Q&A: Dr. Deborah Harper

Dr. Deborah Harper is a pediatrician working for Group Health in Spokane and is president-elect for the Washington State Medical Association. Soon she’ll be busy meeting with doctors around the state as part of her role as an advocate for better health care in Washington.

INLANDER: Do you think that access to health care is a right?
HARPER: It didn’t get added to the Bill of Rights and it’s not in the Constitution, but for the pursuit of happiness, everyone needs access to health care.

What do you see as the largest problem in health care today?
We need to have universal access to a basic level of protection. There has to be a safety net for people, whether that’s funded by the government, or whether it’s something like Project Access that we have here in Spokane.

What is the link between the need for health care reform and our current economic problems?
Access to health care is governed by insurance, which is almost entirely dependent on your job. When there’s a downturn in the economy, a couple things can happen. The obvious one is that you can lose your job and then lose your health insurance. The other thing is that health insurance is expensive, especially for small employers. When times are tight, they may eliminate health insurance. And that just can’t continue.

In terms of actually initiating health reform, a lot people think only of policy, but it sounds like you think that we also need some kind of education for doctors and insurance companies.
And for patients. There needs to be personal responsibility on all of our parts. One of the things that’s killing us is that Americans are not very active and we’re not eating the right things. I think 60 [percent] or 70 percent of Medicare money is spent on the top five diagnosed diseases. Four of the top five — congestive heart failure, high blood pressure, diabetes, and kidney disease — are due to not exercising and not eating right. The other one, asthma, is directly related to pollution.

Physicians need to take some more personal responsibility in the hand-off of patients. In my own practice, I’ve had children who are aging out of my practice who have really serious, chronic diseases and medical problems. I need to do a better job of handing off to their family physician.

In Washington, D.C., there’s been talk of passing a bill that would allow states to…
… become incubators. It’s a neat idea. There are federal regulations that have stopped states from being able to do that in the past. One of the options that’s been thrown out there is to let each state come up with its own reform plan, see which three work and then institute those on a more national level.

What would you say to people who think that universal health care is some socialist plan?
People are screaming about this one $3 trillion price tag that President Obama’s original plan had, but they have no idea how much they’re paying already for the uninsured. When a hospital serves an uninsured person, which they are required to by law, we lose $25,000 on that stay.

Are there any alternative ideas for health care that you think should given more attention?
Something I’m not hearing people talk about is the public health departments. They are so unfunded. Of what our state Legislature thinks the public health department actually needs, they’re getting less than 10 percent of it.

There are a lot of reasons why the public health department is important. Just to be scary for a minute, when you look at bird flu or swine flu, those happen wherever you have urban and agricultural interactions where people don’t have access to health care and nobody’s monitoring — a place like Yakima, for example. It’s really important to have better monitoring and access to public health.