Day 1: Disaster Preparedness, Health Care Reform and Health Care IT (written by Abby Lowe)

Wow. I obviously should’ve worn more sensible shoes today.

I’m exhausted, but Dr. Royer just keeps moving right along. (“I’m not tired until the work is done,” he says. And even though I’m 30 years younger and even though he probably woke up around 4:30 or 5 this morning, I seem to be the one dragging.)

It was a great first day of meetings, though. We met with the staffs of 2 senators and 1 congressman, an expert in health care IT who is charged with helping HHS regulate recent funding requirements and some of our friends at the Catholic Health Association who are very involved in health care reform and have attended quite a few meetings at the White House.

We talked some health care reform today, but mostly carried messages about disaster preparedness—how state and local governments could work better with us and with FEMA to help us be more effective during hurricane evacuations and help us better care for our patients, and the legislative changes we’d suggest to help that process along. Obviously we talked about health care IT--the American Recovery and Reinvestment Act of 2009 (ARRA) provided approximately $19 billion for Medicare and Medicaid Health IT incentives over five years, so we and other health systems want to stay engaged in those discussions.

I might take some time later in the week to delve into health care IT and disaster preparedness, but I learned quite a bit about health care reform today that I think you’ll find interesting.

My head is still spinning, and I can say that even though I do my best to keep up with the health care reform discussions, I have trouble keeping up with who said what, what’s included in a suggested bill, what’s not, what’s been thrown out, who’s working with whom, who feels like they haven’t been invited to the table, etc. It’s a dizzying mix of conversations, negotiations, he said/she said, and it all feels like it’s moving very, very quickly.

But we met today--and will continue to meet--with legislators on both sides of the aisle—Democrats and Republicans, conservatives and liberals. We also heard from some of our colleagues at the Catholic Health Association who speak on our behalf. Here are some things I learned:

1. You can’t let perfect be the enemy of good. The bills being bandied about on the hill aren’t perfect. No bill of any kind on any subject ever will be, but the 46 million Americans without insurance can’t wait. A recently released report by the Institute of Medicine makes clear that Americans without health insurance live sicker and die sooner. And they can’t afford to wait 15 more years for real health care reform.

I also learned that 28 million of the uninsured are small business owners and employers. And it sounds like many of them would be happy about being able to afford insurance coverage.

2. A solution crafted this year won’t be a permanent fix. The bill that is crafted now may work for the next 10 years or so. But given the advances we expect to see in medicine and technology, it may not be appropriate for the 10 years after that.

3. We aren’t here asking for no cuts to Medicare/Medicaid, but we have drawn some lines very firmly about what we will not accept. Hospitals have agreed to $155 billion in cuts over the next 10 years. It sounds like we will be able to cover these costs, provided that the majority of Americans emerge with health insurance coverage. However, we would never stand for cuts in dollar amounts that we could not manage. (We could not shoulder cuts that reached as high as $300 billion, for instance. And after all, what good is insurance if no hospitals can afford to stay open to provide care?)

As a Catholic system, CHRISTUS would not support any kind of reform efforts that included threats to life like abortion. From what we heard today, it does not sound like the current discussions will form a bill that addresses abortions in any way.

4. I heard someone say today that health care reform will cost $2 trillion. $2 trillion is a whole lot of money. It sounds like WAY too much to pay for anything, no matter how it is financed. (Including health care reform.) But the insured of our nation are already carrying that kind of burden. Did your insurance costs go up this year? Mine did. Apparently our costs have been rising for years and CHRISTUS has been carrying that cost, but it got too large for CHRISTUS to carry anymore. So some of that cost was shifted to me and the rest of our Associates on the CHRISTUS plan. Insurance premiums will continue to rise, because insured patients carry much of the burden of health care costs. They don’t carry it all by any means, but many people treated in hospitals cannot pay for their care, and that cost is passed on to those who can.

I also understand that $2 trillion is probably not the most correct cost. I believe the Congressional Budget Office estimated the cost closer to $1 trillion, which does not at all include new accounting rules or the concessions made by industries like hospitals. Legislators are also still working on the final plan, and I believe more cuts in that nunmber will be made. For more information on this, I suggest this article.

5.Being here obviously brings back some Schoolhouse Rock! memories. I have “I'm just a bill / Yes, I'm only a bill / And I'm sitting here on Capitol Hill” stuck in my head.

But we have three more days of jam-packed agendas to get to, and I’m exhausted but excited to see what comes next. Stay tuned! ~Abby