Healthcare reform may be the most polarizing issue today. Depending
on your point of view, you are either eagerly anticipating or just dreading the
changes that are happening. Either way, we can all agree there is profound upheaval
in the system. We are in the middle of an earthquake waiting for the ground to
stop shaking.
While the focus on Obamacare has been on the individual’s
access to healthcare, we need to remember that our hospitals are feeling the
earth move underneath them as well. When hospitals are merely trying to survive
may not the best time to consider what a hospital is and does, but I believe it
is exactly when we need to take a step back and focus on mission.
A hospital is, first and foremost, an institution to take
care of the sick. The Latin root for hospital is the same root for hospice and
hospitality. Hospices in the Middle Ages were way stations for pilgrims who
needed a place to rest/ Today, hospices are known for end-of-life care for
those on their final journey. And the word hospitality denotes kindness and
generosity. What a great family or words! Hospitals should provide comfort for
travelers on a journey – a journey from illness to wellness. And that
hospitality should be extended to all.
We, as a country, have decided that healthcare is not a
universal right, in that not everyone (even under Obamacare) will have free
care. Yet, we can’t seem to decide what level of individual responsibility (either
in terms of healthy lifestyle choices, like smoking, for example, or huge
deductibles which the average person cannot afford) goes along with whatever
care we do receive. That leaves us with a broken system of inflated billing and
inadequate reimbursement that continues to leave a good number of our sick not
only without resources but with outrageous bills.
And, unfortunately, the government is placing more and more
burden on the hospital to make sure that patients not only receive high quality
care in the hospital, but are taking their medicine and seeing their doctor
once they are back at home. The hospital is now supposed to be Big Brother. If
a patient is readmitted to the hospital too soon after being discharged, the
hospital does not get paid for that stay, even if it was because the patient
was noncompliant with their own care outside the hospital. One can argue the
fairness of regulations such as this, but all hospitals are required to play
the same game now, and some will be better at it than others.
I would argue, some will have better results than others in
the new quality outcomes paradigm because they “cherry pick” their patients
based on ability to pay. That brings me to my main point: We must not let a
divided system of care (non-profit versus for-profit) keep the sick from
accessing care.
As a non-profit institution, Memorial has a mission to
provide care for all, regardless of ability to pay. In an era of declining
reimbursement, for-profit institutions – who report to investors – are
increasingly turning away those without insurance (except in emergency
situations, where federal law requires care to be administered to stabilize a
patient). All hospitals operate on a tight margin, and non-profit hospitals
(especially those outside of metropolitan markets) are increasingly feeling the
pinch. We in Lufkin have an ongoing obligation
to provide non-profit care locally so that OUR mission of compassion in Lufkin can continue. It
is what our community forefathers established. It is what hospitality demands.
