By Sarah Schulz, Grand Island Independent

Larry Harbour is a hard-working family man who runs his own business.

Many nights he can be found working into the wee hours to finish a car at his Broken Bow-based detailing shop because he can’t keep good help. The reason? He can’t afford to give his employees, or himself, health care benefits.

“It’s nice to have a business, but what happens if I get hurt?” he said. “It would sink my business. It would cost $600 a month for my family to have insurance. That’s a house payment in Broken Bow. Maybe even a car payment. I’d love to supply it, but I can’t afford it. Health care is pretty much out of my financial league.”

Harbour’s situation isn’t unique.

Many of the two dozen or so people gathered at Grand Island’s Grand Generation Center Wednesday night for a health care reform forum shook their heads as Harbour spoke. He isn’t alone.

A panel — made up of Jon Bailey, director of rural research and analysis programs at the of the Center for Rural Affairs; Mike McGahan, St. Francis Medical Center medical director; and Jennifer Carter, director of health care access program for the Nebraska Appleseed Center for Law in the Public Interest — led Wednesday’s discussion and answered questions.

Connie Benjamin, state director of AARP Nebraska; Jane Fleming Kleeb, state director for Change That Works; and Kathy Bigsby Moore, executive director of Voices For Children, were also present to share their thoughts.

The group addressed the fact that health care reform is being talked about nationally and is being discussed in both the House and the Senate.

Bailey said the current system has many flaws — skyrocketing costs, expanding number of uninsured or underinsured people, and self-employed people who can’t afford health insurance.

“One in four farmers has financial problems due to medical debts,” he said. “Over one-third of the people in this area get insurance on the individual market because they aren’t part of a large company.”

McGahan said the quality of health care is good and, in fact, has made great strides in a short amount of time. Health care changes and advances quickly. What needs to be reformed is how to pay for it, he said.

“If it’s made affordable to everyone, many problems go away,” he said. “The cost is climbing and most people can’t afford it unless they are part of large employee groups.”

McGahan said part of the problem is cost shifting. For example, if it costs a doctor $50 in overhead to see a patient but insurance or Medicare will only pay $36, the doctor has to shift the costs elsewhere, such as to the patient, to pay expenses. If everyone had some sort of coverage, the cost shifting would even out, he said.

“There’s no free lunch,” he said. “Somebody’s got to pay for that. They’ve got to make it up somewhere.”

Carter said the ability to control costs and how to balance those costs is key to health care reform.

“We cannot have health care for all unless we control costs,” she said. “The U.S. spends 16 percent of the national economy on the health care system. We need to refocus on wellness, not sickness, to save costs.”

All three panelists said there are things about the current health care system that are working, but there are many things that need to be changed so that everyone can receive affordable health care. They discussed the need for a public/private option to cover costs and to spread the risk out among a wider range of people and companies.

“We have to build on what we have,” Carter said. “Whether we have a public system that is opened up as is or one that is overhauled needs to be determined. For better or worse, we need to work with what we’ve got.”

Many of the questions from the public centered around what can be done to police costs, prevent abuse of the system and what it would take to change health care.

Their answers included a tracking system to prevent patients from bouncing from emergency room to emergency room to sharing personal stories with elected officials.

“We’re all advocates. You all have stories and no one knows your issues better than you,” Bailey said. “You all have tremendous power. You’d be surprised what a small group can do.”

The panelists encouraged those in attendance to write to and call elected officials to share their concerns and thoughts. They also spoke about what each of their organizations are doing to create reform and Moore told the audience members to sign up to be part of the “network of voices.”

“We need your voice, your story to add to our message,” Moore said.