The Austin Medical Center (AMC) is a 99 bed licensed hospital with a multiple specialty associated clinic. AMC is a rural facility located in a service area of ~45,000 people in southern Minnesota. Their leadership is keenly aware of House Bill 3962 and has allowed HealthTechnica to publish their thoughts.
The following are the thoughts of Austin Medical Center:
The Affordable Healthcare for America Act, recently released by the U.S. House of Representatives (H.R. 3962), was passed Saturday, November 7, 2009. While Austin Medical Center (AMC) has not conducted an exhaustive review of this legislation, we have some overall impressions regarding health reform that we want to share with the public.
We are supportive of health reform and this bill is a step in the right direction. Reform is needed to align Medicare and Medicaid reimbursement to reward value. Did you know all employers and employees, regardless of location, pay the same Medicare tax? Yet Medicare reimburses Minnesota providers far less than other states. Is this fair? AMC could lower its fees and/or slow the rate of increase if government payers paid Minnesota its fair share.
- This bill attempts to fix existing Medicare geographic payment inequities and calls for a study of geographic variations and quality metrics. The goal is to create and implement a reimbursement system based on quality and value. If effective, this would prevent medicare from punishing Minnesota for providing such efficient, low-cost care.
- The proposed insurance reforms are long overdue. All people regardless of health status deserve fair coverage.
- Shared responsibility is critical to the success of meaningful reform. Younger adults with lower health risk should not be able to opt out without a penalty. The reason is that when they need significant care, everyone else but them pays for it. This is unfair. All adults (including the young ones) on employer-sponsored plans subsidize those that are not.
- Assistance to small business is a big plus. Especially in smaller communities like Austin and our surrounding area where future economic growth is highly dependent upon entrepreneurs. When these new businesses grow to a self-sustaining size, they’ll be able to pay their fair share of health costs. Giving them an exemption during the early years is the right thing to do.
- We do not support a public option modeled after Medicare. Today, government-run insurance programs can be heavy-handed, bureaucratic, inefficient systems that penalize medical systems (like AMC) that offer high value care. We cannot assume this public option will be any different. Our fear is that this plan will morph into a federal fixed fee schedule that is priced below our costs. This could drive all private insurance out of the market and we could end up with a government-run system like Great Britain and Canada. While these systems handle public health well, those that are very sick get rationed care. Most Americans will find rationing intolerable. We prefer to see expanded coverage through an insurance exchange like the Federal Employees Health Benefit Plan model, which Members of Congress and all federal employees have. This exchange offers multiple private plan choices and is the best “public option” for offering insurance for all.
This bill (H.R. 3962) is a major step in the right direction. The public option, however, is still a concern for communities like Austin. We encourage you to engage in this debate and dialogue with your representatives.
Sincerely,
David Agerter, M.D., CEO, Austin Medical Center
Adam Rees, CAO, Austin Medical Center
