Think About It: Gut punch to our health care

Sometimes I think that we who flee to the comforts of political sides do so because we don’t have the time, energy and inclination to sort through all the pros and cons of all the issues. We wouldn’t have the time even if we had the time. We won’t live long enough.

We learn to pick our issues and usually pick those that are familiar and important to our happiness. Most likely for the rest, we rely on broad general statements we believe describe our values and/or opinions. I fear this is where it becomes more political than thoughtful.

The inevitable political rhetoric clouds underlying motives that may or may not reflect the values we apply in our decision-making. The result can be disastrous.

Rural health care in jeopardy

A familiar and important issue to my happiness and yours is health care in our community, an area especially susceptible to generalizations that divide us:

“Health care is a right, not a privilege.”

“People should be responsible for their own health care. Volunteer charities like faith-based organizations will provide for the poor.”

“The cost of health care will bankrupt the government.”

“The cost of health care bankrupts families.”

All the above are true on some level and represent the problem of high-cost health care, a problem that needs to be solved and solved soon before our political blinders drive locally controlled health care, along with many services, out of our community.

The level of Olympic Medical Center’s (OMC) outpatient medical services has been under threat ever since President Trump’s administrators of the Centers for Medicare and Medicaid (CMS) reduced Medicare payment for outpatient services to OMC by $3.4 million in 2019 and promised a total reduction of $46.8 million over the next 10 years.

Eric Lewis, OMC CEO, sent out an alarm in September 2018 warning the community of significant and adverse consequences if CMS carried out the action. The community responded with letters to CMS which failed to persuade it of the unique threat to health care in rural Clallam County.

Lewis and OMC’s Board of Commissioners built the loss into OMC’s 2019 budget. OMC announced no cuts in staff but did say that fewer new employees will be hired. Since the reduction in payment applies to off-campus, i.e. Sequim and any OMC service located outside of radius of 250 yards of the hospital, some services will be moved from outside to inside the radius.

It seems reasonable to expect that more Sequim services will be relocated and new services not added in the future as the cuts deepen.

A new threat to rural health care looms in the Trump administration’s 2019 budget request that calls for an $845 billion cut in Medicare and additional dismantling of the Patient Protection and Affordable Care Act, aka ACA and Obamacare.

The American Hospital Association and AARP wasted little time before criticizing the bill. You may recall Lewis telling us that 7,000 Clallam County residents gained coverage from the ACA, effectively relieving the cost of uncompensated care to OMC. The president and Republican party are goal-directed to end the ACA which, in effect, will restore the level of uncompensated care borne by OMC.

To make matter worse, the president’s proposed budget will reduce payment to hospitals for uncompensated care, funds intended to help cover the cost of mandating hospital ERs to accept all patients regardless of ability to pay. Furthermore, the ACA was in part paid for by cuts in Medicare which, if not restored in the event the ACA is eliminated, will result in additional losses to OMC.

It’s a triple whammy and gut punch to OMC, our health care system and community.

Call the president

Since Congress is the body that sets the budget, we are told the budget request is DOA. I don’t think that means we should ignore it because it sets out the president’s agenda and, most likely, his party will advocate for the priorities inherent in the request because decreasing the cost of so-called entitlement programs like Medicare and Social Security has long been on their wish list.

One of the features of the president’s budget is a reduction of drug prices for Medicare. I like that idea. I always thought it was a mistake to promise not to negotiate drug prices under Medicare Plan D.

Here’s where we need to get in the weeds of policy and budget proposals.

What’s the motive? What’s the consequence for us and our family?

Lower the cost to government or people or both? Maintain access to health care in rural communities or not?

The government, unlike business, must consider the consequences of proposed policies on people. I want the president and Congress to do more than lower costs of health care to the government. I want them to legislate the policies and programs that lower health care costs for individuals, families, taxpayers, businesses — everyone. The cost of treating cancer or having a baby should not be a reason for selling our homes, taking out a loan or not having a baby.

I want those who control our access to health care to think care and cost not just saving the government money. I want our president to be our advocate for lower costs for all, not just government. He knows how to negotiate with businesses so they can reasonably profit. Most businesses would save money on health care.

Those who voted for President Trump, especially those on Medicare, should call him and tell him we want and need the services of OMC in our community. My guess is he does not know the impact on communities like ours. He will listen to “his people” but only if they call.

What if all those letters went to President Trump instead of CMS?

The price of inaction is high.

What about tweets?

Bertha Cooper spent her career years as a health care organization and program administrator and consultant and is a featured columnist in Sequim Gazette. Cooper has lived in Sequim with her husband for nearly 20 years. Reach her at columnists@sequimgazette.com.

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