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Health care among topics covered during roundtable

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Xochitl Torres Small talks Wednesday at the Roswell Chamber of Commerce. (Lisa Dunlap Photo)

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US Rep. Xochitl Torres Small met with local residents during a stop in Roswell on Wednesday

A roundtable discussion Wednesday involving a group of locals and U.S. Rep. Xochitl Torres Small made clear that concerns over the cost and availability of health care are top-of-mind among many in Roswell.

The conversation also indicated the complexity of the challenges faced.

During an hour-long exchange with Torres Small, D-Las Cruces, in the downtown conference room of the Roswell Chamber of Commerce, topics ranged from the hurdles faced by health care providers in rural areas to the overwhelming cost of insurance for some small business owners.

Access to services is an issue across Torres Small’s 2nd Congressional District, which she described as “the largest (Congressional) district that isn’t its own state.”

“One of the special challenges with that is access to health care,” Torres Small said. “We have to make sure that everyone can afford the health care they need; we also have to make sure they can get to that — get that health care close to home.

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“But it’s a real challenge — we have some of the most underserved regions in the country.”

The issue of access to health care in large, sparsely populated regions points out the need for challenges facing rural areas, in general, to be prioritized — across party lines.

“I, as a Democrat, represent the largest and therefore most rural district served by a Democrat,” Torres Small said. “I don’t say that to bring party into it, I say that to actually show that rural issues should be a non-partisan issue.

“You want people in every single room talking about when you look at a policy, how does that impact rural communities. You don’t want it just to be the Republicans talking about it; you don’t want it just to be the Democrats talking about it, or the Independents or whatever. You need everyone talking about it.”

One local health care professional pointed out that he’d determined — as part of a market analysis — that the Roswell area has less than a third of the practicing primary care physicians its population needs.

While the services provided by nurse practitioners help offset that, the shortfall is an issue, he said. Even if everyone were adequately insured, they could face a lack of services.

Torres Small later in the discussion touted pieces of legislation she supports that would help address this, one by bolstering residency programs for doctors.

“Right now we actually have more doctors graduating — med school graduates — than we do residency slots,” she said. “So there’s a whole bunch of highly skilled — they’ve got med school — highly skilled people who can’t get a slot for residency.

“One of my pieces of legislation would increase slots by 15,000 over five years, and allocate them to specialties where they’re especially needed. One of those is a rural track program to get them out and exposed to rural communities so they hopefully fall in love with the work that gets done there. …”

Another health care administrator noted that changes to the tax code — specifically how relocation expenses are handled — have created another challenge when it comes to recruiting physicians. Reimbursement for those expenses, he said, is now treated as taxable income at a higher rate applied to bonuses.

One local businesswoman noted the challenges faced by small businesses — saying she was faced with possibly having to lay off an employee to offset the cost of her own skyrocketing medical coverage.

The issue of “surprise billing” was also touched upon, with the congresswoman saying she anticipates it will be addressed shortly in the House.

“Surprise billing” refers to consumers being hit with unexpected out of network costs, most often after emergency room visits or major procedures.

“There’s likely going to be some surprise billing legislation coming up when I go back for votes,” Torres Small said. “Right now in the House, there are two different versions of that. …

“Sometimes that (surprise billing) happens because the insurance companies haven’t negotiated with the care providers. But you have to get service right away, so you get charged the price because you’re not covered.

“We’ve got some good agreement that you should take the consumer out of that equation. It wasn’t their fault that people didn’t have a negotiation or an agreement reached.”

Yet to be determined: What price consumers in that position should end up paying instead of the outsized “surprise” charges — one equal to the Medicare rate, which would be the lowest-cost option, or a rate based on a regional average.

Torres Small also touched upon the Medicare-for-all proposals being bandied about, saying their lack of focus on the challenges faced by rural areas had left her unconvinced. “I am not a Medicare-for-all supporter,” she said. “I get a lot of flack for that in my party.

“But the main reason why is because I haven’t seen a single plan that talks about how you increase access in rural communities with that proposal. …”

Among other topics covered during the roundtable was the proposed United States-Mexico-Canada Agreement. Vice President Mike Pence, during an Aug. 21 visit to Artesia, urged New Mexicans to pressure Congress to pass the USMCA, saying it would be beneficial to the nation’s economy and help encourage increased energy development.

In an economy like New Mexico’s, which relies heavily on trade, stability is key, Torres Small stated.

“… Having the ability for companies to invest based on predictability really matters. Frankly, that’s why we’re in a challenging situation right now,” she said. “Because NAFTA (the North American Free Trade Agreement) was disrupted, it was something that people had been relying on for a very long time, had invested based on that. Without that trade agreement, there is a lot of uncertainty. It’s a real challenge.

“I think it (the USMCA) addresses some of the challenges that have occurred post-NAFTA. I think it’s a good starting place.

“The challenge is, Congress was not involved in that discussion at all. So how do we make sure that we have the right trade agreement? … She added, “as we hash out a plan for our trade, we’ve got to find a way that everyone’s got some good buy-in. … so we have a clear path forward … every single time I can, I’m finding ways to talk about New Mexico’s reliance on trade. Because it’s part of who we are.”

Other topics covered included issues related to the rehabilitation of structures in the downtown Roswell area, and the impact on many different aspects of life — including health care costs — of the litigious nature of present-day American society.

“How do we make sure we’re in a system where people are free, we can enforce our rights, protect our rights, but we’re also working together? … With all of these challenges, we spend a lot of time fighting each other rather than working together to find solutions,” Torres Small said.

Editor John Dilmore can be reached at 575-622-7710, ext. 303, or editor@rdrnews.com.

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