NATCHEZ — Healthcare is expensive. Everyone knows that.

But recently, concerns about how to pay for it have started creeping not only into the minds of the poor, but the working middle-class as well.

It is from that demographic that Mississippi Sen. Bob Dearing has been hearing more and more concerns.

“Basically, when you get outside the middle class, the more affluent can afford just about anything,” Dearing said. “The middle class is looking at every dollar, and they don’t have a lot of extra, spendable income.”

Mississippi Rep. Robert Johnson III said he often hears the same concerns.

Most of the people who have contacted Johnson are not those who have had a medical emergency, but those who can foresee one happening and are worried about how they would pay for it.

Those people tend to talk not about the costs associated with medical treatment, but instead in terms of the cost of health insurance, Johnson said.

“People who work are affected the most because they either have to buy health insurance or they can’t afford any,” he said.

Marbeth Schon is one of those people. A self-employed business owner, she and her husband have insurance, but at $700 a month, it’s not a passing thought.

To top that, they have a $10,000 deductible. That means they would have to pay $10,000 in medical bills before their $700 a month policy kicks in.

“We felt like we needed catastrophic insurance,” Schon said. “We figured we might be able to come up with $10,000, but not $100,000 or $1 million, which is not unheard of if you have open heart surgery or cancer.”

Natchez Regional Medical Center CEO Scott Phillips said the current healthcare system in the United States is great “if you have good insurance and can afford your medications, but if you don’t have that, the access is difficult and it’s going to be hard to jump in.”

Causes

The high cost of insurance is related to the high cost of healthcare — a national cost of more than $2 trillion a year, Phillips said.

One of the reasons costs are that high is because hospitals have had to respond to inflation, said Tim Trottier, CEO of Natchez Community Hospital.

“Like any business, our cost of doing business is a function of what we charge,” he said.

However, if you look at the cost of healthcare and compare it to the rate of inflation for other goods, its associated costs are rising at a higher rate, he said.

Faced with rising fuel and food costs, hospitals have increased bills across the spectrum, but they also have to face an “unfavorable tort climate in many states,” Trottier said. “Basically, frivolous lawsuits against healthcare providers artificially inflate the cost of healthcare.”

Another reason health care in the United States is so expensive is because drug companies are spending an incredible amount of money researching and creating drugs, and they pass those costs along to the patient, Phillips said.

But large portions of dollars spent on healthcare — between 20 and 30 percent — are spent on billing and processing claims.

“An awful lot of what we spend on healthcare doesn’t buy any healthcare,” Phillips said.

And a significant amount of healthcare — Phillips said approximately 40 percent — is unnecessary.

That, however, is not due to profiteering by doctors, but rather because of the constant evolution of medicine and new medical discoveries that render old practices unnecessary, and when they remain in practice, they drain resources, Phillips said.

All of those factors lead to one big problem.

“There are people who let themselves get into really bad condition before they seek help because it is going to cost them money they don’t have,” Schon said.

Proposed solutions

If there is healthcare reform that allows more people coverage, it is going to have to come from the federal level, Dearing said.

“The state can only do so much,” he said.

Phillips agreed.

“The question between the political parties is how are we going to structure the system so everyone can have access that’s affordable.”

That question has vaulted the issue of healthcare into the presidential debate.

The healthcare plan presented by the presumed nominee for the Republican Party, U.S. Sen. John McCain, proposes forming a non-profit corporation that would contract with insurance providers to provide coverage to patients who are traditionally uninsurable — those who don’t have prior coverage or those with pre-existing conditions.

His plan also includes allowing more insurance portability — allowing people to take a single insurance policy from job to job. The McCain plan also includes allowing people to purchase insurance across state lines.

That plan also includes finding ways to lower drug prices by re-importation of drugs and allowing generic forms of drugs to be placed on the market more quickly.

On the other hand, Democratic nominee Sen. Barack Obama’s proposed plan includes providing a national health plan with guaranteed eligibility for everyone and sliding-scale subsidies for families who do not qualify for the Medicaid or SCHIP programs but still cannot afford health insurance. The proposal also calls for the required coverage of children.

His plan also calls for regulation of the private insurance market for those who want to continue with their own private coverage. It also includes an employer contribution to either their employees’ health benefits or to the national health care plan. Smaller businesses will be eligible for a tax credit for their contributions.

The Obama plan also proposes to reduce the cost of medical treatment by modernizing American medical practices and allowing the re-importation of drugs and quicker generic drug releases.

Johnson said he likes the Obama plan, but whoever is elected one thing is true.

“We need to focus our attention on people who are not covered by Medicaid and can’t afford health insurance,” he said.