Local industry skeptical that bill would reform health care
| Saturday, Nov 21 2009 03:09 PM
Last Updated Saturday, Nov 21 2009 03:09 PM
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Disappointment came over Kern health care executives last week as they mulled a new reform plan from Washington that they said lacks tools for containing costs and does little to address a local shortage of government-paid medical practitioners.
A big concern among local industry leaders and professionals was that the Senate bill introduced Wednesday would expand insurance coverage without providing adequate support for doctors, hospitals and other providers of medical care.
"You might have insurance, but if nobody takes that insurance, then you still don't have access to health care," said Russell Judd, president of Mercy Hospitals of Bakersfield.
Added Robert Severs, general partner and CEO of Managed Care Systems, a Bakersfield health care administration company: "I think this started out as total health care reform. I think it's ended up as health insurance reform."
The bill, officially estimated to cost at least $849 billion over 10 years, would require most Americans to have insurance. It would subsidize coverage for the poor, create insurance exchanges intended to lower premiums paid by businesses and individuals, and, among other new rules, stop insurers from turning away customers with pre-existing medical conditions.
Local health-care leaders saw the legislation as a first step toward the much bigger task of providing quality health care that is convenient and affordable. Where they disagreed was whether Congress should hold out for a broader solution.
Dr. Michelle Quiogue said she was ready to move forward with the proposal. A family physician with Kaiser Permanente in Bakersfield, she endorsed the bill as a way of reaching patients who have been left out of the existing system.
"I can't start saving America's health care dollars until I have access to these patients," said Quiogue, who also serves as president of the Kern County Academy of Family Physicians.
Others were more reluctant, even as they withheld final judgment until details of the 2,074-page bill become more clear and Congress has a chance to consider changes to the proposal.
Carol Sorrell, president and CEO of Kern Health Systems, a nonprofit that offers insurance for the poor, called for testing the proposal in one or more states before rolling it out nationwide.
"Let's see," she said. "Let's test it and see what happens."
Of immediate concern to some Bakersfield hospital officials was the possibility that the bill would deprive their facilities of government funding. That's because Kern has relatively large Medi-Cal and Medicare populations, and federal and state agencies could decide to give hospitals less money if they think the legislation provides adequate care for program beneficiaries.
A possible problem with that assumption is that many doctors and other health care practitioners have pulled out of government-subsidized health care because they consider reimbursement rates to be too low.
This raises a question among some executives as to whether it's useful to expand coverage without increasing payments to medical providers and otherwise investing in the health-care infrastructure.
"If you don't invest in providers, caregivers, primary care and specialty caregivers that allow patients to develop and access a medical home, then enfranchsing them with coverage will mean nothing, and will deliver very little on the promise of universal coverage and health care reform," said Steve Schilling, CEO of Clinica Sierra Vista, which runs community medical clinics in Kern and elsewhere.
Without such investment, he and others said, patients will be unable to see their doctors when they need to, and instead will end up in emergency rooms, which are a particularly expensive health care setting.
"They will end up in our emergency rooms because they're not happy with the wait" at doctors' offices, said Dr. Les Burson, president of the company that staffs Bakersfield Memorial Hospital's emergency department.
He and others said Congress should focus more on reducing costs. They suggest cracking down on fraud and waste in the health-care system, clamping down on medical malpractice lawsuits and allowing consumers to enroll in out-of-state health plans.
But some doubt that Congress is the best place to address these issues.
Carolyn Temple, CEO of the Foundation for Medical Care of Kern County and Santa Barbara County, said the 600 physicians she represents are generally skeptical of government attempts to overhaul health care. They would prefer that change come from within the industry.
"None of us think that (government intervention) is the most efficient way" to reform the system, she said.
