The pay of the day …
For the past many months, the news media and legislators have focused on not only the need for healthcare reform, but also the need to do it now. The primary impetus for this has been that there are 40 million or more uninsured, and the insinuation is that these 40 million do not have access to necessary healthcare services.
Not once have I heard from the news media, legislators, health insurance companies, or (to my dismay) even our own hospital associations, that even though there are many millions of uninsured, our community hospitals and physicians do actually provide care to the majority of these uninsured on a daily basis.
And not once have I heard from the news media or legislators that working employees actually not only subsidize this care of the indigent and uninsured, but also the existing cost shortfalls to providers created by the Medicare and Medicaid programs through higher commercial insurance premiums.
The emphasis on providing the uninsured with insurance and throwing in such universally accepted ideas as prohibiting insurance companies from denying preexisting conditions has totally obfuscated the most important healthcare issue, which is how do we continue to pay for all of the services both the insured and uninsured want and need?
Whether you provide access to care by “giving” the uninsured an insurance policy, or by subsidizing the care through payment from insured patients, the cost is the same, and the result is the same. That is, working individuals will continue to pay the entire cost of healthcare for the uninsured, the indigent, Medicare and Medicaid patients, through taxes and other payroll deductions, premiums, and outof-pocket deductibles and copayments. How much will we require them to pay and for what services and for whom are the questions no one wants to talk about.
We need to get back to a basic discussion of health insurance and what costs we are willing to fund.
Wally Winkler Chief financial officer Keokuk (Iowa) Health Systems