Even though Congress enacted legislation Dec. 23 that would postpone Medicare cuts for doctors at least two months, Kevin Dahill fears the worst.
“Over the next ten years, NorMet member hospitals can expect to see $1.4 billion in cuts under” the Patient Protection and Affordable Care Act, said Dahill, president/CEO of both the Northern Metropolitan Hospital Association (NorMet) and the Nassau-Suffolk Hospital Council
Hospitals are already reeling from the cuts in Medicare reimbursement and the demand for services, he said, pointing to layoffs at Westchester Medical Center in Valhalla.
The Suburban Hospital Alliance of New York State (SHANYS) is working in Washington, D.C., to get relief for the Hudson Valley”™s and Long Island”™s 53-member hospitals, Dahill said.
Dahill made his comments at a Rockland Business Association luncheon last month at the Sheraton Mahwah.
Medicare, a program enacted in the 1960s “promised health care for those 65 or over who became severely disabled to be covered. The problem is, the government found it has not put enough away to cover the promise it made. We were supposed to die at 72. …We didn”™t keep our end of the bargain ”“ we live much longer.”
The whole notion of “death panels” the public feared under the Affordable Care Act does not exist, said Dahill, but it served to underscore the real issue of end-of-life care.
“Too many people are dying in the intensive care unit… 89 percent of Medicare dollars are spent on 20 percent of beneficiaries in the last two years of life.
In regard to the Affordable Care Act, “Those who endorsed it saw it as a means to cover people who were uninsured. …but the uninsured in New York are not legal, and they are not going to come forward to get insurance,” Dahill said.
It will change the way small business does business.
“Because of the health care insurance exchanges, companies with more than 50 employees may decide to cut a few jobs so they won”™t be compelled to go into the exchange system,” he said. “Others will simply ignore it and pay the fines rather than force employees to get health care they don”™t want.”
Either way, 2012 will be the tipping point for the Affordable Care Act. “It is 2,000 pages long and most of the members of Congress that supported it did not even know what they were signing up for. …the matter will be in front of the Supreme Court in March. …and depending on the outcome of the 2012 election, we may not see many of PCA”™s components come to pass… if any at all.”
While New York has been far more generous than other states in giving Medicaid, the cost burden has overwhelmed the municipalities to the point that they cannot cover other needed support to other areas. “Health care spending is through the roof, but care is not being rendered the way it should be.”
Hospital, health care providers and physicians must find ways to consolidate.
“It”™s already happening,” he said. “We are seeing many doctors grouping together to provide services, such as Mount Kisco Medical Group and Crystal Run Healthcare, or doctors joining hospital staffs.”
After looking at national health care in England, Dahill said he prefers the competitiveness of America”™s health care system, with a proviso, “We need to change the way we transact business.”
Total payroll and purchases of NorMet hospitals: $8.3 billion
State and local income sales taxes: $298 million
Number of jobs:Â 50,490
Source: NorMet
