Dear editor:
Last week a healthcare summit held in Laramie discussed a problem most of us have seen for 40 years; the problems created when government health programs do not pay the cost of the care.
Since the early 1980’s when the federal government realized that their Medicare aspirations were bigger than their budgets, the feds tried various ways to contain costs.
Basically, they pay for healthcare using arbitrary rates. The initial shock of this was severe enough to cause some doctor training programs across the United States to empty, with virtually no applicants for some specialties. Today’s doctor shortages are the delayed result of the early 1990’s.
By paying less than the cost of the care, government programs are indiscernible from shoplifting. It is not the fault of the patients, but rather the political leaders who pretended that this was sustainable coverage. Medicare Advantage exacerbates this problem by using narrow networks and in many cases paying even less than Medicare. In most states, Medicaid pays the least of all, even less, sometimes as low as half of Medicare payments.
Imagine a grocery store where 60% of their stock was taken out the door at a loss. How long would it stay open? The fact that hospitals and doctors are still providing care forty years later is testament to compassion, ingenuity and work ethics. But we may have come to the end of the line.
Almost half of rural hospitals lost money last year. Smaller communities have more older people on Medicare. We want to provide care for them, but we have the costs of rent, staff and supplies, none of which are cheaper than forty years ago.
It is unlikely that we can fix this problem at the federal level soon enough to save our state’s hospitals from these financial stresses. But at the state level this is possible. Offsetting the losses of rural and “sole community” hospitals, where there is only one hospital in town, with state resources is a good value for taxpayers. Why?
In addition to providing healthcare, Wyoming hospitals are usually one of the top three employers in their town. Losing these jobs has a devastating impact on a town’s current economy. Prospects for the future economy also suffer as it is less likely to attract new businesses as they have no hospital. Wyoming healthcare supports over 40,000 jobs and generates $76 million in state tax revenue. If we cover the state’s hospital losses annually the new net cost to Wyoming would be less than $20 million, and possibly nothing when factoring in the impact of lost tax revenue.
Recently the topic of international trade deficits has been discussed. But at a state level, Wyoming suffers a trade deficit where we send out almost $3 billion annually in healthcare premiums. Wyoming clinics and hospitals bring back this exported money in the form of several billion dollars annually. Healthcare for the state’s citizens provided outside the state grows this deficit.
Direct support for Wyoming’s 25 public hospitals operating at a loss pays for itself. The current system causes this problem, and it is not these hospitals’ fault that they lose money. Our legislature is smart and nimble enough to fix this problem.
John Mansell, MD
Trustee, Campbell County Health
