiana Legislature has cut Medicaid payments to hospitals by 15%, while rural home health agencies were cut an additional 10%. Rural hospitals did not face such cuts. For areas like Jackson Parish, third in the state in number of those with Medicaid or Medicare coverage, that cut would have devastated the hospital. With as high as 85% of the population in some parishes dependent on Medicaid or Medicare, more cuts would spell disaster.

In health care, Louisiana falls last in some surveys. The state also scores 19th out of the 50 as regards care for pregnant women.

As more and more find it difficult to pay for care, the patient census, or number of people actually entering hospitals for care is dropping, as well. The number of patients at the Huey P. Long Memorial Hospital in Central Louisiana is down 30% as compared with the year 2000 and these people pay less than at private hospitals.

"If the state cuts back on the really poor, those who use Medicaid, lots of hospitals will close," said A.C. Buchanan, CEO of Rapides Regional Medical Center, while discussing the plight of state-operated hospitals, once called charity hospitals. "Then people will have to travel greater distances to receive the care they need."

Some surveys show as many as 50% of small, community hospitals are in trouble. Any more cuts and they will no longer be able to keep their doors open.

As for the answer, no one has a definitive one. Everybody has an idea.

"What we see out of Washington is that they are of a mind to bring some kind of healthcare package to the people," said Jordan in Winnfield. "It may not be what we want, but it will make healthcare more accessible."

With more than 25% of Americans living in rural areas, only 9% of physicians choose to practice there.

"Americans in rural communities face unique healthcare challenges which are all too often ignored in our national healthcare debate," said U.S. Congressman Rodney Alexander (D-Quitman) in a recent news release. He along with others who understand the problems of healthcare continue to urge Congress to promote programs designed to help all Americans, but especially those without health insurance, receive better healthcare in the near future.

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