ENID — Dr. David Weaver was tending to one of his patients in the emergency room one night when he witnessed a woman bringing in her son because his left nostril was stuffy.

The same night another man was concerned about the way he was urinating.

Two conditions that while they were concerns, Weaver said, they were far removed from emergencies.

“The emergency room is not there for colds,” he said.

In fact, emergency rooms are the highest cost for hospitals when it comes to providing care, as doctors, staff and specialists are either on the scene or on-call 24-hours a day, said Nicholas Crafts, chief operating officer for St. Mary’s Regional Medical Center.

But the fact the ER continues to be used as a doctor’s office rather than an “emergency” room drives home the fact health care in this nation needs to be reformed.

A need to improve

The medical industry makes up a large portion of the Enid-area work force, and no one knows better the need for health care reform than the ones who work in the business every day. So, need is not at the forefront of debate for Enid health professionals.

“Thirty seven million Americans who don’t have even basic health care services need to be at the forefront of discussion,” said Jeff Tarrant, president of Integris Bass Baptist Health Care Center.

It is a point few disagree with no matter their political leanings.

“I don’t think anybody wants to see anybody else suffer,” Crafts said.

And yet, most Americans want to make sure the right road to reform is taken, as evidenced by resistance to health care changes on the national front.

The recent election to the U.S. Senate of Republican Scott Brown  — who ran on a platform as the 41st vote to resist the Democratic health care plan — brought that home to many in the current presidential administration and beyond.

“We were moving at a very rapid pace,” Tarrant said about the national health care initiatives. He likened it to “taking a step off the edge of the cliff without knowing what was underneath.”

Since that election, things on the national front have slowed dramatically. Many hope that means any plan that comes forth now will be better vetted by Congress.

Local professionals also say true health care reform has to be a plan affordable by and acceptable to the nation’s population that will avoid, Tarrant said, coming back in a few years to fix “unattended consequences.”

If one looks at the nation’s current health care services and adds 37 million ...

“We’ve presented an impossible economic scenario,” Tarrant said.

So where do you start?

“I don’t know, to be honest,” Weaver, a local obstetrician/gynecologist, said when asked where policy makers begin to reform health care. “It’s one of those things that ... where do you start?”

National health care reform is hard to wrap one’s arms around, local professionals say, because it is such a huge undertaking.

Crafts said he’s not sure scrapping the current system — a recent move that based on polls and news reports is unpopular with a majority of Americans — is the answer.

Cyndy Shepherd, director of corporate communications for St. Mary’s, said she hasn’t seen an acceptable, concerted effort when it comes to health care reform.

“We have yet to roll up our sleeves and work with this problem in a bi-partisan way.

“You don’t go from step 1 to step 20 overnight,” she said.

As he has spoken with community groups, Tarrant said he sees northwest Oklahomans as being “fairly conservative” and agrees true health care reform will come with time.

“I almost think our political climate is such we will tolerate only incremental steps.”

And yet, he said, those steps need to be taken soon, he said. America cannot afford to ignore the issue.

Timing is critical

While policy makers in Washington, D.C., are asked to slow down the point of critical mass is fast approaching.

Americans, it seems, are starting to realize health care is facing a crisis, and if they don’t they need to.

“Health care impacts all of us. The entire population of the nation needs to be attuned because it will affect them,” Tarrant said.

Medicare bankruptcy has been a reality, he said, but — even for him — it was in the distant future.

The distance quickly is closing.

As health care services currently stand, Tarrant said, the Medicare trust fund is destined for bankruptcy in 2019, less than 10 years away.

“2019 for me,” he said, “is in the foreseeable future.”

Currently more than 17 percent of America’s gross domestic product is spent on health care. In 2019, ironically, it is projected to be 20 percent, Crafts said.

“We already provide care we can’t pay for in the future,” Tarrant said, adding that makes it critical that any plan adopted does not plunge the country deeper into debt.

Something the recent plan, local professionals say, seemed destined to do.

America needs “reform we can afford,” Weaver said. “The Demo-cratic plan would bankrupt the country.”

But when it comes to true reform, both sides of the political spectrum are playing hardball, he said.

Gotta better idea?

Tarrant suggests starting with the “low-hanging fruit,” which he de-scribes as obvious problems everyone agrees needs fixed or solutions all will support.

• Technology — Being able to store records electronically is a big cost-saver and offers patients access to records anywhere, Tarrant said. It is an expensive investment up front but one that quickly will pay for itself.

• Education and personal responsibility — Areas near and dear to Weaver’s heart.

“There’s a million different areas that you can go on and on about,” he said.

“There’s a significant portion of our population here in Enid that doesn’t have health care,” Tarrant said.

Some have no access, some choose not to have access.

“The reality is if you have ability to obtain health care ... It’s really the responsible thing to do,” he said.

Some of the biggest abusers of health care are patients on Medicaid, Weaver said, because they have no personal stake in the costs.

“They routinely come to the emergency room for ... you name it,” he said.

Lack of personal responsibility in medicine touches on all points of the spectrum from education to lawsuit reform. When one is not responsible for the bill in any fashion, cost is not a factor.

An overabundance of medical testing has become the result, Weaver said, and the costs are enormous.

Weaver cites genetic testing — used to determine if someone is predisposed through heredity to having, for example, breast cancer.

“Why would you get that test if you are not going to cut off your breast?” he said, adding it will not change the outcome.

Many of his patients will ask for an ovarian cancer screening, and there isn’t one, he said. There was a blood test determined to be ineffective 25 years ago.

“Yet I read it all the time on the Internet.”

So women will have surgery based on an inaccurate test, which puts them in greater danger.

“You are many times more likely to die from complications of surgery than ovarian cancer,” he said.

“Everyone’s looking for an answer for things we can’t find an answer to,” Weaver said.

And yet, there are tests, he said, that are worth their weight in gold, like mammograms, everyone should be in line to receive.

Some of those tests are under fire.

A recent study suggesting women younger than 50 have no need for mammograms has drawn the displeasure of every medical association, Weaver said.

The greatest rate of increase in breast cancer is occurring in women age 40 to 50.

“Are you just going to write off those people?” he said.

Weaver said the government is putting huge emphasis on psychological stress from fake positives.

But as a doctor, he said, it is his job to ease fears from false positives. It is better to catch the cancer early when it is treatable.

It is tests like these — preventative medicine — that make a difference.

 • An ounce of prevention ... — is what can make a difference in health care and what the reforms are trying to emphasize. Health insurance in hand may convince more to take preventative measures, saving money in the long run, rather than wait until the problem is critical.

“We’d like to see more focus on prevention,” Crafts said.

One of the biggest forms of prevention that can make a difference now is smoking cessation.

“We’d have a much healthier country if people stopped smoking,” Weaver said.

• Lawsuit reform — is the “800-pound gorilla” that was not part of recent plans for reform.

But it is critical to true reform, both administrators and Weaver agreed.

“One of the things we have to do is cover ourselves,” Weaver said. “When someone comes in with a headache, if you don’t get a CT scan you’re screwed. There are so many (tests) we order to cover our butts.”

The cost of defensive medicine, Tarrant said, is significant, although no one is able to put a true number on it.

Many lawsuits are valid, Weaver stressed, but many are frivolous.

Doctors should be protected from those, just as patients should be compensated when suits are valid, they said.

Payments to physicians have been cut significantly over the years, Crafts said, and “we can’t cut our way to success.”

Margins for hospitals also are flat or underperforming, Tarrant said.

• Health savings accounts — provide a way for patients to stay involved in their care.

Health savings accounts often are coupled with a high-deductible, lower-premium insurance with the difference covered by the HSA, which are pre-tax funds set aside strictly for health care purposes.

HSAs prompt the patient to pay more attention to the bottom line when it comes to costs of testing and care, Tarrant said.

Reforms are happening

Meanwhile, the efforts of this community might do well as an example to Congress.

Health care officials in Enid joined forces years ago to provide a clinic for those unable to pay and slow emergency room visits.

Care facilities have continued to draw quality professionals — Enid just recruited its third neurosurgeon, Crafts said — and upgrade infrastructure to invest in top-notch care.

“We’re going to move forward despite what happens,” Crafts said.

The alternative is to lose medical facilities here in Enid.

“Do we want to be in survival mode, or do we want to be in a health care system that keeps up?”

Weaver said he sees Medicaid patients, even though government reimbursement is less than private insurance, because he cares about the people in his community.

The Midwest mentality — people want to work — is a reason he left his practice in Vegas ... that and the cost of malpractice insurance had skyrocketed exactly because of a lack of that mentality.

But the culture crisis is a heavy player in the health care game.

“Making Medicaid available to more people is going to make the culture worse, I feel,” he said.

It’s like expecting a car insurance company to insure someone who routinely drinks and drives, he said.

Just making insurance available won’t help all. It may help some, he said, but we can’t afford that.

An analogy Tarrant uses focuses on the national education system.

Every child in America has a right to education in a public school system, he said, adding it doesn’t mean it’s the same quality, but it is available.

Take the same analogy, he said, shift it to health care and come up with a basic policy statement outlining care individuals are entitled to.

“I think that’s a good start.”