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Sue G. Brody

National health reform can work for Florida

Last week, Sen. Max Baucus' bill sailed through the Senate Finance Committee and we took an important step toward the most substantive health reform our nation has ever seen.

The debate over the details continues to boil over in Washington. But here in Tampa Bay, we must understand the difference national health reform stands to make for the quality of care we rightfully expect and are able to provide in our local community.

Our informed and engaged opinion about national health reform must be rooted in an understanding of what it means for us, not only as Americans, but as Floridians and residents of our respective cities.

At Bayfront, we understand the crisis of the uninsured. Last year, we provided more than $20 million in uncompensated care. That number continues to rise. According to the Florida Hospital Association, Florida accounts for 10 percent of the nation's uninsured. National reform is expected to reduce Florida's uninsured from 4 million to 2 million, 1 million of whom are excluded from coverage due to immigration status. This significant reduction will make Florida a healthier state, physically and economically. Here's how:

Health care as it exists is more expensive than many of us can successfully afford to receive or provide. Regardless of our individual insurance status, we all pay the price of uncompensated care. As more patients become insured, individual costs of care will decrease and our nation's overall health status will consistently improve.

The plan to insure the nation carries its own significant costs and considerations. But, by comparison, the lives and dollars saved by increasing access, weighed against the investment it takes to do so, is an equation whose answer is evident.

So evident that Bayfront and other hospitals across the country have agreed to join in the financing of national reform to the tune of $155 billion over the next decade. Ten years of rate reductions in Medicare, Medicaid and disproportionate share payments have been pledged by America's hospitals in exchange for legislation that insures 94 percent of the nation.

Such an agreement does not come without pause for a hospital like ours. As a private, not-for-profit facility with razor-thin margins, we will feel those cuts. However, we recognize the immeasurable value of becoming a country where every community is able to provide for its health care needs.

So we stand behind this agreement, but not without firm expectations for reaching those coverage goals and a clear understanding that much work remains. A drop in uncompensated care must be realized before rates are cut. If the coverage target changes, proposed rates must as well.

Sen. Bill Nelson's amendment bringing 200 more physician residency slots to our state is another must-have. More insured means more need for doctors than ever before. Our state's supply of well-trained physicians starts with strong and flourishing residency programs that not only train the doctors of tomorrow, but retain them as important resources in our communities.

Florida's liability litigation climate is another factor that contributes to the high cost of care and can be made better with reform. A multitude of malpractice claims dominate health care delivery in our state. The result: patterns of defensive care that increase costs and discourage specialty and private practice. Liability reform must be governed in a way that protects patients' rights without unduly sacrificing providers' ability to practice.

Outcome-based incentives such as value-based purchasing that rewards hospitals based on performance round out Baucus' plan and make it good for our community. This diversifies the approach to re-engineering our nation's health insurance structure and makes for a quality-driven system that reflects the nation's demands for services.

One of the most promising elements of national reform is the call to action it issues to elected leaders at the local level. While national reform arms our residents with much-needed access, a multitude of local concerns, such as the preservation of services like trauma care and health care disparities, also demand attention.

These answers cannot all be found on Capitol Hill. State government, our county commissions and city councils often set the agenda for such solutions. Our community deserves local answers to this nationwide call-to-care — an equal show of commitment here at home. Health care must be a top priority at every level of public service.

Sue G. Brody is president and chief executive officer of Bayfront Health System, which includes Bayfront Medical Center, a 502-bed, not-for-profit teaching hospital and trauma center in St. Petersburg.

National health reform can work for Florida 10/21/09 [Last modified: Wednesday, October 21, 2009 5:52pm]
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