Comments on: SCHIP Wreck: The Destruction of Community Hospitals http://www.healthcarebs.com/2007/08/24/schip-wreck-the-destruction-of-community-hospitals/ Cleaning the Augean Stables of the Health Care Debate Thu, 09 Feb 2012 21:46:38 +0000 http://wordpress.org/?v=2.3.3 By: Catron http://www.healthcarebs.com/2007/08/24/schip-wreck-the-destruction-of-community-hospitals/#comment-6026 Catron Wed, 29 Aug 2007 15:47:38 +0000 http://www.healthcarebs.com/2007/08/24/schip-wreck-the-destruction-of-community-hospitals/#comment-6026 <em>Community not-for-profit hospitals can tap into many resources that private institutions cannot, such as public funding and potential grants (e.g. HPSA designation, critical access status, etc).</em> This is a classic “not-for-profits have magical powers� claim. The notion that a lot of extra money is available to not-for-profits via public funding is largely a myth. And the actual cash an institution gets via HPSA and/or CA designation is pretty insignificant. The ironic thing about your HPSA and CA comment is that the provider shortages such programs address are <em>caused</em> by the kind of government meddling that SCHIP represents. <em>This won’t be the straw that breaks the camel’s back.</em> Oh really? How many industries do you think can remain viable with trends like <a href="http://www.aha.org/aha/content/2005/pdf/05fragilehosps.pdf" rel="nofollow">this</a>? Community not-for-profit hospitals can tap into many resources that private institutions cannot, such as public funding and potential grants (e.g. HPSA designation, critical access status, etc).

This is a classic “not-for-profits have magical powers� claim. The notion that a lot of extra money is available to not-for-profits via public funding is largely a myth.

And the actual cash an institution gets via HPSA and/or CA designation is pretty insignificant. The ironic thing about your HPSA and CA comment is that the provider shortages such programs address are caused by the kind of government meddling that SCHIP represents.

This won’t be the straw that breaks the camel’s back.

Oh really? How many industries do you think can remain viable with trends like this?

]]> By: Dr Scott http://www.healthcarebs.com/2007/08/24/schip-wreck-the-destruction-of-community-hospitals/#comment-6018 Dr Scott Wed, 29 Aug 2007 13:30:27 +0000 http://www.healthcarebs.com/2007/08/24/schip-wreck-the-destruction-of-community-hospitals/#comment-6018 Even if crowd-out were at 100% (and most estimates are 25-50% at most), non-profit hospitals would not be in horrible danger. First, an SCHIP expansion would cover only a few million children nationwide, meaning a small number in each community. Second, pediatrics is never a money-maker for community hospitals, many of which already have to get by on 50-80% Medicaid patients (an additional 5% pediatric Medicaid would not break the bank). Third, community not-for-profit hospitals can tap into many resources that private institutions cannot, such as public funding and potential grants (e.g. HPSA designation, critical access status, etc). Again, this won't be the straw that breaks the camel's back. Finally, many of those wonderful private plans that are supposedly threatened by crowd-out are no treat to hospitals. Increasing numbers of high-deductible plans create logistical difficulties collecting from patients, and many other patients simply go without because they can't afford the high premiums of their employer-sponsored plans. What percent do hospitals actually collect on the uninsured? A number that's inevitably lower than the 80-90% of cost you mention. SCHIP isn't perfect, but it's better than nothing, and it's better than the current so-called "free market." Even if crowd-out were at 100% (and most estimates are 25-50% at most), non-profit hospitals would not be in horrible danger. First, an SCHIP expansion would cover only a few million children nationwide, meaning a small number in each community. Second, pediatrics is never a money-maker for community hospitals, many of which already have to get by on 50-80% Medicaid patients (an additional 5% pediatric Medicaid would not break the bank). Third, community not-for-profit hospitals can tap into many resources that private institutions cannot, such as public funding and potential grants (e.g. HPSA designation, critical access status, etc). Again, this won’t be the straw that breaks the camel’s back.

Finally, many of those wonderful private plans that are supposedly threatened by crowd-out are no treat to hospitals. Increasing numbers of high-deductible plans create logistical difficulties collecting from patients, and many other patients simply go without because they can’t afford the high premiums of their employer-sponsored plans. What percent do hospitals actually collect on the uninsured? A number that’s inevitably lower than the 80-90% of cost you mention.

SCHIP isn’t perfect, but it’s better than nothing, and it’s better than the current so-called “free market.”

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