I've been quiet on the topic of Health Reform. Until today. Yesterday's Becker's Hospital Review article Mayo Clinic to give preference to privately insured over Medicaid, Medicare patients raises the issue of changing their internal policy for providing care. The new policy at Mayo for insurer's and providers centers on the preferential treatment of privately insured populations over others. "Mayo's move to slightly shift its payer mix indicates the financial pressures Mayo and other health systems across the nation are facing due in part to federal health reform."1
At present, Health reform is not only a political debacle, but it is also a "Money Game." Why? Healthcare organizations exist with small margins and need to lower costs. But how they lower costs IMHO should not be to improve access and care for the elite at the expense of the poor and elderly. The article quotes Dr. Noseworthy, Mayo Clinic CEO. "We're asking … if the patient has commercial insurance, or they're Medicaid or Medicare patients and they're equal, that we prioritize the commercial insured patients enough so … we can be financially strong at the end of the year to continue to advance, advance our mission," Dr. Noseworthy said in the videotaped speech, according to the report.."2
This quote brings to mind the title of Michael Lewis' book, Moneyball: The Art of Winning an Unfair Game.
Regardless of whether you consider it fair or unfair, if you've ever been without healthcare and required a hospital admission, you know what I'm saying. While in Nursing school, I had a hospital admission that I thought my health insurance at the college would cover. I later learned that it was only a supplemental policy to be used along with parental insurance. Bad for me... I didn't have parental insurance. So, I paid monthly until my portion of what they didn't cover was paid-in-full.
Before the ACA, healthcare for individuals was either nonexistent or tough to obtain. This problem applies particularly to those with pre-existing conditions, like Diabetes, Cancer, Hypertension, etc. What follows may be enormous costs that a patient likely cannot or will not pay. When this situation occurs, hospital costs and insurance premiums rise to balance the equation.
Based on prior experience and knowledge of the ACA, I signed up. Although deductible and premium costs were high, it pales in comparison to costs I would incur if an emergency were to happen. So, to end the story, having health care coverage is better than none at all. We've heard the stories about those who file bankruptcy because they were unable to pay for their health care.
We've heard the recent comments saying that 14 million people would lose health care coverage in 2018, and we also learned that the bill is going back to the storyboard for review and revision. Let's hope the new plan improves access to coverage, reduces premium costs, and provides improved quality of care to individuals both young and old. It's generally accepted that "The Triple Aim" has been a cornerstone of national healthcare policy - let's hope it stays that way.
[1] Ellison, Ayla. "Mayo Clinic to give preference to privately insured over Medicaid, Medicare patients." Becker's Hospital Review. Becker's Healthcare, 16 Mar. 2017. Web. 17 Mar. 2017.
[2] Ibid.