A key goal of reform is to provide health insurance for millions who don't have it now. If that actually happens, Ron, a caller from Medina, worries that it will swamp the system.
(Ron) "One of the largest problems I have with the discussion on health care is it's my understanding that the system will add about 50-million more people to the health rolls and using common sense I have a hard time believing there's going to be enough doctors to cover this type of added population, which I think is around 20 per cent additional."
National Public Radio's health policy reporter, Joanne Silberner, a guest on today's show, says the shortage has already hit crisis proportions in Massachusetts which launched its own universal coverage two years ago.
(Silberner) "This has become an issue there where there are now waiting lines to see primary care doctors."
Some provisions in the national reform proposals address the need for more primary care doctors. One helps them pay their way through medical school, another boosts their reimbursement rates slightly. But that would not close the pay gap between primaries and specialists by a long shot. Anne Grantham, a doctor in Akron, knows that well. In an email she says,
"Everyone seems to think that we are making money hand over fist but many teachers and public employees make more per year with far better benefits than we do. Unless our reimbursement changes significantly, anyone going into this field or staying in this field would be crazy."
Another doctor, Dave from Chagrin Falls, is concerned about reform provisions that he says would give government a lot more power to set health care policy and practice.
(Dave) "One part of it had to do with this health care commissioner that will be appointed to decide all policies that in the future all insurance companies will have to abide by, that the government would set all the rules, all the standards and kinda almost turn it into a national health care system kinda like a national veterans...VA health care system." 22
Silberner says no one would be appointed to function as a health care 'czar.' However, one Senate version of reform does call for creation of a commission that would have authority to decide and implement payment policies for medicare. Congress would still have final say on those polices and rates though.
Another issue that has come up in the debate is whether people who currently have health insurance through their employer will be able to keep it. President Obama says, yes they can.
Others differ on that because employers may decide to dump coverage if there is a government insurance option available. Steve Millard, president of the Cleveland small business group COSE, says whether people still have access to their current insurance all depends on how much the government will charge if the employer stops offering insurance.
(Millard) "They're gonna do that math and they may make the trade off and say, hey, it's better for me to put my employees into the government plan."
Much is still to be determined. Both the House and Senate are hashing out details of separate health care reform measures and a lot can happen between now and a final conference committee report.