Misdirected focus - Health-care ‘reform’? Try addressing existing programs

Open Forum
December 18, 2009
The Winchester Star

Misdirected focus
Health-care ‘reform’? Try addressing existing programs

James T. Holland


I’ve served for more than 20 years on the Board of Directors of Valley Health System. I’m very much aware of the need for health-care reform, and the impact of reform on providers and patients.

My son-in-law is an orthopedic surgeon, and my daughter-in-law is a former neonatal critical care nurse. I’m concerned about cost, quality, access, and health-care innovation. However, the “reform” proposals currently being debated in Congress are frightening!

The focus is misdirected. Far too many existing Medicare policies and regulations do nothing to improve health care. They add to health-care cost! Medicaid is out of control, and we have an impending economic disaster with Medicare.

The Medicare program is financially unsustainable as currently designed. Why isn’t an unfunded Medicare liability of $36 trillion more urgent than a new entitlement? I don’t understand why Congress would even consider adding to this problem. I don’t understand why the proposed new health “reform” program is so urgent, while pretending that existing programs are not.

We need health care reform of existing programs!

A few changes to existing law could make a huge difference.

* Require Medicare rule-writters to cooperate with hospitals and physicians to eliminate bureaucratic regulations that add cost, without affecting quality of care.

* Increase competition between existing private health insurance companies. Allow them to develop innovative health insurance programs and offer products in every state. Regulate, but don’t dictate what they must offer, and what they must charge.

* Give all Americans the same tax break that employees get with their employer-provided health insurance plans. Uninsured Americans would be more likely to buy health insurance if private individuals could get the same tax treatment as that offered by employers to their employees.

* Recognize the basic economic law of supply and demand for consumers of health care. If people are offered something for nothing, they will use more of it. Government has to eventually ration care. Let the people ration their own care by requiring them to pay up-front costs every time, and for every service. Their payment need not be great, but they must bear initial cost.

* Increase age limits for Medicare eligibility. The age eligibility needs to be increased, rather than reduced as was proposed.

* Focus benefits on catastrophic coverage, and healthy lifestyles. To save Medicare, the program needs to gradually move from all-inclusive coverage to catastrophic coverage with incentives for not smoking, exercising, and maintaining a healthy diet.

I am also concerned about the negative impact of excessive taxes, costly regulations, and government mandates that add costs to all businesses. During my career at O’Sullivan, I was directly involved in making decisions that created many jobs. Management made decisions to open new businesses, close businesses, and relocate businesses.

We chose to expand and grow in Virginia because of the right-to-work law, and the business-friendly attitude of government. We closed plants in Massachusetts, New Jersey, and Michigan because of high taxes, high energy costs, high workers compensations rates, and the high cost of dealing with organized labor. All of these high costs were byproducts of government polices toward business. Government attitudes toward business influenced every decision.

Government is missing an opportunity to stimulate the real job-creating engines of the economy. The current government philosophy is influenced by a passionate socialist desire to punish big business, punish “rich” owners of small business, and punish “rich” entrepreneurs who take risks with new business ventures. These are the very people and businesses that create jobs.

It is a mistake to allow the Bush tax rate to expire. It is a mistake to pass legislation that adds cost to business. It is a mistake to micromanage tax breaks, and subsidies, and limit government support to politically favored businesses.

If we are to revive the economy, create jobs, and reduce government debt, we need to change the socialist mindset. End the practice of punishing businesses and entrepreneurs. Our current crisis is so great that unprecedented tax and regulation reform is needed.

Recent stimulus programs have failed because they are short-term solutions. Tax and regulatory actions are long-term, and the crisis requires a long-term solution. If only Congress would reduce taxes on all businesses and individuals to a maximum rate of 25 percent. This would unleash the creative energy and ingenuity of all Americans.

We need to change government attitudes toward business: Work with business to reform laws that add costs to business. Regulate, but don’t suffocate.

Government is a partner in the success of every individual and business. Why not work together?

Don’t take my word for it. Check with every economic development agency in the United States. These agencies seek to attract business, and create jobs by offering tax breaks and eliminating bureaucratic red tape. They will work with entrepreneurs, big business, small business, and they are very flexible. They try to undo what government has done.

James T. Holland is a resident of Frederick County.

Good gracious, looky here at these profits for Winchester Medical Center

Folks, just amazing of these (in excess of revenue) profit figures that just the Winchester Medical Center (not-for-profit) alone is producing since 2001 according to Quad State Business Journal was $11.8 million.

So ... here you go ...

2001 - $11.8 million 

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  '

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2005 - $54,346,679 (per IRS990)

2006 - $57,422,678 (per IRS990)

2007 - $66,617,961 (per IRS990)

Folks, you read where The Pub documented that from 2001-2005, that was a 383% increase, well my goodness, from 2001-2007 that has risen even more so up to 460%.

You tell us what in the world in going on?  These numbers are getting to big for The Pub to even comprehend for this "not-for-profit" organization.  Please keep in mind, this is just Winchester Medical Center alone, there are many other revenue generating services that has not been factored in yet.

Reference this previous post:

Wednesday, October 14, 2009
Valley Health has made epic strides in Excess of Revenue (Profits) since 2001

 

Have an outstanding day!

Her miracle - A little sister who passed help forward

Her miracle
A little sister who passed help forward

By Courtney Lynn Chapman
December 9, 2009

My 5-year-old sister suddenly got ill. She was vomiting blood. She was so ill that my amazing mother took her to the Winchester Medical Center Pediatric clinic to be checked out.

They admitted her to the hospital because she was dehydrated. No one had a clue what was wrong with her. She was a very miserable sight to see, and it was very hard to see her the way she was. She lay there in the hospital bed so helpless she couldn’t even carry her tiny self to the bathroom.

They ran many tests on her, but still had no answers to our questions about what could be wrong with her. She was there for three days, and took a turn for the worse when that Saturday came.

The bacteria causing her illness moved to her kidneys. When it came to this, the Winchester Medical Center could not handle it anymore. Our very supportive family all jumped in their cars and headed down to Charlottesville where my sister was being taken. When we all arrived there, she was in PICU (Pediatric Intensive Care Unit). Her case was severe. More tests were run, and we then found out she had E Coli — and it went straight to her kidneys. It is rare for that to happen, but it did.

Days passed and she wasn’t getting better. Many people were praying for this little girl, and thank God they did. She was put on a dialysis machine to function her kidneys. Slowly a month passed and she came back to the same silly little girl that she once was — except now she has a tube in her belly just in case she has to be put on a dialysis machine again.

She is home now, but we are still waiting for her kidneys to be fully functioning. She is my miracle. Not only is she my miracle, but she is one to many others, too.

Long before she was put in the hospital, she saved the soda-pop tabs that you can break off. She was about 4 years old and knew that they helped save people’s lives. She didn't know that they got people minutes on a dialysis machine. I mean to tell you that this little girl saved all of those tabs she got her hands on. She saved them to help someone. Little did we know she would need the help.

That little girl proved to me that miracles do happen. You just have to believe.

I also want to say that if there was an award for best parents, mine would win. They stood by my sister no matter what. They were there day and night for the entire month she was in the hospital. They are the best anyone could ask for, and I wouldn’t change that at all. God bless everyone and thank you for your prayers.

Courtney Lynn Chapman, 17, is a resident of Winchester.

City sues agency over local senior center funding

City sues agency over local senior center funding

By Vic Bradshaw
The Winchester Star

Winchester — The city government has filed a lawsuit seeking $500,000 in damages from the Shenandoah Area Agency on Aging.

City officials say the nonprofit organization committed fraud by not providing the money it collected and promised to donate toward building the Active Living and Recreation Center in Jim Barnett Park.

The lawsuit, filed Thursday in Winchester Circuit Court, alleges that the agency accepted federal and state money earmarked for the project, as well as donations from citizens and businesses.

The agency has not given the city government the funds “despite repeated demands,” according to the lawsuit.

The city government says SAAA acted fraudulently because it intentionally solicited and collected “charitable funds under a misrepresentation” that they would be used for the project.

The suit seeks $250,000 in compensatory damages, $250,000 in punitive damages, and various smaller amounts of financial relief.

Jeff Buettner, president of the Winchester City Council, said the council was reluctant to take legal action against SAAA, but felt it had no choice.

“We absolutely did not want to do it,” he said. “But we had citizens pledge money on this project and it’s not [being returned] to Winchester. We had Congress give money for this project.”

City Attorney Anthony Williams said the city government did not require SAAA to sign an agreement indicating it would contribute $250,000 toward the building project. However, by soliciting money for the project, he said, SAAA became obligated to give the funds to the city.

For Remainder of the story ... Click here to view comments or make comments on The Winchester Star website and Click on Dec. 5th!

Insurance companies - Plenty of competition: state lines have nothing to do with it

Open Forum

Insurance companies
Plenty of competition: state lines have nothing to do with it

Howard Sharp
Winchester Star
December 5, 2009

Quite a few years ago, my wife was in need of outpatient surgery for a broken bone that could not be set correctly. After being told many times to be at the hospital no later than 6 a.m., we made sure we were not late. The nurse who got my wife settled told her to relax, as she was scheduled for 1 p.m. What?

I headed for the doc’s office with fire in my eyes. The surgeon’s chief nurse told me that the mix-up was the fault of an insurance company, because the company had not told them if they would let them operate on another patient or not.

That statement did not cool my jets. Arriving back at the surgery location, the doctor presented himself and started telling me where I was wrong. I stopped him and asked how he would feel if it were his wife lying in the bed. He apologized for the scheduling mix-up, and we got on with business.

The point of the story is that insurance companies don’t tell anyone if they can get medical or surgical services. They only state if and how the contract with the insured will pay for such services. For any member of the medical profession to state that an insurance company will not let them perform a procedure is pure ignorance. The decision to perform a medical or surgical procedure is strictly between the physician and the patient.

Insurance contracts, either individual or corporate, are written by attorneys and employees of those insurance companies. These contracts must be approved by the state corporation commission. There’s your McCarran-Ferguson Act, Winchester Star.

Now, besides approving these contracts, the bureau provides other services to the taxpayers. It sees to it insurance agents are tested and duly licensed. The bureau also rides strict herd on these companies to make sure they administer the contracts correctly — including enforcement, if necessary.

The last figure I was aware of showed more than 200 companies licensed to do business in Virginia. I am sure most people have heard of Aetna, Prudential, United Healthcare, Travelers, John Hancock, and Equitable.

The point of this statement is actually a question. What makes Congress, Michael Halseth, and The Winchester Star make statements that companies selling across state lines would make premiums cheaper? All of the larger companies operate in all states and the smaller companies in most. If the current system does not provide for competition, then how many companies does it take?

It’s called risk. All companies must consider prior claims experience for different groups of people, ages of participants, male or female content, and estimated cost for the future. It does not matter what state the company is selling from: the rates have to be predicated on where the contract is being sold to cover the customer.

Some insurance companies are not capable, or do not want take such a risk. Large employer groups are usually rated to a degree on the claims experience of their own employees. Smaller employers are usually rated among other smaller employee groups in an area or across zones in a state. Quite often, there are professional or trade associations that sponsor a pooled group for its members.

So, Winchester Star, the types of pools you mentioned are out there. Yes, there are state mandated benefits to contracts in many states. But there are also federal mandates already involved that will increase with a “national” program. Taking all of this into consideration, I don't see how anyone can say that buying across state lines will make contracts cheaper, or that a law passed in 1945 created a monopoly or stopped competition.

Speaking of competition, what kind of competition does the Winchester Medical Center have, and what kind of financial reserves are they sitting on? What kind of competition do the physicians of this area have? Are these professionals willing to take a large reduction in pay? The odds are high of their incomes taking a large hit with any of the current bills.

Maybe the hospitals, the physicians, and the insurance companies should sit down and work out these financial hang-ups without government being involved. Is it too late? This Big Three of the medical world could cut down greatly on waste and fraud among the three areas to reduce cost greatly. Problem is, they all have a different ox being gored and the “patient/customer” has tired of it, so the politicians have jumped in with both feet to avoid the real issues they need to address.

When people don’t like their medical insurance coverage, they should remember it was likely written by business people with the input of people with hospital administration degrees, and physicians, and signed off on by “lawyers.”

A wise local businessman, Ed Bridgeforth, used to tell me about his “competition. You’ve heard of Coke and Pepsi, haven’t you?” If anyone has heard of the aforementioned insurance companies, then they should understand that, yes, they have plenty of competition, and state lines have very little, if anything, to do with it.

Howard Sharp is a resident of Frederick County.

Click here to view comments or make comments on The Winchester Star website and click on Dec. 5th!