Live Blog: Healthcare Conference: Public Policy Institute at JU

[TheCat]

Jim O'Loughlin speaks first:

Begins to describe the historical context to help frame what is happening today.

1940s - During the war there were wage controls to prevent inflation. So, employers added health benefits to recruit employees.

1960s - congress recognized the short comings of employer based insurance. The elderly, poor and women were largely left out. Medicare/Medicaid created.

1980s - Reagon required hospitals to under the Emergency Medical Treatment and Active Labor Act (EMTALA) to provide care to every patient seeking care regardless of their ability to pay.

The policy decisions have created gaps:

- 3.9 million of floridians have no insurance.
- majority are low-income working families
- 38% are below the poverty level.
- 60% have at least one full time worker in the family.


Medicaid Expansion:

- by 2014 states may extend medicaid eligibility to all legal residents.

[TheCat]

Hugh Greene, CEO of Baptist Health is speaking:

http://issuu.com/arashkamiar/docs/ju_ppi_healthcare_policy_conference_31243d157102b2

The 7 Assumptions for Health Care's Future according to Hugh Greene, CEO of Baptist Health:

1. Change is inevitable. That status quo is not sustainable.
2. Delivery system changes, including payment methodology will occur. Pay for performance is here to stay.
3. Consumerism in health care will continue to rise with greater transparency of price and outcomes.
4. Greater provider accountability for performance related to quality
5. Greater integration of health care providers.
6. Major shortage of physicians and other clinical staff. 1) New demand as more people are covered 2) as the population ages more people need care 3) medical workforce is getting older/retiring.
7. Health care will remain vibrant in the local economy, and US health care will remain among the best in the world.

[TheCat]

We are being warned that the next presentation is controversial.

Moody Chisholm, CEO of St. Vincent's Healthcare is speaking:

St. Vincent is committed to the care of all persons and that is backed by our Catholic Values regardless of their stage in life. "Everyone has inherent dignity and the RIGHT to healthcare."

We are supportive of aspects of this very flawed bill.

From our perspective we do not need expansion of medicare but we do need meaningful expansion of coverage.

77% of the uninsured are employed and, they are all jobs that we depend on as an economy (aside from their inherent worth).

With Medicaid we have adverse selection. Those that sign up are in the midst of healthcare expenses. We are going to pick up that tab one way or the other.

Medicaid is split with Fedieral government.

The costs of expansion from 2014 - 2021, $51 Billion by federal government and $3 billion by state.

Just the sales tax from federal funding and economic stimulus will create more than enough money to pay for the states share.

See the presentation on the link

http://issuu.com/arashkamiar/docs/ju_ppi_healthcare_policy_conference_1e51d5ab45d592

Moody challenges Weatherford and advocates an expansion of coverage in a meaningful way.

[TheCat]

We're onto Russ Armistead, CEO of UF Health

Presentation:

http://issuu.com/arashkamiar/docs/ju_ppi_healthcare_policy_conference_938c16056c95ff

[TheCat]

Armistead is focused on his actual job function:

UF is a "safety net hospital" . These are places that see more people who are uninsured or can't pay. We are the canary in the mines. If we go trouble is coming. We have the least amount of cash on hand. About 30 days worth of operating cash. So, we are a signal to other hospitals.

What is UF Health:

Owned by the city and operated by UF Health Jacksonville.
5th largest employer in jax.
Low cost

Funding down 43% or 27million as compared to 2008.

[TheCat]

Next Up is Bill Rupp, CEO of Mayo Clinic

The world is not about to end in healthcare.

Shows that the cost of medicare per recipient is vastly different per state in La Crosse, WI , $6k.  In Miami, $17k.

Developing "Mayo Clinic Care Network" which is essentially a selling of their knowledge to hospitals.

[TheCat]

lack of price clarity is going to go away. Admits that hospital pricing is meaningless "we get paid all sorts of prices by different insurance companies"

[TheCat]

We're at the start of our first session. Joseph R. Antos of the American Enterprise Institute is speaking.

Repeats what has been said in prior presentations...the website is the least of our worries.

The current law went out of its way to not to disturb anything which is problem when we are facing the issues we are facing...to fix them there will have to be a shaking.

This is his presentation:

http://issuu.com/arashkamiar/docs/ju_ppi_healthcare_policy_conference_042caef6d01eca

[TheCat]

Medicaid Expansion:

is it a no brainer?

"cheap" is not free.

lower federal payment for enrollees out of the woodwork.

the uninsured remain with us  - and DSH is cu

coverage does not equal appropriate care

a deal is not necessarily a deal.

[TheCat]

Antos is doing a bit of "sky is falling" .

Medicaid fosters dependency. Instead, promote a sense of ownership and responsibility. Allow Medicaid to provide bridge financing for those who are temporality uninsured. Promote main-stream coverage (premium assistance for employer-sponsored insurance.

[TheCat]

Antos:

The New Norms, 2017 and beyond

- informed choice of health plans
- wider acceptance of fixed subsidies
- tighter networks
- non-physician practitioners, telemedicine
- smarter prevention

The Old Standbys

- Employer coverage remains dominant
- Medicaid reform depends on states, not feds
- Medicare continues to struggle with the new reality.

[TheCat]

Dawn Emerick

CEO of Health Planning Council. 7 county organization. Starts speech. I was once a user of medicaid and I was really happy to have access to it as a single mother when I needed it.

Her presentation:

http://issuu.com/arashkamiar/docs/ju_ppi_healthcare_policy_conference_f5e8fdb04d0dd8

[TheCat]

Emerick:

Insurance is just one piece of health.

USA is 72 in health system performance.

We spend 7.5k per person on health care in the us.

49 million people are uninsured in the USA.

In NE Florida total uninsured are 335k.

**take a look through Emerick's slides. Good charts to study. **

[TheCat]

A donut hole will exist in NEFL if we do not expand medicaid.

Emerick encourages us to google "Oregon Medicaid Study". She disagrees that the study says that the medicaid option fails.

Oregon had enough money for 10k but they had 90k people eligible. They did a lottery and studied the 10k who enrolled. They compared the 10k people to private insurers and found that the health of the people were the same. They also found that those people on Medicaid sought medical attention more often than private insurers. The question, Emerick, says, why did those on Medicaid need to keep going back. This study is about the quality of care not the quantity of care.

[TheCat]

CEO of Haskell, Steve Halverson presenting.

He is the last speaker. His focus is to provide a business perspective on health care. Says "I'm not a doctor or a health care person, I think that nothing changes without a disruption."

Our healthcare system is a profoundly broken system.

The healthcare system has reached a breaking point.

The state is somewhat hostile to healthcare providers. 21% of the state do not have coverage. That is unusually high.

We already have a system of universal healthcare it is called the emergency room.