By PAUL GIANNAMORE
The Weirton Daily Times
WEIRTON, W.Va. — While the health care debate in Washington seems to be on the back burner to other issues for now, expect it to surface as an election issue for the 2018 mid-term elections.
That was the word from Vincent Deluzio, managing director of R&V Associates, the business managing firm at Weirton Medical Center. The issue is stalled for now after a GOP-backed plan passed in the House and has failed to catch on in the Senate.
Deluzio emphasized that a national debate on health care should take time, involve the providers, the insurance industry and citizens and not be simply split along political lines.
“You have to take your time with it and not have Draconian measures in place while you discuss it,” Deluzio said. “The national debate has to be, ‘How much money are we going to spend as a nation on health care?’ You have to have some degree of national debate to do that right. You can’t just say it’s an individual choice or it’s for the free market to decide.
“The free market doesn’t decide who gets cancer. The free market doesn’t decide which babies are born with tremendous problems,” he said. “We, as a society, have a certain amount of a common interest in providing certain degrees of care.”
He and John Frankovitch, Weirton Medical Center’s chief executive officer, said it’s not a political view but an industry view when they say the debate has been too focused on referring to Medicaid as an entitlement program that needs to be reined in. The health care industry already is doing much to rein in costs, the two men noted, but there is a fallacy in thinking that cutting programs to pay for care for the poor will make the costs fall out of the system.
“The patients will be part of the system, regardless,” Frankovitch said. “The question is how do we pay for them in a way that makes sense for everybody. The suggestion that somehow, you can yank that funding out of there and the patients will go away is just not true.”
The WMC officials said they’ve reached out to Congressional representatives in West Virginia and Pennsylvania.
Sen. Joe Manchin, D-W.Va., said the GOP plan would cut more than $800 billion from Medicaid and reduce subsidies for tens of thousands of West Virginians.
“The money is then used to give our nation’s wealthiest people a $661 billion tax cut. This will cause thousands of West Virginians to lose their health care coverage. Our state will be forced to pay hundreds of millions for health care instead of putting the funding toward improving our schools, strengthening our economy and repairing our infrastructure,” Manchin said of the House-passed plan.
“West Virginia families will be one illness away from bankruptcy under this plan. Although the Democrats passed the Affordable Care Act strictly on party lines, the process was done out in the open. This bill went through committee hearings and mark-ups; they voted on Republican amendments on the Senate floor and the process was transparent,” Manchin continued. “Now, the Republicans are drafting a bill behind closed doors and will not take any input from the other side of the aisle. We cannot keep making this partisan mistake, and I will be working on bipartisan solutions on behalf of West Virginians.”
Deluzio said the cost of care is an issue that cuts across all economic strata. A person with a $60,000-a-year job and a savings account can be wiped out by one illness. If a person makes $100,000 a year but has a policy with a $6,000 a year deductible gets sick, that person will struggle to find the $6,000.
“Don’t kid ourselves that this is just a problem for the poor. It is not. We see that. We have to deal with bad debt, and they cross all economic strata,” Deluzio said.
Frankovitch said people end up delaying care and then go to the high-cost treatment of the emergency room to deal with the results of having chosen food over medicine or rent over going to the doctor for preventative care.
“It is literally a disaster. That is so much harder on everybody,” Frankovitch said. “It is harder on us. It is harder on the patient, of course. It’s harder on the system.”
Health care in the nation is organically changing based on a combination of economics and technology, Frankovitch and Deluzio explained.
Instead of trying to duplicate services that cannot be sustained by smaller hospitals, Weirton takes advantage of its proximity to some of the best hospitals in the world in Pittsburgh, through alliances and agreements that allow patients to be treated at WMC and be sent to the city if needed. Through recruiting that plays off the advantages of a good quality of life locally, the best doctors can be brought in for patients at the beginning of the process. Frankovitch said the result is better levels of care available through intake at Weirton than might be found in driving to a Pittsburgh hospital and getting in through the emergency room there.
Through telemedicine and cooperative arrangements, treatment is being pushed down to communities where access wasn’t as great to higher levels of care before, Deluzio said.
“You don’t have to have the Mayo Clinic in every little town in America,” he said.
“For someone who lives in this area, I have good news,” Deluzio said. “You have good care locally and you are connected to some of the finest health care systems in the world. Not everybody in our country can say that.”
As for the health care debate, Deluzio said the system needs to end up somewhere between a universal care, single-payer system and a system that relies solely on market forces and punishes individuals for not purchasing insurance.
“Medicare generally works. The issue, I think, is how do you deal with the employer benefit issue and how do you deal with the poor? If you manage it properly — most people have jobs in this country — it’s just the cost of doing business,” he said.
Both sides of the debate will have plenty of data to support their particular side in the election of 2018, he said.
“This debate will turn into a public battle in the 2018 election, unless Congress miraculously comes up with a bipartisan resolution this year,” he said.
The solution lies in letting the system work with some clarity from Washington.
“Give us the rules. We’ll figure it out. We will find a way to deal with the changes. We already have been managing our facility to deal with the changes. That’s what’s been going on in how we employ people, in the services that we offer and the locations we offer.
“That is what has to happen. We can’t just sit here in a tower and ask why it can’t be like it was 30 years ago,” he said.
“It is important for people to understand that they have to hold their politicians to account for the system to be sure that health care is affordable and available where they live,” he said. “The institutions must be strong enough and stable enough to provide it. We’ll do our part.”
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