Critical issues will face the new U.S.
President. Restoring the economy,
ensuring national security and bringing America together are high priorities.
“Americans depend on hospitals to be there
24/7, providing the right care at the right
time,” says Barry Arbuckle, Ph.D., president
and CEO, MemorialCare Medical Centers,
and chair, California Hospital Association.
Smart Business spoke with Arbuckle
about what advice he’d give the new president on fixing the nation’s health system,
which is now on the critical list.
What would you tell the president?
Health care is among our fastest growing
industries, leading the nation in job creation.
But most hospitals operate on the financial
edge as demand for care rises and expectations increase. Hundreds have closed. Those
surviving create a strong community
resource despite a difficult environment.
While balancing the budget, the president
and Congress cannot further strain the health
system. Many substantial challenges faced by
hospitals must be addressed at the federal
level where solutions are economically and
politically difficult. We can achieve better
health and better health care, knowing the
only interest that is special is the public interest. Protecting America’s health is vital to all
our futures.
What are the critical issues?
Extending coverage to tens of millions
uninsured and underinsured must be
addressed strategically and swiftly in realistic
steps and timeframes. More Americans
worry about health costs than losing their
jobs or paying rent. Universal coverage
requires universal responsibility for financing, utilization and delivery shared by
employers, government, health plans,
providers, physicians and patients. If reform
focuses solely on this issue, Americans will
still deal with a needlessly complex, inefficient, uncoordinated and dysfunctional system. Hospitals face thickets of inexplicable
regulations, bureaucracy and unfunded mandates. Red tape, administrative requirements
and barriers to government programs and
private coverage must be minimized
How can the new president respond?
He has a unique opportunity to reshape
health care. He can start by permanently re-enacting the Children’s Health Insurance
Program. If we believe in educating every
child, we should ensure they’re healthy
enough to learn. As federal deficits are
addressed, no further cuts can be made to
Medicare and Medicaid. Reduced government reimbursement means less hospitals
caring for communities and continued cost
shifting to the private sector — further stressing American businesses struggling to compete in a global economy. Funding and payments must be sufficient to support quality
care, technology, drugs, procedures, knowledge and evolving standards of practice.
What are some local examples?
Medi-Cal is critical to the health of millions
of Californians, but government payments
are woefully inadequate. In 2007, it cost hospitals $3 billion more to treat Medi-Cal
patients than received. While the Federal
Emergency Medical Treatment and Labor
Act requires hospitals to guarantee treatment
to anyone seeking immediate, necessary
emergency care, it’s unfunded. California
hospitals provided $9.7 billion in uncompen-sated care in 2007. Solutions to health care
access must identify ways to pay for it.
What else should be addressed?
Since good health is critical to a productive
and vibrant America, let’s encourage wellness in homes, schools, workplaces and
communities. We must spend limited
resources on care, not paperwork. Colleges
lack capacity to address shortages in nursing
and health professions. Let’s remove lobby-ist-influenced regulation that increases
health costs — like Medicare legislation precluding the federal government from negotiating drug costs for those it insures. We’re the
only developed nation where that’s the case
— and our costs are higher as a result.
What role does quality play?
Teams of MemorialCare physicians and
health professionals continually identify best
practices and cost effective treatments that
are being implemented nationally. Quality
care means adopting health information
technology that addresses financial, regulatory and technological barriers, including inter-operability and standardization.
What can employers do?
Encourage elected officials to enact reform
that increases numbers of insured, reduces
regulations, improves reimbursement and
focuses on wellness. Costs can be reduced
through workplace screening and prevention. Ask federal and state government leaders to partner with employers, insurers,
health providers, community programs and
the private sector to promote health and prevent disease. The goal should be that when
people need quality health care, they will
enter a system that is efficient, affordable and
accessible to all.
BARRY ARBUCKLE, Ph.D., is president and CEO of MemorialCareMedical Centers (www.memorialcare.org) and chair of the California
Hospital Association. Reach him at [email protected] or (562) 933-9708. MemorialCare Medical Centers include Saddleback
Memorial Medical Center in Laguna Hills and San Clemente, Orange Coast Memorial Medical Center in Fountain Valley, Anaheim
Memorial Medical Center, Long Beach Memorial Medical Center and Miller Children’s Hospital in Long Beach.
