Published: July 08, 2009 08:25 pm      

LCRH CEO: Health care system needs to change, but ...

Overhauling a nation’s health care system is no small task, but nearly everyone is in agreement that changes have to be made.

“Everybody wants the system to improve,” said Lake Cumberland Regional Hospital CEO Jeff Seraphine on Wednesday. “They want it to be more affordable, they want it to make more sense, be of a better quality.”

But the mutual feelings end there. Lawmakers are feverishly working to pull in compromises from industry leaders — including the American Hospital Association, or AHA, an organization that represents and serves all hospitals and health care networks, and their patients and customers.

That includes LCRH, which, like other health care providers, will be significantly impacted by whatever plan makes it through Congress.

“Everybody has to be at the table willing to give up something to make this work,” Seraphine said.

This week, Vice President Joe Biden announced that the nation’s hospitals agreed to give up $155 billion in future government payouts to help counterbalance the significant cost of President Barack Obama’s overhaul plan.

“That $155 billion is a compromise,” Seraphine said. “They (lawmakers) initially came out with more than $200 billion.”

That agreement came after lawmakers conceded to not push for deeper cuts that had been in discussions.

And, perhaps more importantly, hospitals also won an understanding that should a public health insurance plan be included in the overhaul, it would reimburse hospitals at above the rates Medicare and Medicaid pay.

Seraphine said LCRH, like most hospitals, receives approximately 70 percent to 72 percent of its revenues through Medicare and Medicaid reimbursements. Those rates are quickly becoming insufficient in the face of rising health care costs.

“It’s not just Somerset,” Seraphine said. “It’s across the health care system.”

And the AHA is worried that a public health care program — should it be included in the overhaul — could prove to be a catastrophe for the health care system.

“The idea of a government plan that encourages more people to join that plan that pays government rates would be disastrous,” Seraphine said. “We then actually become more dependent ... on government programs.”

Those concerns are behind the AHA’s pursuit that any public plan come with negotiable rates — not pre-set rates that will essentially be the same as current Medicare and Medicaid rates.

Seraphine emphasized that the plan is still in the beginning stages of the lawmaking process — and he said no amount of compromises will help push a plan through that may still come with an exorbitant price tag.

“If it (the overhaul plan) still has a trillion dollar price tag, how can anybody bite that apple?” Seraphine asked.

As lawmakers continue to hash out the details to what Seraphine called “the most complicated issue that they’re going to take up there,” the idea still remains that something has to be done.

“It’s very difficult,” Seraphine said. “It’s very complex.

“There’s a lot of forces of change up there,” he added.