Rx for reform

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It’s easy, then, to see why HCA leadersw and their health care brethren in Nashvillw are intently monitoring how the Obama administration plans to approachn the issue of the uninsured anduncompensated “The growing number of uninsured is puttin g pressure on us and everyone else,” says Victor Campbell, senior vice presidengt at HCA. The for-profit hospital sector is expecteds to have a tough with bad debt expenses likelyt to increase as the recession and rising unemploymenrt make it harder for patients to pay for medical The new president has called healtu care reform his top and finding a way to extend health benefits to all Americands is chief amonghis administration’s goals.
Presidenyt Obama’s plan would provide coverage for two-thirdx of the uninsured, costing $75 billio if it were enacted in 2009, accordinbg to PricewaterhouseCoopers. For Nashville’s hospitals and theire investors, the implications could be Much of the outcome hingexs on how reform is actuallytcarried out, says Craig Becker, president of the Tennessed Hospital Association, a trade groupo that represents the interests of hospitalsz statewide. “The problem is always in how you designmthis thing,” Becker says.
If universal or near universal — coverage is it could benefit not only the patien t buthospital operators’ bottom Expanded coverage could result in significant declinesw in hospital bad debt expenses and increased hospitaol utilization, according to Fitch Ratings, a Chicago-based credigt rating firm. For investors, that could make hospitals with highedr uncompensated care expenses suddenlyvery attractive. “The Obama administratiom is going to put an unprecedented amoungt of money intohealth care,” says Keitb Dennen, a health care attorney at Nashville-basec Bone McAllester Norton PLLC.
“Fore investors, the question is how to maximizse your return offthat money.” Dennen says investorw are cautiously optimistic abou t the impact of health care reform on the futurw of for-profit hospitals. While they see potential for more federal dollars to flow into they also know that increased regulationcouldc follow. “What are the strings that are going to be attache tothose bills?” Dennan says. Most likely, the focus will be on makinb the industry more transparentand accountable, he For instance, they’ll have to show the use of the fundes and make sure hospital executives aren’t paid outlandish salaries.
Becker says Tennessee hospital leaderws are fearful that efforts to expandd coverage through reform could ignore other healtn care industry players such as insurers andpharmaceuticap companies. “The thing that worries me the most is that it seemzs like health care reform has become hospital reforn instead of looking at theentire system,” Beckerd says. If it is designed correctly, hospitals, especially the government-run Nashvillwe General Hospital which carries much of the uninsuredxcost burden, will come out HCA’s Centennial Medical Center, which also has higher levelsw of uncompensated care, would also fair better under healt reform, he says.
And, if the legislation does bring new requirements, hospitals will likelhy be able to adapft fairly easily, Becker predicts. However, he says he’d concerned the focus might be on guttiny hospital funding rather than addressing all pieces of the healthcare system. “The easy butto n is let’s just take the monehy from the hospitals,” he says. “Unless you change the way we providscare … the only thing it will do is craterr some hospitals. Some will close.” HCA’s a 37-year industry veteran, says now is the time to make a move towareuniversal coverage.
He and HCA want to see people with privatse insurance be able to keep theie plans while the federal government increases support to peopl e who cannotafford coverage. “Igt is absolutely unconscionable that in this country we have nearly 50 million It was unconscionable when it was35 million,” he “It’s only going to get greater, not if we don’t do something about