November 28, 2014

Elyria
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HEALTH CARE RULING: Area hospitals see no boon from insurance mandate

ELYRIA — The historic Supreme Court ruling that upheld President Barack Obama’s controversial health care reform is being met with mixed emotions in Lorain County by those who are pegged with the responsibility of offering health care to the masses.

In the halls of local institutions like EMH Medical Center in Elyria and Mercy Regional Medical Center, reactions to the high court’s ruling have been along the lines of: The law is not perfect, but a step in the right direction.

“I am not surprised by the Supreme Courts ruling,” said Don Sheldon, EMH Healthcare president and CEO. “I think it’s an appropriate interpretation of the law. What it will do is allow the major changes in health care that we have been working hard at to move forward. I don’t think the health care law as passed is a perfect piece of legislation, but it was very important for the country to begin to act on the challenge of providing health care coverage for everyone and controlling the cost.”

Sheldon said he knows firsthand the astronomical costs of caring for the uninsured.

In 2011, the amount of uncompensated care the hospital reported was close to $46 million. It’s a figure that has increased by at least $4 million every year for the past several years, he said.

“It is merely a reflection of the economy, not just regional and nationally, but also globally,” Sheldon said. “We continue to see a rise in the number of uninsured, and it puts a significant challenge on our overall budget and our core goal of fulfilling our mission to the community.”

Ed Oley, Mercy’s president and CEO, said the health care reform law will not improve the bottom line of hospitals such as his, where uncompensated care topped $22 million in 2011 and is projected to surpass $25 million this year. Instead, the net effect will be less revenue in hospital coffers although more patients will be insured.

“It is certainly going to provide additional access to groups in our community, to populations in our community that did not have access to health coverage, and we believe that is a good thing,” Oley said. “But the mandate now has to be paid for, and to be able to fund it, we expect over time fairly substantial reductions in the reimbursements of the services we provide today.”

Sheldon said he likewise expects a future where more people are covered, but hospitals will see less money.

“In the end, the federal government also has a limit to the amount of money they have,” he said. “In order to provide this additional coverage to million of Americans without breaking the bank will mean that a large amount will come from decreased reimbursements. On the one hand, more people who walk in the door will have coverage, but on the other hand, you will receive less money for caring for them.”

Sheldon and Oley both said the trend has been moving in that direction for years, and both have taken steps to protect their organizations.

“Everyone has been working on finding ways to provide the highest quality of care at the lowest possible cost,” Sheldon said. “We have been working on that well before this legislation passed. That is the key to success for any health care organization. If you can accomplish that and — in addition — do that in a caring and compassionate way, you have the best chance for long-term success.”

“We have been obsessed over the past few years in controlling our costs,” Oley added. “Irregardless of the vote (Thursday), there were many components of health care reform that were put into motion in the last two or three years that was going to change the way we care for patients today and in the future.”

Speaking of the future, Sheldon said he knows the Supreme Court’s ruling will not end the fierce debate on how health care should be reformed in this country. But in a nation where reportedly 30 million Americans are uninsured, ignoring the problem would be disastrous, he said.

“Health care costs have continued to go up in this country for years and it has become a significant burden in this country,” he said. “Not to attempt to change that course will be irresponsible. Even though I disagree with portions of the law that has been passed, I know it’s the right thing to do to work on solving the problem.

“To think we would get it perfect the first time around is ridiculous,” Sheldon said. “But now we must take the legislation and law we have and have the courage to work on it so the final solution, which will take years to come to fruition, is coverage for all and affordability to the country.”

Contact Lisa Roberson at 329-7121 or lroberson@chroniclet.com.