Spokane7
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July 26, 2009 in City
Health reform packs heavy wallop locally
Medical officials follow debate closely, brace for financial impact
With health reform dominating headlines, the stakes in Spokane are extraordinary. About 25 cents of every dollar spent in this community is tied to health care.
Some clinics are concerned that the congressional proposals are asking too much of their practices, and hospitals are bracing for deeper givebacks – even after the state hit them with multimillion-dollar cuts in Medicaid spending.
Magnifying these developments are the unending increases in health insurance prices for workers and businesses and the troubling number of personal bankruptcies tied to medical bills.
Dr. Dean Hill, president of Heart Clinics Northwest, wrote an open letter to patients in mid-July stating that if reform proposals cutting Medicare payments by 25 percent to 50 percent are enacted, the clinic may be forced to limit its regional reach to Spokane cardiologists.
“Our practice cannot sustain this insult, and if they are implemented January 1, 2010, as proposed, the impact to you, as a patient, will be radical,” Hill wrote. Medicare accounts for more than half of the clinic’s patients.
In an interview, Hill said the big picture for heart care is already grim.
Heart disease is the leading killer in the United States. It’s no different in Spokane as obesity rates soar and the number of cardiologists can’t keep pace.
Hill said “drastic cuts” in Medicare and Medicaid reimbursements to Spokane health care providers would only result in undercutting the key reform goal of increasing patient access to care without compromising quality.
Fair and adequate reimbursements are a sore spot for Spokane’s medical community and worrisome for older patients.
Spokane doctors and hospitals have contended for years that they are penalized – or not paid as much as their peers in other communities – for the same patient care. Many providers say such a policy makes treating Medicare patients unprofitable.
As a result, local surveys have shown, many primary care clinics are loath to accept new Medicare patients and instead welcome those with private coverage.
It’s a point Dr. Andrew Agwunobi, chief executive officer at Providence Sacred Heart Medical Center, seizes upon.
He likens Sacred Heart to the region’s medical safety net that will treat anyone regardless of ability to pay. To do so, however, requires reform that gives all Americans some coverage.
Agwunobi said Spokane’s relatively tight-knit medical community and its use of technology alleviates some redundancy and other “wasteful spending.”
Agwunobi said such collaborations should be pursued in other communities, saving federal money and cutting down on costly and unnecessary readmissions.
President Barack Obama has said everyone – hospitals, doctors, businesses, insurers and patients – must be ready to sacrifice self-interests for health care reform to take root.
Many consumers feel they’re already doing their part. Their pay stubs detail health insurance premiums that continue to soar at rates dwarfing inflation and cost-of-living wage increases.
Those without employer-sponsored plans are hit especially hard. The big three individual health insurance plans in Washington state are instituting double-digit rate increases, citing more expensive claims, high prices for prescription drugs, and a population that is unhealthier and aging.
Those rate increases have prompted calls for a public plan option – a government insurance company with enough clout to compete with private insurance firms.
Regence BlueShield chief executive Mark Ganz said holding the line on rising health costs should come first. If a federal government option becomes available, he said, it must adhere to the same rules and costs to ensure “a level playing field” with private insurance companies.
Despite the steep price tag for health insurance, bankruptcy attorneys counsel their clients of the necessity of coverage.
“We look at all the options for people and we tell them: ‘If you don’t have health insurance and something happens, you’re in more trouble than before,’ ” said John Munding, a bankruptcy lawyer in Spokane.
It’s a difficult conversation to have – especially with those who can’t enroll in an employer-sponsored plan, those who are in their 50s and years from Medicare eligibility, and those who don’t qualify for the Medicaid program for the poor.
Kevin O’Rourke, who files more than 100 consumer bankruptcies a year, said medical bills trail only credit card debts as the leading cause of Chapter 7 bankruptcy.
“People become trapped and there are few ways out,” he said.
Stubborn unemployment trends threaten to exacerbate consumers’ problems, which circle back to clinics and hospitals trying to collect payments.
Sacred Heart Medical Center, for example, wrote off about $39 million last year – $23 million in charity care provided to the poorest of patients along with $16 million in bad debt write-downs, according to the Washington State Department of Health.
Deaconess Medical Center wrote off about $13 million, including about $5 million in charity care and an estimated $8 million in bad debts, although the hospital’s financial statements are incomplete on the health department’s spreadsheets.
Deaconess executives declined interview requests. In a brief statement e-mailed by spokeswoman Christine Varela, the hospital indicated that it supports efforts to provide insurance coverage for the 47 million uninsured Americans.
Wayne Smith, the chief executive of Community Health Systems Inc., which purchased Deaconess last year, met privately with Obama on June 4 regarding national health reform, according to visitor logs made public this week.
Richard Umbdenstock, president of the American Hospital Association and a former chief executive officer of Providence Services in Spokane, has met with White House officials a half-dozen times.
Agwunobi, now in charge of Sacred Heart, said the status quo is no longer acceptable.
“People shouldn’t be worrying about where they are going to get care,” he said. “We think there are a lot of good ideas being talked about. Some others ought to be thought through more purposefully.”
White House honoree boasts roots in Colville 
HSR0601 on July 26 at 2:33 a.m.
Let’s score this SECRET, KEY and GAME CHANGER first, CBO !
The House leaders reached a deal on Medicare payments: A “Pay for Value” reimbursement system that rewards doctors and hospitals that achieve the best outcomes at the lowest cost.
As a result, The House gained a lot of votes, a lot of people who were withholding support.
The federal Medicare program insures some 44 million elderly and disabled Americans at an annual cost of $450 billion, almost one-fifth of total U.S. health care spending.
Supporters of the agreement say it could save the Medicare System more than $100 billion a year and improve care, that means $1trillian over a decade. (Please visit http://www.kare11.com/news/news_article.aspx?storyid=820455&catid=391 for detailed infos)
The Times in a July 7 editorial argued “As much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients,” Thus the remaining $239 billions over a decade do not matter.
No one can disagree with this best outcome / evidence-based system, and private insurance, too, will be greatly influenced by this change with the focus on value over volume. !
Dr. Armadio at Mayo clinic says, “If we got rid of that stuff, we save a third of all that we spend and that is 2.5 trillion dollars on health care. A third of that and that is 700 billion dollars a year. That covers a lot of uninsured people.”
THANK YOU !
liarsinnews on July 26 at 8:41 a.m.
There has to be a better way to pay for those with a bona fide health care expense and have no health insurance, than charging those of us on Medicare who have supplemental BC&BS.. My insurance costs, including medicare, cost my wife and I, over $7,200.00 annually. I can`t take more increases.
Ninch on July 26 at 9:53 a.m.
The cheerleader HSR0601 neglects the fact that limiting tests and procedures for Medicare patients is code language for limits based on age, i.e. number of years of life expectancy (on average and not per individual) and denial of quality of life. According to Obama one should be denied a pacemaker because at 100 years they have already exceed the “average” life expectancy. Obama also has many times discussed the waste of a hip replacement for his grandmother who had terminal cancer despite the excruciating pain of a broken hip. In other words, ObamaCare shows lack of compassion and sometimes hate for old people because they are too expensive. Obama wants to mandate that all elderly prepare for “end-of-life” (sooner rather than later) instead of seeking to live a quality of life. According to ObamaCare guidelines, Senators Teddy Kennedy and Robert Byrd should be “accepting death” instead of getting treatment. Obama reflects the far left attitude that old people are burdens to society and ignores all the contributions that our elderly have made, e.g. military veterans, grandparents raising grandchildren, and (ironically) decades of community service. Look at how they denigrated John McCain for his “old” age during the campaign, even though McCain’s 97-year old mother (and her twin sister) are still very healthy and active.
Jaspear on July 26 at 10:26 a.m.
There are two reasons for this mess that no one is talking about:
1. There are no published prices. In no other industry is it legal to do this. When was the last time you found out what your groceries cost after you bought them? Would you give a mechanic a blank check to fix your car? Whenever possible, patients should know the price in advance and consent to it. Even emergency rooms could post the prices of common procedures, doc costs etc. on-line so anyone who wanted to be informed in advance, would be. Knowing the price before you bought the product would increase competition and lower prices.
2. Money should be money; the same for every customer. Why does someone without insurance pay the “rack rate” while the insurance companies get huge discounts? No matter how you pay, the complexity of medical procedures do not change. If an electronics store charged 5 or 10 times more for a TV if you payed in cash, the CEO would be in jail. The same rule should apply to health care. If a health care provider wanted to offer in-house financing or a discount that would be OK, but for everyone else money would be money, the price could not change based on the source of payment. No longer could hospitals and doctors gouge private payers. The system as it is now is nothing more than collusion between health care providers and insurance companies. Collusion that results in exorbitantly high prices for the very people who can least afford it.