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Friday, July 3, 2009
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Health care officials point to pain from Pawlenty budget cuts
Associate Editor Area health officials told state lawmakers Thursday how their institutions will be affected by the March 1 elimination of a state medical assistance program for low-income patients without private insurance.
The General Assistance Medical Care program was among the unallotment cuts Gov. Tim Pawlenty made in order to balance the budget after he and lawmakers failed to reach agreement.
The discussion Thursday took place before members of the Minnesota House Health Care and Human Services Policy and Oversight Committee at St. Joseph's Hospital in Brainerd.
Dr. David Boran, chief medical officer of the Brainerd Lakes Health System, said St. Joseph's Medical Center cared for 530 GAMC patients this year. Sixty-two percent were seen in the Emergency Department and 20 percent of the 530 patients were admitted to the hospital. He said the gross charges for these patients exceeded $2.8 million. After partial reimbursements are made by the state the hospital costs are $1,093,259, resulting in subsidy of $420,00 to care for these patients.
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Crow Wing County Community Services Director Susan Beck told legislators Thursday that the typical General Assistance Medical Care recipient earns less than $696 a month as Rep. John Ward, DFL-Brainerd, listened. Brainerd Dispatch/Steve Kohls
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The GAMC patients, Boran said, are primarily very low-income adults between the ages of 21-64, without children. They often suffer from chronic health problems such as diabetes mellitus, AIDS, heart disease, chronic mental illness or chemical dependency.
Boran noted that as a result of the governor's veto $18 million in federal revenue in Fiscal Year 2011 will be lost across the state. This year, he said, St. Joseph's Medical Center will receive $650,000 in Medicare payments for providing a "Disproportionate Share" of care to the poor.
"This plan is penny-wise and pound-foolish," he said of the veto that will also result in the loss of federal matching funds.
"Minnesotans who pay federal income taxes will, in effect, be subsidizing the Medicaid programs in all those other states that do not cut their Medicaid funding," he said.
He said the cost shifting that's part of the health care system - charging those with private insurance more to underwrite the cost of government programs - is a hidden tax.
"This cannot go on," he said. "Employers in Brainerd and elsewhere are stretched to the limit," he said. Some can no longer afford to provide health insurance for their own employees, let alone underwrite the cost for others. Brainerd Lakes Health is unable to underwrite additional costs."
Jani Wiebolt, president of St. Joseph's Medical Center, said the hospital has implemented a wage freeze, a hiring freeze and has had workforce reductions. She said St. Joseph's average daily census is 70 patients and noted that there are four hospitals within a 35-mile radius.
Susan Beck, Crow Wing County Community Services director, said the budget cuts would unravel the current health system and force more people to the emergency rooms for health care.
"We're very reliant on the services of St. Joe's," she said. "Without St. Joe's we lose a huge piece of the mental health puzzle."
While Beck said she didn't have a simple solution she told the panel care coordination would be a part of the answer. The needs of GAMC patients often include housing, employment, mental health and medical, she said.
Rep. John Ward, DFL-Brainerd, discussed the good work being done by the Region 5 Adult Mental Health Initiative.
Wiebolt said the hospital has not planned another round of layoffs. She said whatever cuts might come would likely be in the supervisory and support areas rather than "care at the bed side."
Rep. Erin Murphy, DFL-St. Paul, said "If we don't solve this problem hospitals are going to take a financial hit."
Rep. Paul Thissen, DFL-Minneapolis, said an integration of services that would provide ongoing support in such areas as housing, might be part of the solution. Before March, he said after the meeting, he hoped that a different model of GAMC can be structured with an existing revenue source or reform proposals can be initiated that might lead to refunding of the program.
"It's clear ... just eliminating health care coverage is not the way to get there," he said during the meeting.
Other lawmakers who attended the committee meeting were Rep. Al Doty, DFL-Royalton, Rep. Karla Bigham, DFL-Cottage Grove, Rep. Tom Huntley, DFL-Duluth.
MIKE O'ROURKE may be reached at mike.orourke@brainerddispatch.com or 855-5860.
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