Having the ear of President-elect Barack Obama's pick for Health and Human Services secretary, South Dakota health care professionals are sending local ideas for health care reform to Washington, D.C.

About 100 community members came together Saturday afternoon to discuss the future of primary health care in the state, with the goal of delivering the results to former Sen. Tom Daschle by Inauguration Day.

Theresa Matthews, an independent pharmaceutical consultant, said Obama has an incredible opportunity to change the way Americans think about health care.

"He can really rise to this occasion," Matthews said. "He can say, 'We're going to reduce our health care costs dramatically because we're going to be the healthiest nation on earth.'"

The Black Hills Medical Society and the South Dakota School of Mines & Technology sponsored the community forum that focused on access to primary care, public health, patient responsibility, prevention and unfunded mandates.

"We wanted to show Tom Daschle and our community that physicians are interested in changes to health care," said Dr. Kevin Weiland, president of the Black Hills Medical Society. "We know it's coming, and we want to be a part of it."

Participants represented a wide swath of the community beyond health care professionals, including business owners, local officials, Congressional staff members, attorneys and Medicare recipients.

Many of the suggestions Saturday had to do with overhauling the way health insurance works - including reimbursement of primary care doctors and the lack of incentives for making healthy lifestyle choices.

Primary care used to be considered one of the most rewarding fields of practice, Dr. Cynthia Weaver, president of the South Dakota State Medical Association, said. Now, the way insurance companies reimburse primary care doctors favors procedures over quality time spent with a patient.

Dr. Steve Massopust, a primary care doctor, agreed.

"The skill primary care has isn't a procedure," Massopust said. "You need to be reimbursed for total care of a patient, not how many visits you have."

Daschle wasn't at Saturday's forum but called in to talk about the changes he believes need to be made to a system in which an automaker like General Motors can pay more for health insurance than steel.

"Those three - access, cost and quality - all have to be addressed in a powerful and meaningful way, a comprehensive way," Daschle said.

Providing incentives for healthy lifestyle choices and improving health care literacy was the focus of one of five small-group discussions participants chose from.

The discussions were run by health care leaders from throughout the state: Dr. Dale Bachwich, a DakotaCare board member; Dr. James Engelbrecht, clinical professor at USD's Sanford School of Medicine and past American Medical Association delegate; Dr. Charles Hart, president and chief executive officer of Regional Health; Dr. Rodney Parry, dean of Sanford School of Medicine; and Weaver.

Unlike other types of insurance, group health insurance rarely has incentives - or disincentives - for lifestyle choices, group members discussed. Why not make a smoker pay more for insurance than a non-smoker?

Engelbrecht, who led the discussion, also talked about improving health care literacy for everyone, school-age children through retirees. In his role at DakotaCare, he has educated employees about issues such as generic drugs and cancer screenings in diverse settings including board rooms and warehouses.

"It's very powerful to go in and talk to a group of employees," Englebrecht said. "They're all equally receptive to being taught these things."

From the get-go, organizers made it clear the point of Saturday's session was to propose solutions, not air grievances.

"We already know the pitfalls," Weiland said. "Physicians are in the trenches of health care. We make it go. We already know the stories."

Contact Emilie Rusch at 394-8453 or emilie.rusch@rapidcityjournal.com