Hospitals Need Fair Reimbursement To Survive

Area hospital administrators offered some insightful perspectives on health care reform Thursday, during a forum in Abingdon hosted by U.S. Rep. Rick Boucher.
We were pleased to hear their views, and can agree with many of the points they made, particularly the need to eliminate waste, duplicity and fraud in our nation’s health care system.
Speaking to an audience estimated at 1,500 people at the Southwest Virginia Higher Education Center, the hospital administrators said they oppose a single-payer, government plan.
These hospital administrators have a vested interest in the health care debate. They know their providers, patients and the harsh economic reality of the region. And overall, they are worried that a new, government-run plan could spell financial ruin for them and chaos for the local medical system.
What they did rally around were common sense ideas, many of which this newspaper has strongly supported – eliminate unnecessary medical testing, reduce claims processing problems, insure more people so fewer people use emergency rooms as clinics, and expand electronic medical records.
The mood of the crowd? Anything seen as government intrusion was answered with boos. If it was seen as free enterprise growth, it was lauded and cheered.
But this polarized crowd stopped catcalling and grew quiet when Boucher and the panel reminded them that health care costs are rising, local hospitals are overwhelmingly dependent on Medicaid, the government insurance plan for the poor, and Medicare, the government insurance plan for the elderly.
Neither comes close to reimbursing hospitals for their actual costs. So hospitals shift their costs to private insurance patients to try to make up the difference.
That doesn’t work well either, because the fewest number of local patients are those with private insurance.
Don’t forget that there will be a gap of more than $1 billion between Medicaid reimbursements and services rendered in Virginia next year, regardless of health care reform. And Medicare is on the brink of bankruptcy.
Ignoring a problem that is eating our wealth and costing everyone is not an option.
The panel included Wellmont Health Systems CEO Mike Snow, Mountain States Health Alliance CEO Dennis Vonderfecht, Johnston Memorial Hospital CEO Sean McMurray, Holston Medical Group founder Jerry Mullins ,and Mary Wakefield, administrator of the Health Administration Services Administration in Washington, D.C.
Wakefield was the only one of the five who gave any real support for a government plan. The others said the aim should be to provide better health care service, by reducing waste, improving patient health and increasing competition to bring down insurance costs.
Boucher said lowering costs and improving access, not “single payer,” is the real focus of health care reform and that is the message he has heard from constituents for years. He vowed to oppose any measure that would increase the national debt or lower quality of care for Americans. He also, rightly, noted the need for “more creative thinking” on the measure, because there are not 60 senators who currently support a single-payer plan.
Any measure should guarantee insurance portability between jobs and insurability despite pre-existing medical conditions.
We agree, but people who engage in risky behaviors, such as smoking and excessive drinking, or who are obese or have certain medical conditions should be expected to pay higher premiums. People who have had numerous car accidents pay higher auto insurance; the same should hold true for people who engage in risky health behaviors.
Boucher deserves credit for voting against sending a health care bill to the floor of the House before the summer recess. We strongly support his reasoning: The health care reform issue – in scope and consequence – deserves time and attention, and no one should feel rushed to make a decision. Boucher took a reasoned approach to a complicated issue that affects us all.
It appears now, in these shifting sands, that Congress will focus on legislation that will shore up Medicare and develop state or regional cooperatives, not a single-payer program.
We are arriving at a reasoned place in this debate, one based on economic reality and that will provide a platform for true reform.