Diagnosis Not Great health care in 2009 in the U.S.

 

Thursday, Mar 05,2009, 12:07:21 PM   Click:

TITLE: Diagnostic big step for health care in 2009 in the USA



The appointment of Tom Daschle as a Director of the U.S. Department of Health and Human Services could be an important indicator of the shape and health care reform will take in 2009.

Daschle has long advocated a universal health care, and many analysts expect the health care reform remains the main focus of the Presidency of Barack Obama - despite the country's economic problems.

"It will be very hard to push the Congress - and certainly its programs reflect a liberal - but not necessarily socialist - later," said Dr. Steve Berkshire, a professor of health administration at Central Michigan University.

Most analysts, the reform will allow greater access - but because hospitals and doctors manage their practices more efficiently.

"I do not see them be able to save too much money in it," said Larry McEvoy, chief executive officer of the memory of the health system. "There are too many other economic issues. They are most likely to improve access, which means doing more with fewer resources. We will have to work more efficiently. "

Although doctors and hospitals to investigate the rationalization of practices, improved efficiency and productivity, insurance providers will be held near Washington, Denver and the small business market.

"We will see an increase in the welfare focus on the programs of the small group market," said Marc Neely, Cigna Regional Vice President for the central region of the country. "Smaller companies have been moving towards greater plans focus on the consumer, but they have pretty well done everything they can to reduce costs in that direction. "

Insurance companies offering other products: wellness programs and assessments to reduce the premium costs for small and large companies.

And local hospitals are strengthening their belts, preparing to ride the wave of bad economic news that has a system tries to refinance debt and another trying to decide what to do with excess property.

Reform

Congress has already issued a 98-page appeal to the health care reform - and Obama has created an office of health care reform. But the economic stimulus package - which could reach $ 1 trillion - left the system redesign health care issue for 2009.

"They do not disturb people who have insurance - or insurance products," said Berkshire. "But they probably will plan something around a new government agency for people without insurance options."

Companies that do not pay the insurance plan through taxes to support the purchase of a large basin of the former is not insured, he said.

"But they will not Medicare or Medicaid," said Berkshire. "Significantly, perhaps serious reform can not take place next year."

One thing that Congress could do is expand the State Children's Health Insurance Plan, "said Daryl Edmonds, president and general manager of Cigna in the mountain states region.

"That would cover one third of uninsured people in the country," he said. "But in Colorado, many children are currently eligible and not enrolled. We must do a better job to get the word exists, educate people. "

Although Obama said health care reform is still a priority, Berkshire, it could be autumn 2009 before the reform of legislation is before Congress.

Senator Max Baucus has issued the call for reform, a white paper that addresses the health care reform. The plan covers all Americans, the expansion of care with an emphasis on quality, greater value to best account. He also said that the reform must eliminate waste, eliminate overpayments and design a funding system that works for patients, as well as hospitals and health care providers.

This call to action is echoed by McEvoy, who said that nearly 30 percent of health care dollars is spent on waste, not on the needs of the patient or the hospital.

"It's one of the things we are considering in the coming years," he said. "We are going to focus on providing the best quality care very efficiently."

The Baucus plan creates a national insurance pool called the Health Insurance Exchange. Those who have health coverage to keep what they have, but for everyone, the exchange is a market where Americans could buy and compare the plans of their choice.

Obama's plan also emphasizes personal responsibility and well-being - teaching people to be the guardians of their own health, "said Margaret Sabin, CEO of Penrose-St. Francis Health Center.

"I saw some parallels in terms of how it feels to be a steward of health," he said. "It will certainly make health care a cornerstone of his administration."

Local hospitals

With other industries, hospitals face their own challenges during the economic recession.

Memorial responsible for losses in its investment portfolio and the funding of interest rates that have risen in recent weeks. The system is looking for ways to refinance its debt during the credit crisis.

Penrose has a glut of property - two large buildings that are not fully utilized.

Both hospitals have plans to meet their challenges - and are optimistic about the future.

"Not only is this the beginning of the year, it's the end of my first 60 days," said Margaret Sabin, CEO of Penrose-St. Francis Health Centers. "We will have three areas of concentration - clinical, operational excellence and the development of overall growth."

Penrose will also focus on educating its employees about personal responsibility - the creation of programs to keep them healthy. This will affect the bottom line - as the system to move toward electronic documents.

"We want to be a model for the community," she says. "We want to be a credible source of health care needs."

If she admits that times are tough - and Penrose is no exception, Sabin said that the system has a good profitability. But in future, it will carefully choose how to spend his money.

"We are buying a new cyber-knife to the cancer center," she says. "We decided that this program has benefited directly from patients - that is the cutting edge of technology. But for that we had to put some building renovations. We decided to focus on health care and patients' needs - the rest, we will not do without. "

Penrose is to see a "soft" bottom line, and Sabin said it was under budget, but it is still meeting its costs, with surpluses to improve its equipment.

"A big positive in all this is a focus of what we want to focus on what we need," she says. "And I think that is done at national level. There are many things we want - but do not necessarily provide quality health care. We limit our attention to things that have a direct impact on patient care. "

Much of the philosophy of Sabin McEvoy is consistent with the plans of memory. McEvoy finished his first year in memory - and he admits it was difficult.

"I am pleased that we are the future," he said. "That is what I talked about recently is the past. It is time to look to the future. "

Over the years, Memorial will be focused inward - on its internal procedures, processes and policies. The hospital must ensure that this work is as productive as possible in order to meet its obligations and health care.

"We have now completed expansion," he said. "And we have reduced our mission. Now we just want to provide quality health care possible."

Like all industries, Memorial will do more with less. Financial difficulties can be summarized as problems with the stock market and the lack of liquidity in the credit market. These problems mean that capital expenditures should be carefully evaluated.

"Gear in health care is expensive - new scanner, new emergency room," he said. "It costs a lot of money. We will carefully examine these expenses. "

Memorial plans to spend the new year focusing on relationships with physicians, creating better more value-based relationships with physicians who practice in hospitals.

But the main thing is that the hospital - in the face of interest rates on the debt to 12 percent - will have to be careful with its financial resources. "

Both health systems are struggling with other factors of a bad economy - an increase in charity care. Sabin said charity care increased by 2 percent and 4 percent of Penrose, and the memory is seeing an increase as well.

"It is important, she said. "and I am sure that across the nation."

Memorial but also to focus on its culture - creating a workplace that values its employees and expects the best of them.

"We have several key objectives," said McEvoy. "We want to increase the quality of the visit of the patient flow redesign their visits and make sure they are really clear in the process. We want to make it easy for them. We will focus on the labor force, and we will establish links with physicians to ensure that we can create a better system of care. "

Small businesses

Small businesses - those with between 50 and 250 employees - are cutting health care budgets in order to remain competitive. And the nation to see the insurance providers are not an end to that trend.

"Health care is probably the second biggest expense that pays," Edmonds said. "And people looking to reduce costs. We will see more people cut off from health care. "

Most health care providers offer some form of individual coverage to try to keep some of these customers.

"We are working on strategies to keep costs as well," said Neely. "Over the past two years we have seen the plans focus on the consumer, but there are signs that the movement towards the ends. In its current form, the average deductible in Colorado of $ 1000. "

Companies struggling to enable the higher premiums - some will see an increase of 20 percent in 2009 - are drawn from welfare plans that give credit for things like gym membership and health brown bag seminars.

"Businesses are also being wanted more information to justify the increases," said Neely. "We are reaching a point where people want more information to change the cost-control and they want to educate their employees become better consumers of their dollar. "

But sometimes, companies want the data that does not necessarily exist, "he says. Often, the costs for surgeries and other procedures depend on the complexity of the case - and are not readily available.

But there are some places people can reduce costs - pharmacy plans are one of them. As the rising cost of medicines, the pharmaceutical industry is a very real element of this increase, he said.

"If we can teach people to be more intelligent consumers of pharmaceuticals and prescription drugs - the move to generics, the savings could be about 50 or 60 percent," said Neely. "And we're working on other points as well - a franchise of specialty, the high cost of drugs for cancer and hemophilia, for example."