As Congress engaged on heated debates on health care reform, Filipino-American leaders held a forum and passionately delivered their points to push for reforms to require insurance to be more transparent to consumers and remove pre-existing conditions and big out-of-pocket expenses.

In a forum sponsored by the National Federation of Filipino American Associations (NaFFAA)-DC area, Filipino-American lawyer Eliza Navarro Bangit, a senior research associate at Georgetown University, revealed that some health firms have hidden out-of-pocket expenses that forced patients to pay upfront when struck with illness. She said one patient didn't know that she had to pay hospitalization and other procedures, and was forced to pay thousands of dollars when she had a heart attack recently.

She said that in some cases, costs for office visits, prescriptions and mental health outpatient visits were not counted toward the patient's out-of-pocket maximum. And when illnesses occurred, patients were forced to pay more, which have forced some into bankruptcy.

In a lecture, Bangit said that since Congress is expected to pass the health care reform bill, Filipinos in the United States must be well prepared. She said health care should be available, adequate and affordable to many immigrants. "Under the mandate, all Americans will be required to have health insurance, even if many firms won't be able to afford health care," said Bangit.

In a paper, Bangit advised patients to look for more comprehensive coverage that they can afford. When reviewing policy, patients should check to see if all costs for medical care will apply to one deductible or to two – for example, a separate deductible for drug costs, determine if the deductibles apply separately to individuals and family members. "If you have a high deductible and each family member has a separate deductible, it can be costly," she said.

Bangit also said that the current problem on health care is that many patients have been denied by their insurance to pay for their health care due to pre-existing conditions that would hopefully be abolished by Congress.

Dr. Nathalie Bernabe Quion, a specialist in pediatrics and a member of the Philippine Medical Association, said it's time for nurses and doctors to come together to advocate for equal distribution of health care services. "The number of underinsured and the uninsured is rising," Dr. Quion said.

There are about 47 million Americans who are uninsured, including immigrants who are getting insecure when they get sick.

Dr. Quion said that more and more patients were being discharged early from the hospital even if they are not yet ready or not yet well because the patients are saving costs and expenses.

"Health care is getting too expensive and when patients are discharged early, they surely end up again in emergency rooms," Dr. Quion said. "Patients are overloading the emergency rooms and the system," she added. She also expressed concerns on a shortage of doctors in America, which is estimated to have 10,000 shortages of physicians. [Several studies suggest there could be a shortage of close to 100,000 in the next 20 years, according to coverage in Salon and CBS.]

Diana Comiso, a Filipino-American director of nursing services at Fox Chase Rehabilitation, said prevention and wellness programs were needed to lower health care costs. "We must have wellness programs to take care of ourselves," she said.

But the biggest concern among Filipinos is that taxes may go up for business owners.

Filipino-American John Cabrera, vice president of sales and marketing at CF Alliance Insurance, said that health care costs have gone up and labor costs too have been soaring. "There are small businesses who can't afford health insurance. The government has to provide subsidy," Cabrera said.

Cabrera is also worried that health care reforms could lead to higher premiums for families and individuals, as studied by the America's Health Insurance Plans.

Filipinos who participated in the forum also urged the government to implement tort reform to lower medical malpractice costs to doctors as part of its health care reform agenda. The government too needs to create competition to lower health care costs. It was discussed that health insurance in Maine is very expensive because there is only one big health care provider.

"It's time that our health is taken care of in an equitable way," Dr. Quion said.