Tuesday, November 24, 2009

Surprise: ObamaCare Will Bankrupt Hospitals Serving Elderly & Poor, Moody's Says


Urban hospitals that serve large populations of the elderly are going to be in even bigger financial trouble as a result of cuts to Medicare written into the Obamacare bill, so much trouble that they might be forced into closure. Certainly, the added financial pressure will not be good in any case. Most at risk are hospitals in New York City and Texas that are centers for heart surgery and neurosurgery.

Also likely to be forced into closure by Obamacare are community hospitals that serve the poor but aren't subsidized by a larger hospital system.

This information comes from a report recently issued by Moody's Investors Service, which keeps an eye on the financial health of commercial and government entities.

That's a lot of bad news for many poor and elderly patients who need the medical services of hospitals but don't live in more affluent areas. It's also bad news for others in those areas who won't have a convenient community hospital to turn to for even emergency services, and for people who will need heart surgery and neurosurgery.

I've been warning ObamaCare advocates that government care isn't going to be the same care they are used to, only cheaper, available to more people, and absent pain-in-the-neck paperwork. It's going to be a lot more like the VA government-care system, where ordinary hospital care is offered not by community but by region, and veterans commonly have to travel long distances for common tests and procedures like eye exams, x-rays, or physical therapy evaluations that most people expect to get right in their neighborhoods.

From ModernHealthCare.com:
Spending varies across regions, but Moody's noted those ranked as most expensive included mostly urban and densely developed communities and providers there could be targets for reform efforts, as written in the report.

“Attempts to minimize variation in healthcare costs among regions is almost certainly going to involve cuts to Medicare reimbursement to high-cost providers,” according to the report. Stand-alone hospitals without the resources of a system, dependent on referrals and unable to attract insured patients, will be most likely to struggle.

The five most-expensive regions—which are defined as geographic areas in which patients are referred to the same hospitals for major cardiovascular surgery and neurosurgery—are Miami, Fla.; McAllen, Texas; the New York City boroughs of the Bronx and Manhattan; and Harlingen, Texas.
I note that hospitals in the Bronx and Manhattan are among the most expensive to operate and thus at highest risk of taking cuts for services rendered under ObamaCare. That fact makes it even more interesting that residents of those two New York boroughs have been among the strongest supporters of Obama's campaign, election, and policies. The Bronx loved him, and the Manhattan vote for Obama was just about unanimous.

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