'No' vote on health bill is not a surprise

“Southwest Virginians clearly depend on their community hospitals for their health care delivery, so we must take every step to make sure the financial success of our local hospitals is not placed at risk. I simply could not vote for legislation that would place their [hospitals] very survival at risk and the House legislation does that.”

– U.S. Rep. Rick Boucher, D-Abingdon

It should come as no surprise that U.S. Rep. Rick Boucher, D-Abingdon, voted against the health reform act that narrowly passed the House of Representatives on Saturday.

In town hall meetings he hosted in August, Boucher made clear that he believed a public option or single payer system would harm community hospitals in his Ninth District. Then, and again Monday at a news conference at Bristol City Hall, he invited officials from Wellmont Health System and Mountain States Health Alliance to explain why they believe a public option or single payer plan is financially untenable for this region.

Most local patients – about 62 percent – have Medicare, the government insurance plan for the elderly, or Medicaid, the government plan for the poor. Neither covers the actual cost of medical procedures, so those costs are shifted onto patients with private insurance. It’s an unbalanced system and would be made worse under a public option, which is expected to pay even less than Medicaid or Medicare reimbursements.

Our community is older and poorer than many, with only about 32 percent of patients having private insurance. Further cutting reimbursements to local hospitals could be catastrophic to future care for everyone here.

Marvin Eichorn, the chief financial officer of Mountain States Health Alliance, which runs Johnson City Medical Center and other health care facilities, said including the House public option in the final bill would mean ruin for Mountain States.

“There’s no way, if that public option gets put into place, that we can survive,” Eichorn said Monday. “We’ve got very small [profit] margins to begin with – that would take away whatever margins we’ve got.”

Last year, Mountain State’s operating margin was just $7 million of the $800 million taken in, Eichorn said.

U.S. Rep. Phil Roe, a retired physician from Johnson City, Tenn., also voted against the bill. He didn’t attend Monday’s news conference, but in a written statement he compared the House public option to TennCare.

“The TennCare plan tried to provide universal coverage and make health insurance affordable, and in the end it nearly bankrupted the state as the program tripled in cost,” Roe said. “It shifted costs to the private plans, who were forced to make up the underpayments of the government program, increasing everyone’s premiums. In the end, 45 percent of those on the public plan previously had private insurance and either dropped their coverage or were dropped by their employer.”

Boucher did not vote in lock step with the Democrats, as one partisan claimed in a letter we received here Tuesday. He was one of 39 Democrats who voted against the House health care reform bill. Boucher’s reasons were legitimate for the Ninth District.

Anyone who was listening at the August forums knows Boucher supports the basic reforms most Americans do – cutting costs by reducing fraud, abuse and waste; ensuring people don’t lose coverage because of pre-existing conditions; and that citizens can keep their insurance when they change jobs. And remember that he voted against sending a health care bill to the floor of the House before the summer recess. We praised him then and strongly supported 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.

The biggest problem now is determining a path to fix a problem that is eating away at our wealth and costing everyone. We must remember 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.

On Monday, Boucher said the majority of voters in Southwest Virginia likely opposed the House bill, but still want some type of reform.

Still, there is a mammoth climb between the House squeaking out a bill 220-215 and getting a reasoned measure through both houses of Congress and signed into law.

Locally, there are citizens who strongly support a public option and are angered that Boucher did not support the House bill. Members of the Virginia Organizing Project and their supporters plan a protest Thursday at Boucher‘s Abingdon legislative office.

We believe we must hold fast to reason and economic realities in this debate, not political gamesmanship and posturing. Keeping focused on the needs of our citizenry and existing health care providers, as Boucher is doing, is the right course.