The national debate over health care came to Cody on Thursday, when local health care experts and politicians expressed their concerns with the health care system and the new health care law passed by Congress.About 30 people attended the meeting, hosted by Dave Kellett (who is running for Wyoming House District 25) and other local TEA Party advocates at the Park County Library.

Rod Barton, chief executive officer for Powell Valley Healthcare, and Pat McConnell, chief financial officer for West Park Hospital in Cody, both provided historic looks at the way health care has been provided and paid for.

Barton noted that, initially, doctors billed patients, and patients paid doctors directly for their services.

Eventually, private health insurance became available, and, sometime after World War II, some employers began providing health insurance as an employee benefit.

Then, beginning in 1965, Medicare and Medicaid began providing a financial “safety net” for the elderly and the poor.

McConnell provided statistics showing that, in 1960, 46.9 percent — nearly half — of all medical costs were paid by the private sector. Insurance paid 28.7 percent and government paid 24.4 percent.

That picture changed completely by 2008, when government paid 47.3 percent — nearly half — of all medical bills; insurance paid 40.8 percent and private payers, 11.9 percent.

With that came a change in how people shopped for medical care, McConnell said. Since the money for medical care was not coming out of their pockets, the focus for many when shopping for medical care was on quality — or perceived quality — regardless of the cost.

That was further complicated by cost shifting caused by government reimbursement rates set lower than the cost of the services provided through Medicare and Medicaid.

Barton noted that, in Powell, Medicare pays 44 percent less than it costs to provide health care services.

To make ends meet, hospitals shifted the balance of unpaid costs by billing at a higher rate for insured and private-pay patients.

McConnell said the cost for health care in 2008 increased at an annual rate of 8 percent, while the consumer price index rose at a rate of only 3 percent.

As medical costs have risen over the years, insurance companies, in an effort to limit their expenses, raised their rates and began refusing to cover patients with chronic or costly conditions.

The result was the dysfunctional system that prompted Congress to take action this year when it passed the health care law in March.

But no one at Thursday's meeting was happy with the result.

McConnell said the aim of the law was two-fold: Increasing availability of medical care and health insurance while decreasing cost to individuals.

But McConnell said there is no way to do both.

“You can't fix prices and assure access,” he said. “It's one or the other. It's a trade-off. You have those who don't have health care vs. waits for health care in the future.”

McConnell said other countries that have tried to do the same thing have failed as well.

“They all have shortages of medical care,” he said.

“What (the president and Congress) are trying to do violates the laws of economics,” McConnell said after the meeting. “They're called laws because they're proven true. What scares me is, they think they can subvert those laws.”

Adding to that problem is the fact young people have fewer and fewer incentives to go into the medical profession.

After seven years of medical school, “a medical student has $250,000 in student loans to pay, and they're not going to make as much money as someone who has a business degree,” he said.

Jennifer Talich, an agent with State Farm Insurance in Cody, said it's too soon to know what effects the new law will have on the insurance business.

“Plan benefits may increase — with accompanying price increases,” she said.

McConnell and Jason Whitman, an optometrist who is running for Wyoming House District 24, both noted that the health care bill initially was estimated to reduce the country's deficit by $124 billion. But, shortly after it passed, the estimated cost of the program increased by $115 billion.

Whitman predicted that the costs of the new program could run as high as $2.5 trillion in 10 years.

“I could spend $1 million for 100,000 years and not spend that much money,” he said.

Kellett said the bill creates 159 new bureaucracies. When he printed out a list, it took up six full pages.

“I about fainted,” he said.

And the main bill is so long that it cost him $129.80 to have a full copy of all 2,438 pages printed, he said, noting that it is only one of three bills currently being compiled to form the full health care program.

“The reconciliation bill is 1,900 pages,” he added. “How are we going to figure this out?”

Kellett said residents should demand that the Legislature have a special session to pass an act that would change the Wyoming Constitution to prohibit the federal government from dictating health care decisions for Wyoming residents.

But Rep. Pat Childers, who attended the event, said he's heard it's too late now to get the act on the November ballot.

McConnell said the new law will not solve health care problems, but he sees no other solutions, either.

“There are no answers,” he said.

Barton was a little more optimistic.

“I understand it's not a perfect bill,” he said. “But the answer is not to throw everything out. To throw the whole thing away — that's not a good solution.

“Some changes need to happen, and we need to talk about what those changes should be.”

One of those changes should be a public mind-set change, he said.

“Thinking that everybody gets everything for nothing — that has to change.”