According to data from the Center for Medicare & Medicaid Services (CMS), hospital care in Kitsap County is 40% more expensive than in the surrounding communities. In documents filed as part of the lawsuit, a former physician president at TDC summed up the affiliation with CHI best: “You can now get your outpatient care in a complex, relatively unsafe, and vastly more expensive location.”
First, the Balanced Budget Act of 1997 capped the number of residency slots in teaching hospitals which were eligible for Medicare payments. This mistake has facilitated a shortage of primary care physicians across the country. A larger supply of primary care physicians is associated with a lower mortality rate. In fact, adding 10 primary care physicians per 100 000 population increases life expectancy by nearly two months, whereas the same increase in specialty physicians only improves life expectancy by 19 days.
The viability of rural hospitals, fighting to remain financially solvent despite implementation of additional mandates, must be balanced with the need for nurses working 12-hour shifts to have protected time for meals or breaks. Both are important and a viable resolution exists somewhere in between. Sacrificing meals and breaks for nursing staff already dangerously spread thin is not the solution to keep rural hospitals afloat. And indeed, Senate Bill 1155 passed with bipartisan support and will now head to the Governor’s desk for signing.
The country bearing the closest resemblance to the U.S. proposal, where decision-making is centralized, is France, where the government is responsible for 77% of total health expenditures. There is an out-of-pocket cost share for patients though it is relatively low, at 7% annually. The Netherlands, Singapore, and Taiwan are also highly centralized; however, they are smaller in scale–with populations similar to that of individual U.S. states – and their relative affluence allows them to sidestep long wait times.
In a socialist construct, one central power controls the means of production and the goods produced, goods which may someday include U.S. physicians. The Cuban government generates $11 billion annually by “leasing” their physicians out to foreign countries, in order to fund the Cuban national health system, which is “free.”
In a world where opinion is shaped through social media, a public health strategy based on trying to “educate people” by shoving “facts” in their face when the facts are in dispute is not going to work very well. In reality, it may backfire and produce exactly the opposite result from the one you intended. And that is exactly what is happening here.
Health care inflation continues to exceed the base inflation rate. Health insurer CEO compensation has ballooned out of control –in 2017, Cigna CEO David Cordani took home $43.9 million, Humana CEO Bruce Broussard made $34.2 million, and Aetna CEO Mark Bertolini earned nearly $59 million. That’s approximately $162,000 per day.
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.
Nonprofit hospitals, in general, are facing challenging times. And that challenge is going to reverberate through our county, whether that means a major facility on a new construction timeline or further corporate creativity to reduce health care costs.
The opioid crisis has grown exponentially – ravaging communities and taking an estimated 64,000 lives each year – escalating into a public health epidemic. In response to the increased availability of synthetic opioids like oxycodone and fentanyl, the Surgeon General called for expanded access to the opioid overdose antidote, naloxone, by using the slogan: Be Prepared. Get Naloxone. Save a life.