Editorial: Hospital Hospice
Editorial Board, Hillsboro Argus
May 27, 2011
It always happens at the end of a legislative session. The stuff that is left over gets gutted and stuffed into a bag. Teddy Roosevelt called it making sausage. When done, it’s handed to the service, agency or department like a burnt offering. And even if the schools went first this time, the cuts were deep. It’s budget time. Everybody’s miserable.
One of the last guys in line this time around are the hospitals. They’ve caught a fast ball in the teeth. Out of all the state agency cuts, 42 percent will come from hospitals. On closer examination, in the first year of the plan Oregon Hospitals will take an 11 percent cut. It gets worse. The second year of the biennium wields a 26 percent whack.
Much of the money up in smoke here is from the Oregon Health Plan. It pays for children’s health care. Low-income adults also are on the ticket. Federal and state funding support the plan. What will happen here as the payments are reduced, along with reduced Medicaid payments — hospitals will be forced to pick up the slack. The problem is only about 70 percent of the actual costs are now being covered. By cutting even more, doctors are given little choice but to stop seeing the OHP patients all together.
On the other side of the squeeze — there is talk of increasing the hospital “provider tax.” This is money from hospitals to leverage federal Medicaid matching funds. The hospitals supposedly get the money back when they serve OHP patients. This round robin of payments has a huge hole in the center. It called the emergency room. Hospitals fear — and rightly so — as OHP and Medicaid patients find more doctors’ doors closed, they’ll head to the ER for their medical needs.
We fear our own community hospital, Tuality, will have a particularly tough go. It hires 40 to 50 doctors. Its price structure is one of the lowest in the state — its margins some of the skinniest. Well managed, it has been able to weather the health care storm while providing excellent care. The hope is on reform in the works to actually manage care and drive down costs by coordinating physical, mental and dental care for state-funded patients. But to be realistic — we think it is just a hope.
We are entering a difficult place. It’s amazing to us a governor with an emergency room background would sentence hospitals to hospice in an effort to bail out his budget. (wcg)
Link to the story: http://www.oregonlive.com/argus/index.ssf/2011/05/hospital_hospice.html
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