For the first time in a decade, the number of uninsured children in the United States increased in 2018. Apple Health seemed like the quintessential success story because it expanded Medicaid coverage for children — in Kitsap County alone, the number enrolled grew from 9,000 to over 21,000 in the last 10 years. However, Medicaid reimbursement also decreased by more than 35 percent, after a federal provision that kept Medicaid payments on par with Medicare expired in 2015. Some states set aside funding to maintain rates equal to those of Medicare, but Washington was not one of them.
In the fiscal fight over health care costs, pediatricians are on the chopping block. In hospitals and clinics across the country, pediatricians are being laid off in droves, leaving the clinical burden to mid-level providers, family physicians, and emergency room doctors. These decisions are being made by suits over scrubs, and they are putting patients at risk.
The Pacific Northwest hospital group may be considered the “golden child” for now, but what happens if profit margins decline and further cutting costs is not feasible? The Jewish Hospital merger experience should serve as a cautionary tale for Kitsap County. Will our beloved community hospital be sold off five years from now or can we escape the same fate by devising a viable alternative for healthcare in our community?
There are people who say you’re the wrong man for this job. I am undecided on this. You’re famous for your hatred of complicated solutions. They annoy you. They annoy you because you know they’re a waste of time and energy. Time and energy that can be put into more important things.
Physicians care deeply about our patients and our communities. Physicians must ensure they have input on the next healthcare go-around. Meaningful healthcare reform will require pragmatism, diligence, compromise, and patience. Working across the aisle is vital to developing better health care legislation for the American people.
The CEO of the Mayo Clinic, Dr. Noseworthy, was last heard recommending patients fire their physicians suffering from burnout. While he does not have truckloads of compassion or empathy for colleagues; he is, at least, honest. Dr. Noseworthy recently confessed “We’re asking…if the patient has commercial insurance, or they’re Medicaid or Medicare patients and they’re equal that we prioritize the commercial insured patients enough so… We can be financially strong at the end of the year to continue to advance our mission.” The ‘ailing’ nonprofit generated a paltry $475 million last year.
Legislators in more than 30 states have proposed legislation to promote price transparency, with most efforts focused around publishing average or median prices for hospital services. Some states already have price transparency policies in place. California requires hospitals to give patients cost estimates for the 25 most common outpatient procedures. Texas requires providers to disclose price information to patients upon request. Ohio passed price transparency legislation last year; however a lawsuit filed by the Ohio Hospital Association has delayed implementation. The cost of a knee replacement is $15,500 at the Surgery Center of Oklahoma, whereas the national average is $49,500.
Compensation at the “Big 5” ranged from $10.1 million for Humana’s CEO to more than $66 million for the CEO of United Healthcare in 2015. CEO compensation for Anthem, Aetna, and Cigna also fell within that range. Affordable health care has definitely helped people. But who exactly are we trying to help? I am not convinced it is the children growing up in America today.