Legacy on health care will live on

Rep. Charlie Norwood's announcement last week that he would leave Washington and return home to deal with cancer at a hospice brought back memories. Norwood died Tuesday at age 65.

Over lunch in an Atlanta restaurant during his successful 1994 campaign to go to Congress, the Augusta dentist introduced himself and outlined his views. A decorated Vietnam War veteran, Norwood was bright, ambitious and ready to make his presence felt in the coming Republican majority.

Another Georgia representative, Newt Gingrich, was on his way to becoming speaker. Norwood, a tireless booster of Gingrich's Contract with America, was destined to become the House's foremost expert on health issues.

For a while no Washington news story on health matters was complete without Norwood's views.

But the new century brought new issues, and Norwood's fell out of favor. War, terrorism and popular culture pushed health care out of the headlines. Now the political winds have shifted again. Health care is certain to be among the foremost domestic issues in next year's election. Charlie's former mentor Gingrich is regaining prominence on the strength of his health care pronouncements.

As Norwood departed Washington, he introduced his original Patient Bill of Rights legislation to allow a patient to sue HMOs for improper care. Interestingly, the largely symbolic departing shot picked up a Democratic sponsor.

A couple of weeks ago, I wrote a column on health care that generated a near record number of e-mails and letters, many of them with ideas about reform that echoed Norwood's broad concerns.

A particularly thoughtful missive came from Ben Thatcher, who runs an independent insurance brokerage company in Stockbridge and Blue Ridge. In the insurance business since 1985, Ben has some firm ideas on how to fix what is plainly broken. Here is an excerpt from Ben's letter:

"Health insurance rates are rising two to four times faster than inflation. Employers are getting squeezed more every year. The result is that more costs are being shifted to employees, or employers are dropping coverage altogether. Insurers can't help it because the cost of health care is going up so fast, although some demagogues would like to blame 'the big fat insurance companies.' ... The major players in health care had better put their heads together to come to a private agreement, or the politicians will pressure development of a national government health plan. Here's my suggestion for a private solution to the problem:

"1. The drug companies need to be stopped from advertising prescription medications. We claim to be a 'drug free' country, but we are quickly becoming the most medicated country in the world. Part of this means the drug companies must be stopped from using their dollars to influence physicians to prescribe their meds. A huge portion of health care cost increases have come in the form of higher drug costs.

"2. Make health insurance mandatory for every citizen with a job as in Massachusetts and California. ... Make health insurance available to all citizens regardless of health conditions.

"3. Insurance companies, doctors and hospitals need to get together and come up with a plan to make their services more affordable and coordinated. Right now these interests have a highly adversarial relationship. A lot of technological tools are available that can help make cooperation work.

"4. The public needs to become more involved in the cost of their health care. This means that individuals need to feel the cost of insurance as well as the cost of treatment. I would suggest insurers spend more dollars on preventive medicine to promote health and have the public pay a pretty hefty deductible and fairly high co-payments to see the doctor for services beyond preventive medicine. If employers gave their employees a budget for coverage and let them decide how much they are going to pay for insurance, I believe we would see a dramatic change in the types of coverage that were actually purchased.

"5. Tort laws need to be modified so doctors' malpractice insurance premiums can come way down. Everyone pays for malpractice coverage. The cost of doing business always gets passed down to the payer for services. Many doctors pay as much or more for malpractice insurance as they receive as take-home pay.

"We need universal health care, but I'm very leery of the government being that source. I think government needs to guide the process, as each state has an insurance department, but the private marketplace still needs to handle the funding, administration and actual care of patients."

Ben Thatcher's letter included much more detail. In his heyday, a fit Charlie Norwood would have delighted in the renewed discourse. The tone and volume of the mail suggest that health care reform is finally on its way to becoming a national reality, which Norwood foresaw a long time ago.

Syndicated columnist Bill Shipp writes on Georgia politics. E-mail him at bshipp@bellsouth.net.

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