By Mike Shields
KHI News Service
WICHITA, July 26
Insurance companies and government health programs should cover prevention and counseling as well as they do crisis care, doctors at the University of Kansas Medical School-Wichita said Thursday.
Reimbursement for those services would be especially helpful in dealing with childhood obesity, the faculty physicians told members of the Kansas Health Policy Authority here on the second day of their 20-city listening tour gathering input for the health reform plan they are to present in November to lawmakers.
“We can figure out their BMI (body mass index) and tell them, but that”s about it,” said Dr. Bob Wittler, chairman of the school”s pediatrics department.
“You have to wait until they have Type II diabetes to treat them,” said Dr. Russell Scheffer, chairman of psychiatry.
The doctors also described other problems needing remedy:
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Too few medical students choose primary care specialties because primary care doesn”t pay as well and the students graduate saddled with student loan debts. But primary care medicine is crucial for prevention and holding down costs.
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The medical field is expanding but there are not enough doctors and nurses.
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Doctors can”t provide the care they want because many of the services, including mental health care, are not adequately reimbursed by insurers or the government
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“We find a reimbursement issue every time we try to be innovative,” said Dr. Jim Early, an expert in preventive medicine.
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Scholarships are no longer provided for psychiatry students, Scheffer said, “and all the current students are looking for jobs outside the state.”
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Too little research is done on the benefits of preventive care because drug companies, a major funder, have no interest.
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Reimbursement forms handled by doctor and insurance offices are not standardized, a costly administrative problem.
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Physical education courses are no longer required for many school students, but soda and snack machines can be found everywhere. “Now we have them sit down so we can tell them they should be exercising,” said Dr. Robert McKay.
Health policy authority officials made three other Wichita stops. They began the day at a safety net clinic. After visiting with the faculty doctors they met with insurance underwriters and then with a small group of congregants at Central Christian Church in northeast Wichita.
The underwriters urged the officials to make use of programs and systems already in place instead of making wholesale changes. Robert Langhofer, vice president of sales for Fiserv Health, recommended that the reform included elements that would “level the
playing field” for companies seeking to compete with large, entrenched insurers able to demand discounts from providers. Others suggested that regulatory hurdles to new types of health plans be eliminated.
Members of Central Christian Church asked officials to include in their reform plan incentives for more “personal responsibility.”
– Mike Shields is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
mshields@khi.org
or at 785-233-5443, ext. 123.