When Rep. Peter DeFazio visited the coast three months ago, people crowded into town halls to vehemently voice concerns and ask questions about public health care reform. 

It was a different setting Saturday morning at Coos Bay City Hall.

A panel of experts fielded questions from about a dozen voters during a public forum on the local impacts of a national health care policy.

Bay Area Hospital Chief Financial Officer Tim Salisbury began the discussion by expounding on a worsening health care trend among the middle class in this area. The lower economic class has medical access through services such Medicare and Medicaid, but the middle class, he said, is often going without. 

“They are used to paying for health care,” Salisbury said. “They have never had to access services, but now they can’t afford it. The working class can’t afford to go to the doctor.”

The panelists nodded. Each agreed that the country needs health care reform, but what it should look like is a point of contention among politicians, voters and health professionals.  

“It’s easy to define what we want,” said Doctors of the Oregon Coast South Chief Executive Officer Bill Murray. “The difficult part is figuring out how we can get there.”

But Saturday morning there were no agendas, only answers.

The League of Women Voters of Coos County hosted the event, which considering the antagonistic topic, was amiable. Each speaker gave a brief introduction, then speakers addressed written questions from audience members.

Kathy Laird, executive director of the Waterfall Clinic, said the number of uninsured Coos County residents seeking care is increasing, while funding continues to be an problem. And the director of the local Retired and Senior Volunteer Program, Christine Coles, said Coos County has one of the largest elderly communities in Oregon, which presents an added challenge.

Q: What is an attainable/effective way to contain health care costs?

A: Murray: “It comes from all of us using health care appropriately and the insurance companies and federal government setting an example and not administering a ton of bureaucratic rules that get in the way.”

Laird: “We don’t spend enough time on prevention. We treat after the fact and then pay for it after. It would be more cost effective to focus on prevention.”

Q: What are some of the specific challenges to our area when it comes to national health care reform? 

A: Murray: “The challenge is the number of people who need access to health care is increasing. We are rural and small and don’t want to be left behind or have fewer choices. Providers leave because we are small, and they are losing money. We need to make sure we have an affordable option and doctors have incentives.”

Q: Have you read the house bill?

A: Salisbury: “I’ve read a four-page summary. It will change so much. It [the final bill] is not going to look much like this one does.”

Q: For middle class people who don’t have medical insurance because they can’t afford it, are they better off paying for a public option?

A: Salisbury: “I don’t know. No matter what, we have to be prepared for taxes to go up.”

Q: How can uninsured people negotiate the same prices that insurance companies get?

A: Murray: “It’s kind of like buying a car. The list price isn’t the price that gets paid. Most providers are willing to talk about a discount.”

Q: How many of your clients are not able to get insurance because of pre-existing conditions?

A: Laird: “A huge number of patients are managing chronic diseases, but it’s hard to tell. We don’t know who has been denied.”

Q: Are physicians not accepting Medicare and Medicaid a problem in the community?

A: Murray: “The vast majority still accepts Medicare and Medicaid. It does get harder each year because of more cuts.”