Editorial Cartoon by David Horsey

America's Hospitals Can't Afford Healthcare Cuts Obama, Congress Are Considering: They're suffering already

Rich Umbdenstock is president and CEO of the American Hospital Association.

It promises to be a very hot summer in Washington as the health reform debate takes center stage and various options are discussed.

We must not lose sight of the fact that we will need good policy changes -- not just payment cuts -- if we hope to find long-term solutions to the healthcare challenges vexing America: 46 million uninsured, an aging population, an epidemic of obesity and chronic disease and the need for a more coordinated system of care.

The men and women working in America's hospitals see the challenges we face and the opportunities for change that are needed. Providing coverage to our nation's uninsured is vitally important and a goal that hospitals support strongly. And there are reforms that must take place: lasting changes that emphasize wellness and prevention; removing the barriers to hospitals, physicians, nurses, and other caregivers to working together to better coordinate care for patients; and allowing caregivers to remain focused on improving patient care -- not on navigating a complex, red tape-ridden system. And the best part about these solid policy changes is that they all have associated cost savings.

These are the changes hospitals strongly support.

What hospitals cannot support, and hospitals cannot sustain, are budget cuts on the magnitude of nearly a quarter trillion dollars.

Cuts in the government programs that serve our nation's seniors, disabled, poor, and children to the levels that are being discussed would put in jeopardy the many services on which communities rely. Specifically, gutting the Disproportionate Share Hospital programs under Medicare and Medicaid as President Obama recently proposed -- programs designed to help hospitals care for large numbers of uninsured and that help make up for government underfunding -- and doing so before coverage has been activated could threaten further the ability of hospitals to provide care.

For those hospitals that will continue to care for large numbers of Medicaid patients, these reductions will have a devastating impact.

Blunt cuts are not the reform our nation needs.

Hospitals recognize and agree that care must become more affordable, and hospitals are taking steps within their organizations -- without legislation -- to do their part to make changes that improve patient care and save costs. We applaud these hospitals and are working to spread their learnings throughout the nation.

Make no mistake -- many of America's hospitals will not be able to withstand the cuts that the administration and the Congress are considering.

They already are experiencing increases in charity care and nonpayment for services as the economic downturn affects more and more Americans and their employer-provided insurance coverage. The public will judge reform efforts on whether such changes improve care for themselves and their families and will support the organizations and caregivers they depend upon to deliver needed healthcare.

We urge the administration and Congress to adopt thoughtful reform that addresses the underlying challenges our nation faces.

Our communities and patients depend upon it.

Day of Reckoning at Hand for Health Insurers
by Robyn Blumner

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Healthcare Reform Estimates Have Democrats on Defensive
by Kent Garber

The inciting spark was the Congressional Budget Office's released of preliminary estimates on the costs of the two main Senate bills. Kennedy's was tagged at $1 trillion. The other, being developed by Finance Committee Chairman Max Baucus, would cost $1.6 trillion.

Uwe Reinhardt: Plain Talk on Healthcare Reform
by Bernadine Healy M.D.

If there were a Straight Talk Express for health economists, Princeton professor Uwe Reinhardt would be the engineer. Born in Germany and raised in Canada, Professor Reinhardt has personally experienced medical systems in different countries. Over the past 25 years, he has become a critical voice in the debate about reforming America's healthcare system.

Employers to Make Deeper Cuts in 2010 Health Coverage
by Martha Lynn Carver

Look for employers to cut more deeply than ever into health care coverage for their workers in 2010. Companies are getting walloped by higher than expected costs just when they can least afford it.

When Healthcare Reform Hits Grandma
by Bernadine Healy M.D.

Obama has laid the groundwork for a massive overhaul of America's healthcare system into a more publicly managed, cost-conscious enterprise that focuses more on wellness than sickness. Driving most government outlays, however, are the many millions of Americans, particularly the elderly, with extremely resource-intensive chronic diseases.

However, what's tried and true, is the government's power to restrict reimbursement and change medical behavior. Medicare, which covers virtually all of the elderly, can say "No" to expensive treatments. That's great if the care is unnecessary. But you can't always tell if you're not at the bedside.

Government-run Healthcare Insurance-Program Sure to Backfire
by Phil Gingrey, M.D.

My fear is that creating a government-run health insurance plan wouldn't guarantee quality care by physicians -- in fact, it will not guarantee care at all. The quality of care in a government-run health plan may seem irrelevant to those individuals who are happy with the coverage they currently have -- after all, President Obama promised during his campaign that, "If you like the plan you have, you can keep it." But most individuals don't really have their own health coverage -- they get it from their employers.

Obama's Uphill Battle to Reform Healthcare
by Kent Garber

President Obama stood at a podium flanked by six healthcare leaders and announced what he called "a watershed event in the long and elusive quest for healthcare reform." Obama, by almost any account, had just scored what appeared to be a major concession from several of the country's biggest healthcare players.

Obama's Hidden Business Tax Increase
by Matthew Bandyk

Obama's proposal would require companies to account for their inventories on a first-in-first-out (FIFO) basis rather than a last-in-first-out (LIFO) one -- an eye-glazing change that's highly significant. In an era of rising costs, to assume that you're selling your oldest inventory rather than your newest increases reported profits and thus taxes, even though nothing real has changed. If inflation turns worse, as many analysts predict, FIFO would force companies to pay real taxes on phantom profits as the value of goods gets inflated while they sit in inventory.

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(c) 2009 U.S. News & World Report