Wednesday, July 29, 2009

Health Care Reform

July 27th, 2009

Health Care Reform…

What is Being Said; What is NOT Being Said - and Why We had Better CHANGE

Last week I went to hear President Obama speak while he was visiting Shaker Heights. I came away from his speech inspired and even more focused on looking at our own health care costs in our hospital and our community… and in consideration of what are we doing to change ourselves and our system.

At ACH, we are just a microcosm of what is happening on a national basis. Compared with larger cities in Ohio and to other health care facilities in the region, the cost of care in Stark County is far less than in most places, yet, it is getting more expensive all the time. We are self-funded in terms of health coverage for our hospital employees. If the current trend continues we will drive ourselves out of business because our own health care costs are simply too high.

The most important message I heard President Obama give is this: all of us should be demanding change and the quicker, the better. Health care is hurting the economy big time and just because we haven’t experienced job changes here at ACH yet, it is a fact many Americans have and many more will. I believe the President should keep pushing the issue. I wish he would appoint a group of objective experts (with no political agendas and who are simply inspired by the desire to do the right thing) as the team to take a fair plan to Congress and urge them to get it passed. Now that would be real change.

It wasn’t long ago I heard Tom Daschle and Tommy Thompson’s recorded comments agreeing on almost 80% of the things that should be done to fix health care. Why not start with that list?

What happens when the stimulus dollars for Cobra-assisted health insurance runs out? Many hospitals have already had layoffs.. Fortunately, we have been able to avoid this at ACH to date. Yet, how much will laid-off employees be spending for their Cobra plans? At our hospital, we offer three health plans. For those employees utilizing our highest level of coverage, it would cost $22,000 for family coverage. The least expensive option plan at ACH (which includes an HRA) would still be $9,000 a year. Both plans are extremely costly, particularly if you are receiving only an unemployment salary.

Somehow, we have heard so much about the uninsured that many of us with coverage haven’t really taken a close look at what is actually happening to both us and to the health care system as a whole. What is not being said is that there really isn’t enough money around to make the current system work and that we all are going to have to pay more, expect less, and assume more responsibility for our own health care costs and our own individual health, period.

I can’t change what is happening on the national level but I can begin at home by trying to impact change here at the local level. I want to double check our statistics, but a few years ago the hospital was paying about 70% of the cost of family coverage and 94% of the health care costs for single coverage for full time employees. Today those numbers are 85% and 88%, respectively. Our costs of care have skyrocketed, so our employees are paying more for family coverage even though their share of the costs is actually down from just a few years ago. Similarly, singles are paying more of their costs on a percentage basis and yet, there is less money for wages and needed investments today.

It is clear that we need to redesign our health benefit plan to include incentives for taking better care of individual health (and that of dependent family members). We need to promote transparency so that people can know what their out-of-pocket expenses for health care will be PRIOR to receiving services. We are part of the health care system, so we need to teach ourselves and others how to shop for health care smarter.

At one time in my career, I was in favor of a single payer system that was not necessarily public or private. I was just trying to simplify the paperwork and bureaucracy. But perhaps the most useful single payment system would be one that is not entirely unlike the one I hear the President suggesting. With an ideal single payment system, pricing should be known in advance of service. As it stands, billing and the payment of insurance claims are far too bureaucratic and costly and the buyer is too disconnected to be able to determine the best way to spend their health dollars. Transparency and competition in health care care will benefit all consumers. It will help ensure accountability -- either by forcing us to pay more for health care services services by choice or by forcing us to take better care of ourselves -- or both.

I want to give President Obama 100% of my support for demanding that the system change and I wish that he would not relax his timetable. Hopefully he will find a way to get something done in Congress without having to bargain for it. Let's hope he will be able to encourage his peers (i.e. fellow politicians) to do the right thing.


P.S. There is very little with which I could disagree in President Obama’s Shaker Heights presentation, but there were two comments he made which gave me extra consideration. One such statement was a remark about how people in unions are not actually receiving pay increases because their health care costs are going up faster than their salaries. The truth is, this problem is affecting all employees, both union and non-union. Likewise, I agreed with his assertion that the Cleveland Clinic is a world class health center, but I am unconvinced that it is the model of efficiency for our own health system. If you drove down the road an hour (within Stark County), the cost of your open heart procedure could be almost $100,000 less than it might be at the Cleveland Clinic. That is why we need known pricing and transparency. Our health system is ready to compete -- we must change our manner of educating consumers so that our businesses outside of health care can compete globally.

Monday, July 13, 2009

July 8th
Headed off for some vacation, but before taking off, wanted to play some catch up from a few stories from 2009…

From JC: Miracle Workers

Summary from 55 days of ER/ICU/Community Care/Rehab:

I could go on forever…but let me summarize:
~Dr. Catalano and the ER staff were so helpful
~I equate the care I received at CCC to ICU and ICU to the best
~CCC/rehab colleagues are miracle workers. I am confident that my husband would not have walked again without Mike,Amanda,Maggie and Carol
~Outpatient therapy continued to work their magic

From CB:
Three surgeries this past year, the last from Dr. Palutsis, he was excellent. The whole hospital, atmosphere was just unbelievable.

Just wanted to recognize certain people. Bob Mick night shift, the rest of nurses on # East and Lori in Nuclear medicine, she was right there by my side and she was wonderful.

Anonymous: Thank You to my doctors. Dr Kolb, Dr. Byers, Dr. Johnson and Dr. Singh

Tuesday, July 7, 2009

It Has Been A While

It has been awhile… but my inspiration to Blog was triggered by a card received from a patient. It made my day and I am sure it will make others'. It was that simple reminder why we are all here. In the midst of all the distractions and interruptions that divert our focus, a reminder that the patient should be at the center of all we do was and is a good thing.

In her card, M.D. writes:

“I have been to the hospital and to several doctors' offices many times…recently I became very ill and visited the ACH emergency (department)…I was treated with compassion and kindness and felt so comfortable with my care…I never met a doctor who made me feel he had all the time I needed to answer all of my questions and really cared about me, as (did) Dr. Bosch…I will always be grateful…the nurses couldn’t have been more attentive and their kindness will always be appreciated…a special thank you to Rhonda and Debbie…I am so proud to let others know what a great emergency room and hospital we have in our community."

Great work. Glad to be part of the ACH family.