Volume 18, No. 2, Spring 2010
Dr. Richard F. Salluzzo, President/CEO, Cape Cod Healthcare:
“All of us support the idea of universal health coverage. Despite the CBO projections of reductions in expenses in the national debt, I am concerned about the trillion-dollar cost. I believe we are not addressing issues such as middleman fees, processing costs and malpractice/tort issues. I don’t understand why we have not looked seriously at a single payer option or even attempted to borrow ideas from countries that spend far less on healthcare than we do, and have as good, if not better, outcomes and patient satisfaction.”
Carol A. Vigliano, RN, BSN, Clinical Liaison for Bayada Nurses:
“I am very pleased that the healthcare bill has passed. The bill is better than nothing. I am pleased for seniors that it will help with their drug plan, that MassHealth recipients in Massachusetts will have more. But, most of all, as a cancer survivor myself, that preexisting conditions will be covered. I could write a book about the positive aspects of the bill, but the nastiness of the opposition party makes me sick.”
Dr. Herb Gray. Medical Director, Falmouth Hospital:
“From the physicians’ perspective two significant omissions from the bill are (1) tort reform with ramifications of continued high liability premiums, no abatement of the number of lawsuits brought against physicians and the not insubstantial cost of practicing defensive medicine and (2) a fix to the Sustainable Growth Rate, which is used to determine Medicare payment rates for physicians who are currently facing 21.2 percent cuts in Medicare reimbursement based upon these SGR-cuts that would have the greatest effect upon primary care physicians.”
Andy Young, former trustee Cape Cod Hospital:
“I need to hear about the details and ponder some of the implications first. My guess is this will benefit the average Cape Codder.
By Gary Sheehan
What started out as Healthcare Reform, and eventually morphed into Health Insurance Reform, has now come to pass, after a grueling battle covering the United States over the last 12 months. What is so interesting about the discussion is not what it accomplished, coverage for 32 million American citizens, but what was missed in the conversation and can no longer be ignored.
I find it remarkable that in a country with such a wealth of resources it took us this long to get to this point. Americans deserve healthcare coverage, free from abusive practices from coverage providers, and should be able to rely on that protection being there when they need it most.
The point that was continually discussed during the debate was not if individuals are entitled to or deserve that coverage–there was near universal agreement that they do–but how can we rein in overall healthcare spending so it does not continue to take a larger and larger share of our national economy.
I don’t see many solutions to that problem within this bill. Many went to great lengths to vilify the insurance industry with their rhetoric and proposals, and there certainly are egregious abuses carried out on a regular basis by insurance companies. But the continuing increase in premiums is not their fault alone. They are paying out for downstream medical care to beneficiaries within their coverage pool; but the cost of that care is rising at a remarkable rate.
As the CEO of Cape Medical Supply I am at a unique crossroads. We offer insurance coverage to our 45 employees. And we have seen the cost of that coverage rise at an annual rate of 7–15 percent over the last several years, even when competitively shopped.
Meanwhile, at the same time we have seen the reimbursement for services we provide CUT.
Where is all the money going?
Until we get honest about looking at the drivers for cost increases we will continue to have an ultimately unsustainable system because now everyone is covered! Once the key cost drivers are identified we must figure out a way to decelerate the growth and reassemble the system so it incentivizes care delivery in such a way that doesn’t drive up overall spending at such unsustainable rates.
Healthcare needs major reforms, but I don’t think we have addressed them with the current legislation and I fear they won’t be addressed anytime soon. This was the chance to achieve something much more substantial for our country’s healthcare system and we missed that opportunity. I appreciate not letting “the perfect be the enemy of the good,” but that’s not an excuse to ignore the fiscal realities.
A final personal note: I am a cancer survivor. I received expensive treatment right here on the Cape. Today I have a young child who wouldn’t have been possible without that care. We have an amazing healthcare system in this country—fortunately including right here on Cape Cod.
We just can’t afford to continue paying more and more for it. We must recognize that too much “healthcare” money has nothing to do with actual care. It’s paid to bookkeepers who never touch the patient. If we could smooth out the back office functions necessary for those who deliver that care to actually get paid for what they do, we could eliminate layers of cost from the system.
We all must understand that “Health Insurance Reform” will not solve the problems we have with paying for healthcare in this country–it may in fact make them worse. Only time will tell.
(Mr. Sheehan is President/CEO of Cape Medical Supply, gsheehan@capemedical.net.)