By KEVIN CHIRI
Slidell news bureau
SLIDELL – It may be President Barack Obama who will forever be remembered as the president who pushed national health insurance through Congress.
But Slidell Memorial Hospital CEO Bill Davis said it isn’t the leader of the United States who was really behind what he calls “the period of greatest uncertainty in the history of health care.”
Davis said the Affordable Care Act (ACA) that takes effect in 2014 across the country, which forces all Americans to have health care, is actually a culmination of rising costs throughout the industry that threatened the very future of health care.
“Costs have risen year-after-year but we are seeing reimbursements drop from the government for Medicare and Medicaid,” he said. “That burden is becoming too much on businesses providing health care for their employees since there are 10,000 people every day who are going from commercial insurance to Medicare.”
The aging Baby Boomers are putting more people on Medicare every day, thereby paying health care providers a lower reimbursement than private insurance did. Davis said Medicare and Medicaid pay 6 percent less than private insurance, meaning the providers are falling in a deeper hole every day the Boomers are moving to Medicare.
“The cost increases to providers can’t keep going up and that is what led to health care reform. It came from industry, not government,” he said.
With the Affordable Care Act providing new guidelines for the way health insurance companies offer coverage, the biggest change is in higher deductibles and co-pays, meaning the burden for paying will fall on the individuals who seek services.
Davis said the biggest change for consumers now is that they are being given more responsibility for their own care, and given incentives to live healthier lives so they don’t end up in a hospital.
“There may be lower premiums in some cases, but you are positively going to see much higher deductibles,” he explained. “People better be saving money for health care because they will have to pay their share.”
The alternative, Davis said, is for Americans to be healthier and thereby, avoid the need for health care as much as in the past.
“People probably use health care now more than they should, simply because it hasn’t cost them much to see a doctor,” he said. “That is going to change. This new system will make people take better care of themselves or they will pay for it.”
He said there have been some complaints about higher premiums for unhealthy habits, such as smoking or being overweight, but he said that health insurance is charged the same way all other insurance is. The more risk there may be, the higher the premiums.
“If you have had several accidents driving a car, you are seen as a higher risk and you pay more for car insurance,” he said. “So it’s no different than if you are overweight or a smoker–you are a higher risk and will pay higher premiums.”
Davis said today’s society has changed in such a way that they don’t view doctors or health care in the manner the previous generation did.
“There is a huge generational spread today—the older generation that respects doctors and the young generation that questions everything they say or do,” he said. “The 40 and younger generation has grown up with high tech and trained to question authority. They don’t see doctors the way their parents do. Instead they are researching things on the Internet and questioning doctors about it.”
He said the result is that clients are now viewed by health care providers as “consumers rather than patients. And the industry has to respond to that. There is tons of public data now on doctors and hospitals so you can see the satisfaction level of what they offer. We’re dealing with consumers now, not patients.”
He also sees a change in the new generation of doctors, and said studies have shown the younger doctors don’t have the higher level of production as older doctors did.
“Younger docs still work just as hard, but the studies show they do two-thirds the work of the older docs,” he said. “It’s about lifestyle changes. Docs in the older days simply worked more.”
Davis agrees that the industry will probably see between 3 to 4 percent more patients with millions more Americans having health insurance, but he said reimbursement percentages for procedures, tests and doctor visits is going down, so he is concerned how the providers will handle that.
“We know there is going to be a continued reduction in reimbursements, but the hospitals have no ability to take our time in paying the suppliers we deal with,” he said. “We have seen $5.1 million in cuts from the government programs in the past year, which is all being used by Congress to balance their own budget. But that puts more pressure on us.”
Davis is like other hospital CEOs in St. Tammany Parish who understand the many changes on the horizon, some he likes and some he doesn’t. But he said reform had to come in some manner.
“Doing nothing about the rising costs of health care would not have been leadership and even if we are uncertain about all of this, it’s a step in the right direction,” he said. “The cost increases to providers could not continue to go up, so something had to be done. But I still don’t think this is the finished product.”