Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, May 1, 1994 TAG: 9405010095
SECTION: VIRGINIA PAGE: A-1 EDITION: METRO
SOURCE: PAUL DELLINGER STAFF WRITER
DATELINE: CHRISTIANSBURG LENGTH: Medium
Boucher, D-Abingdon, told about 50 doctors and hospital representatives that Congress is unlikely to enact the president's proposal in its entirety, or any of the others being suggested by individual legislators.
Rather, he said, he and other Energy and Commerce Committee members want to take the best parts from each proposal and come up with a comprehensive approach to health care. Boucher said that is why he has been meeting three to four times a weekend with medical and hospital groups such as those in Christiansburg and asking for their ideas.
There seems to be general agreement in the 9th Congressional District and nationally that the nation needs to address health care and that universal insurance coverage should be part of that, he said, but the consensus breaks down after that.
"The path that we should take is not at all clear, as far as how the public wants us to go," he said. "If we had all the answers, we wouldn't need this meeting."
New River Valley residents generally might favor President Clinton's proposed extra 75 cents on each pack of cigarettes, for example, he said, but 9,000 farmers in seven counties west of here, for whom tobacco is an annual $45 million crop, would not.
"I don't think it's going to be quite as much of a concern as you think," said Dr. Scott Kincaid, a Radford Community Hospital board member. Kincaid said tobacco is such an addictive drug that smokers would continue buying cigarettes even if the price went up 200 percent.
If smoking should decrease, Kincaid said, it would promote health. He suggested that the cost of government subsidies to help farmers switch to another cash crop would be less than the costs of tobacco-related illnesses.
Boucher said he wished there was such a crop, but there isn't. And he still felt that the extra 75 cents per pack would mean less tobacco consumption, which would hurt the district's economy.
His other concerns with the Clinton plan, he said, are its requirement for all employers to provide 80 percent of insurance costs for their workers and its proposed reductions in Medicare and Medicaid outlays to hospitals.
Even with Clinton's proposed 3.5 percent cap on the costs small employers would pay for insurance, with the rest coming from government subsidies, Boucher said, that extra $200 to $300 a month could force some of the district's many small employers to lay off workers or go out of business. "We should not enact health care reform at the expense of jobs," he said.
Some hospitals in the district now receive most of their income from Medicare reimbursements, he said. If such reimbursements are reduced, those hospitals could be affected.
Pulaski Community Hospital Administrator Chris Dux agreed, saying that Medicare reimbursements cover only about 88 percent of hospital costs in providing care to Medicare patients. Under the Clinton plan, he said, that would drop to 68 percent in five years. "The mathematics just don't add up."
Dux also criticized the plan's proposed caps on health care costs. He said an emphasis on maintaining wellness, rather than treating illness, could reduce costs over time, but society needs to take responsibility for its own health by avoiding drugs, alcohol and tobacco, and using seat belts.
"We have to take a look at those issues, and we have to say, `What can we afford?' " Dux said. "We can't have it all and not pay for it."
Boucher said people are concerned about health costs rising 12 percent annually in recent years, and asked Dux if his hospital could get along with increases kept to the levels of inflation.
Dux said any kind of price caps would mean eliminating services and jobs. He said health care costs are increased by technology and government regulations, unlike other goods and services.
"It's not the same, and I think we need to understand that," he said. "If that ends up being part of the package, then I'm going to have to reduce the level of services . . . and I'm going to have to reduce the number of employees that I have." Roger Cooper, president of Smyth County Community Hospital, said his hospital has a shortfall of $2 million a year in reimbursements compared to costs. If employers do not pay for their workers' insurance, he asked, who would?
Boucher said he favored including the size of a business and its financial ability into a sliding scale that would exempt some employers with only a certain number of workers. Informal discussions now under way among Energy and Commerce Committee members are trying to decide what those levels should be.
Other suggestions from those at the meeting included making malpractice reform part of the program and better educating the public on maintaining a healthy lifestyle.
Those attending the meeting represented hospitals in the city of Radford and counties of Montgomery, Wythe, Smyth, Giles and Pulaski.
by CNB