Ailing hospitals
The financial reports are in for local hospitals. The news isn’t good. Uniontown, Highlands, Brownsville General, Frick and Greene County Memorial hospitals continue to spend more money treating patients than they are paid for those services. If it weren’t for investments that have little to do with caring for patients, the red ink would run deeper, according to the Pennsylvania Health Care Cost Containment Council. The figures came as no surprise to those who run the hospitals. Highlands Hospital in Connellsville posted the worst operating margin of -9.69 percent, which means for every $100 it spent treating patients, it received about $90 reimbursement.
These kind of negative numbers can and do lead to cutbacks in services. Look to Brownsville General, which has a -4.53 percent average margin during the past three years, for an example. The hospital closed several wards and is now banking that an expanded mental health ward will be its fiscal salvation.
A combination of things contributes to the poor fiscal health of these hospitals, including ever-escalating costs for staff, insurances (most notably malpractice premiums) equipment and constantly evolving treatments.
However, the main problem identified by the hospitals is poor or nonexistent reimbursements. Medicare and Medicaid haven’t paid the hospitals the full amount that it costs to treat patients who are enrolled in these government-subsidized insurance plans. There is the possibility reimbursements will improve as hospitals stand to gain better rates through the mega Medicare bill that Congress recently enacted.
As welcome as those funds will be, that won’t entirely solve the problem in impoverished areas such as Fayette and Greene. One of the main cripplers for hospitals is that poor, uninsured people use the emergency room as their personal care physician.
By federal law the hospitals can’t turn away people seeking treatment. But far too often the waiting and exam rooms are crowded with patients complaining of flu and minor ailments that could better be treated by family doctors.
The people lining the ERs with minor health problems rather than emergency ailments either don’t want to or can’t pay to see a doctor when they can get “free” care at the hospital. Someone has to treat these patients, and someone has to pay the bill. The hospitals carry these as charity cases, and our local hospitals do a tremendous amount of this, far more than the state average. But this just leads to tighter operating budgets and less money to invest in staff, training and equipment.
While universal access to affordable health insurance would certainly solve the problem, it isn’t going to happen. Rather than wait for a federal or state solution, local health officials could pool resources to look at more cost-effective ways – perhaps with low-cost or free clinics – to provide health care to the uninsured. There has to be a better way than continuing to drain hospital resources. If the financial trend of recent years were to continue unabated, it wouldn’t be that difficult to imagine losing one of our local hospitals.
We would welcome ideas and suggestions, especially from those in the health-care field. Send your comments to the address listed below.