Exploring different sides of the health care debate

In the past four months, activists on both sides of the health care reform debate have participated in loud town halls or rallies, with signs blasting either the state of health care in this country or government reform efforts.

But as the debate continues, private insurance rates keep rising. In North Carolina, rates have risen five times faster than earnings over the past nine years.

A recent Elon University poll showed that, in October, more than 75 percent of people in North Carolina believe the health care system needs some kind of reform.

But if people tend to agree on the need for reform, they can't seem to agree on how to accomplish it.

We talked with four people in the region representing different sides of the argument. We wanted to hear their stories, their hopes and concerns, and their thoughts about reform. We spoke with a retired clinical social worker who's married to a former military man and doesn't trust government health care; a student without health insurance; a small business owner looking for a break from insurance companies; and a working man who just wants to hold on to what he has.

Beverly Brookhart

Lives in: Carolina Lakes, Harnett County

Occupation: A retired licensed clinical social worker, she owns a custom quilting, knitting and design business, The Weaving Spider.

The idea of more government-run health care causes Beverly Brookhart to shake her head.

Brookhart, who is 69 and married to a retired military man, knows first-hand how long it takes to get an appointment at the Veterans Affairs Medical Center in Fayetteville.

She knows how continuity of care suffers when new doctors transfer or are stationed elsewhere.

And she knows what it's like not to have a choice of doctors.

That's why she shakes her head: She doesn't want the government to get more control of something as important as health care.

In fact, Brookhart feels so strongly about how poorly the government runs health care that she and her husband pay $340 a month to stay on the private health insurance plan he enrolled in before he retired from a private company. And Brookhart said they'll still keep it, even though rates will rise to $457 a month for the couple next year.

Now, they are covered by three insurance plans: the private plan, TriCare for Life and Medicare. The extra expense is worth it, she said, to have more choice and better care.

But that's not the only problem Brookhart has found with the health care reform bills. She's been reading them and has a list of reasons they won't work:

The government is inefficient and can't manage the billions of dollars of waste associated with Medicare fraud.

The national debt is already too high.

Illegal immigrants shouldn't have access to government-funded care.

She also has a list of ways to reduce insurance costs, including more competition for insurance companies, creating legislation against frivolous health care lawsuits, and creating more preventive care clinics for the needy as an alternative to expensive emergency room care.

Brookhart says there should be some kind of sliding scale for insurance. For instance, someone who makes $150 a week should pay a smaller percentage than someone who makes $1,500 a week, she said.

"There shouldn't be a free ride for anyone," she said. "That makes the cost of care go up for everyone."

Linda Dail

Lives in: Fayetteville

Occupation: She is co-owner of a chain of Batteries Plus stores in North and South Carolina.

Linda Dail doesn't like to get into the politics of health care reform.

Dail's got better things to do than worry about Democrats and Republicans, liberals and conservatives: She has a business to run.

Dail, along with her husband, Bill, co-owns a chain of Batteries Plus stores, a shop that specializes in selling batteries for everything from watches to trucks.

They have 26 employees in their stores, which are spread throughout North Carolina and South Carolina. Since opening in 1995 with two or three employees, they've grown steadily, she said.

One of the big problems about running the business is health care insurance.

It's a problem that costs her company about $3,000 a month, with no end to the rate increases in sight, she said.

But when you bring up health care reform, Dail's a little shy about it, for obvious reasons. She's heard the anger and passion from both sides, and she sees some sense in both arguments.

She's well-informed on the issues, too. That is, as well-informed as anyone can be with the constantly changing and vague nature of the reform bills.

"I've read and read, and they're not putting everything in words," she said.

But Dail is sure of one thing: What's happening now with health insurance is not working, either for her business or her employees.

Primarily, she believes -- and she's nervous about saying this -- insurance companies have too much power over small businesses.

Because her company employs fewer than 50 people, her insurance company, Blue Cross & Blue Shield of North Carolina, requires that at least 75 percent of the eligible staff join the group.

That's not always easy, because -- while Batteries Plus pays 75 percent of each employee's monthly premium -- insurance costs rise or fall depending on the age or sex of the person. What may cost one employee $100 a month could cost another $200, and that's without family coverage. Some people -- especially those making $9 or $10 an hour -- simply can't afford it, she said.

So why not change insurance companies?

It's not that easy, Dail said.

Because Dail has stores in more than one state, she can only use insurance companies that provide coverage and maintain good provider networks in both states.

Fact is, she said, there aren't many insurance companies like that to choose from around here.

Dail isn't sure what the answer is, but she's leaning toward a public option that would allow more people coverage at a lower rate. The public option could be the answer for her and other small businesses and could force private insurance companies to compete, she said.

"Our government already provides assistance for the indigent and the elderly, so why shouldn't there be something in between?"

Pia Jessup

Lives in: White Lake in Bladen County

Occupation: She is a graduate of nursing school and a full-time student getting her master's in theology.

Pia Jessup has gone without health insurance since March.

That's when she turned 25 and benefits from her father's TriCare coverage stopped.

Since then, a few things have happened in Jessup's life: she graduated from the University of North Carolina at Pembroke with a nursing degree; her father died; and she began a master's program at Hood Theological Seminary in Salisbury.

These days, she's a full-time student who's also studying for her nursing board exams in December.

When the exams are over, she hopes to get a part-time job while also pursuing her master's degree.

Jessup plans to combine her theological work with her nursing background -- maybe becoming a hospital chaplain or a church nurse.

Her dream would be to work with sick children, she said.

She thinks her perspective will be unique and that she could help sick people who may have a spiritual crisis that can come with poor health.

Right now, Jessup doesn't have a job, and her mother, a licensed practical nurse at a local hospital, doesn't have the financial means to help her get health insurance.

While she knows going without insurance is risky, Jessup isn't sure she has too many options.

"I mean, I fall in one of those situations where money is an ever-present issue," she said. "If something were to happen, the first thing in my mind is, 'How am I going to pay for it?' "

That goes for health insurance and doctors' visits as well, she said. Mostly, she just tries not to get sick or hurt and takes care of herself with over-the-counter remedies, she said.

"We kind of live day by day and pray that the Lord will carry us through," she said.

While Jessup tends to put her own insurance worries out of her mind, she still thinks about health care reform.

One of the biggest problems, she believes, is providing affordable care to the working poor -- those who make too much to qualify for government-paid Medicaid and not enough to pay for private insurance.

Without affordable insurance, those families can only get sicker and deeper in debt, she said.

But she also believes providing affordable health care is a moral obligation for the country -- a human right and not a privilege.

"At this point, we have to ask ourselves, 'How do we value a human life?' " she said. "Is it based on money?"

Justin Hinson

Lives in: Stedman

Occupation: He is volunteer services coordinator at Cape Fear Valley Health System.

The thing that frustrates Justin Hinson most about health care reform is the possibility of paying for people who won't pay for themselves.

He doesn't know much about all the issues surrounding reform, but as he sees it, he works hard and gets his insurance through his job at Cape Fear Valley Health System. He doesn't want to support people who can work but don't.

For Hinson, that's the bottom line. It's about fairness.

But he's also not crazy about how his insurance premiums and co-payments keep rising every year. He spends $60 a month on insurance. If he goes to the doctor, he has to pay $25 a visit.

Last year, the premiums and the payments were lower.

Another thing that's changed is his vision insurance. It used to be part of his health care plan, but now he has to pay $15 extra a month.

Overall, however, Hinson is pleased with his plan, and he's not sure the country's health care system needs to be reformed. At least not on a large scale.

"If it ain't broke, don't fix it," said Hinson, 20. "The people that don't make enough money, they have the Medicaid process."

Most everyone Hinson knows is against large-scale reform, at least the kind that's being proposed by the federal government, he said. He thinks reform will change the financial outlook of the health system he works for. Whether that's good or bad, he's not sure. All he knows for sure is that it's bound to change things, and not necessarily for the better.

Right now, Hinson has it pretty good, and he knows it. But he realizes there may be some room for improvement in the system -- some way to lower premiums and keep the rising costs at bay.

"If it's done right, it could work," he said. "But only if it's done right."