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Executives at Forum, HMHP:Time has come for change
By Don Shilling
Covering the insured doesn’t necessarily mean hospitals will receive more revenue.
Leaders of the Mahoning Valley hospital systems support national health-care reform but are waiting to see whether politicians can find the right prescription.
The ailments are clear, said Bob Shroder and Walter “Buzz” Pishkur. Having more than 45 million Americans without insurance is unacceptable, as are the large expenditures that hospitals must make in providing charity care, the hospital executives said.
“It’s a broken system. It does need to be fixed,” said Shroder, chief executive of Humility of Mary Health Partners.
The big questions are how to provide care for the uninsured and who will pay for it, said Pishkur, president and chief executive of Forum Health.
Those questions will be explored Monday at a town-hall meeting sponsored by The Vindicator and WFMJ-TV Channel 21. A Conversation on Health Care will be broadcast live from 6:30 to 8 p.m. on WFMJ.
Five invited guests, including Shroder and Pishkur, and 100 area residents will discuss health-care reform with U.S. Rep. Tim Ryan of Niles, D-17th.
Both of the local hospital systems spend tens of millions of dollars a year on providing care for people without insurance and who can’t afford to pay. President Barack Obama campaigned on providing health-care insurance for all Americans, and Congress is now debating his legislation.
Shroder and Pishkur said the uninsured should be on an insurance plan, not only to cut the charity care of hospitals but also to help people. The uninsured often wait too long to receive treatment for diseases, which makes recovery more difficult and drives up the cost of care, they said.
The executives noted, however, that covering the newly insured doesn’t necessarily mean hospitals would receive more revenue.
Under the current system, hospitals provide charity care, but they also lose money on providing care for people on Medicare and Medicaid because of low reimbursement rates, they said. Those shortfalls are covered through negotiated rates with the insurance companies that cover the rest of the patients, they said.
Pishkur said he is concerned reform will lead to fewer people being in the group covered by insurance companies. If that happens, the drop in charity care would be offset by a loss of revenue from insurance companies, he said.
Debate in Washington has included offering other options to people besides insurance companies, such as insurance exchanges or a government-run plan. Some are concerned that insurance companies would not be able to compete with the prices offered by those options and would be forced out of business.
Shroder and Pishkur said they don’t have recommendations on what system would work best, but they think the financial concerns of hospitals need to be considered.
Shroder said any solution should allow health-care providers to negotiate with insurance entities so providers can cover their costs.
He added, however, that he thinks it is unrealistic to think health care for the uninsured can be paid for by cutting back on waste in the system. Either extra costs are going to have to be built into premiums for those that can pay, or taxes must be raised, he said.
“I know that’s a bad word for any politician, but they have to get realistic,” he said.
Shroder said reform should include an overhaul of how providers receive reimbursement. Fees are now based on standards of care from the 1980s, and much has changed since then, he said.
For example, for-profit surgery centers have opened because they have identified certain procedures that are profitable, he said. Some surgeries now require brief hospital stays, but reimbursement guidelines were set when stays were lengthy, he said.
Shroder said HMHP, as a Catholic institution, does not want new legislation to force it to provide certain procedures such as abortion.
Though concerns about revenues and other issues are important, much good can come from the current debate, Shroder and Pishkur said.
Pishkur said the overall health of the nation could be improved if people had incentives to participate in wellness programs.
Shroder said this is an opportunity to eliminate measures that lead to a denial of coverage, such as pre-existing conditions and exceeding lifetime maximums on expenses. It also is a chance to allow individuals and small businesses to join pools so they can be part of a larger insurance group, he said.
“This is a hopeful time,” he said.
shilling@vindy.com
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Comments
Step back for a moment and think about how this $1,000,000,000,000.00+/10 year HR3200 will be paid for. Can we do that? Is it important at all if we can afford it? Or is it ok to lower the standard of living of future generations of Americans (our children) to pay for our stuff, even if it means they can't afford their own health care? After all, that's the same "just so it's not me" mentality that's behind the class warfare tax policies.
So it is estimated that $544 billion/10 years will be raised in a class warfare tax policy. So we're still short $456+ billion dollars, and that's assuming that this program, unlike the vast majority of government programs like Medicare and Medicaid, won't go overbudget. And that's on top of the other spending programs already signed Obama.
The House Medicare and Medicaid savings proposals would, according to the CBO, save the federal government only $219 billion, a far cry from the $622 billion the administration projects. Once again, that's assuming they're able to pull it off. These "savings" are from the gutting of the Medicare Advantage Program.
“For example, the largest savings proposed in the president’s budget would arise from a decrease in payments to private health insurance plans operating under the Medicare Advantage program,” said CBO Director Elmendorf.
“If enacted, that change would permanently lower the level of Medicare spending, but it would probably not offset a noticeably larger share of the cost of an expansion of insurance coverage in the second 10 years than in the first,” said Elmendorf.
So let's see we've gutted Medicare Advantage and we're still short $237,000,000,000.00. (456B - 219B). The rest could be made up by cutting payments to providers, which the Lewin group estimates could save as much as $250B. Not only is HR3200 now paid for, it has a possible surplus (assuming all went as planned).
Of course, if you cut payments to providers, you'll have less of them, and Canadian-style rationing, and another so-called heath care crisis.
So if you've read the above, and understand the principles of cause and effect, and still support Obama"care", than please go to your nearest hospital and request a Cat Scan of your brain. If you see the obvious problems involved with cutting Medicare Advantage funding, payments to providers, huge tax increases, huge expansion of government spending, and trusting your health to inept politicians...than consider something revolutionary...such as free market and tort reforms...or actually reducing waste...such as creating a smaller government.
www.mcclatchydc.com/homepage/story/75205...
www.cnsnews.com/news/article/53320
Yes, the uninsured do spread diseases, so do the over medicated--people given drugs they don’t need. Anyone with half a science background can tell you that a “Virus” cannot be cured or controlled by vaccinations. In fact, the same tiny “flu virus” is 25ft tall and causing more problems. Egg allergies is one of them.
Q; Health care for the uninsured. A: better government controls and keeping countries like Canada and Mexico from pick-pocketing from our system in order to support their “Free” government national systems.
Q: Insurances, including Medicare and Medicaid are just one of the problems. Over billing by hospitals and physicians is outrageous. Why does it cost $200 a visit for a heart specialist to check your heart with his stethoscope (10 min. act)?
The other side of the Insurance trash, is “Mal Practice Insurance”. Who pays for these Lawyer Happy ambulance chasers? THE PATIENTS DO..
Why do you think it’s called “PRACTICE”--it’s like the auto mechanic who has no clue what is wrong with your motor vehicle, jack it up and try 20 different parts until it runs--General Motors ate their problems now it's health cares turn.
Q: Charity Care, why? A: I question your volunteering outside the USA. Assisting children and adults who’s governments pollute our country with illegal drugs. Drugs smuggled into the country in the linings of mink coats!! And good old America picks up the rehab tab.
Consider the hospital and rehab centers!! Visiting Physicians, Nurses, personal aides and local transportation does more good than institutions will ever do for patients.
Waste Management? Tell me there is no waste in your local hospital, and I”ll sale you the Chesapeake Bay Bridge, cheap~~
Realism in Government--you betcha! Vote another Republican or Democrat into office, disallowing 3rd party independence a voice. In fact, we are the voice for change.
Mr. Shilling,
Please do not insult the intelligent people on these boards with the false claim of 45 Million people in the United States being uninsured. The true number of uninsured is 9-10 Million people. Illegal aliens, people who have the access to health care through their employer but opt out, and the morons not capable of filling out a few forms to be eligible for Medicaid do not count in this debate. Either you have not done your homework or you are a biased hack. Which one is it?
I eagerly await your reply.
Regards,
PS
For-profit health care should not even exist. It is fundamentally unethical to enhance one's private wealth as a result of someone's misery. Not everything is a commodity and not everything is for sale. Health care is not a commodity and does not belong in the private market. Would be nice if we knocked corporate welfare out as well.
THESE HOSPITAL EXECUTIVES KNOW NOTHING ABOUT HEALTH CARE RANT RANT RANT
Hey Attis,
Great call, let the taxpayer fund everyone's health care. What is truly unethical would be for the participants of government health care to smoke, eat bad foods, partake in illegal drug use, and have unprotected sex.
If you can guarantee every citizen will cease with those unhealthy activities, then by all means, I would not mind paying for other people's health care through tax dollars.
With your reasoning, I should not have to pay for my car, house, or food. I will be miserable if I cannot travel, sleep under a roof, or stay nourished.
Profit is so evil, we should do away with all business profit and ration the country's wealth evenly. Let's just all work 8 hour days, take 2 weeks payed vacation, and compensate every company and employee the same. Start learning Chinese!!
While we are at it, why not do away with all competition and motivation to get ahead. A great analogy would be awarding all 32 teams in the NFL with the Super Bowl Trophy each year regardless of the outcome of the season. That way everyone feels good, and as an added bonus the Browns could be winners for a change.
Just because you want it, does not mean you need it. If a person wants higher quality health care, they need to 'ration' their spending. Instead of dining out every so often, eat at home, and use the savings to buy better health care. Buy a less expensive car, cheaper housing, or cut back on entertainment if health care is that important. The beauty of the free market we live in provides us with the opportunity to get ahead through entrepreneuial ventures or by taking another job if you 'NEED' more!!
Quit asking for handouts and do something about it.
Your Favorite Capitalist,
PS