vision2020
Re: Hospital Consolidation
Costs of surgery at the new facility would most likely be
lower because the types of surgery they will do are the most
profitable. That is the reason the specialists want the
facility. They can make more money separate from the
hospital.
This will be hard on the hospital's because these "high value"
outpatient surgeries subsidize other activities at the hospitals.
It's especially bad given the Hospital's current medicare squeeze.
David
At 10:21 AM 12/17/99 -0800, you wrote:
>For me, the question still remains - will the cost of surgery at
the
>proposed facility be higher than it would be if done currently at
Gritman
>or at Pullman? Is that a valid concern? Lori
>
>
>At 09:58 AM 12/17/1999 -0800, you wrote:
>>I believe there are two answers to your question.
>>First costs are averaged. That is the charge for outpatient
surgery, such
>>as arthroscopic knee surgery, is higher to help offset the cost
of quadruple
>>bypass surgery.
>>Second, Those who can pay, or have insurance that pays, pay
higher charges
>>to cover the costs of those less fortunate. By only taking
those patients
>>who can pay, or who have insurance that can pay, charges can be
lowered.
>>
>>John
>>
>>John and Laurie Danahy
>>jdanahy@turbonet.com
>>----- Original Message -----
>>From: Lori Keenan <lkeenan@norby.latah.lib.id.us>
>>To: John and Laurie Danahy <JDANAHY@turbonet.com>;
<vision2020@moscow.com>
>>Sent: Friday, December 17, 1999 9:50 AM
>>Subject: Re: Hospital Consolidation
>>
>>
>>> John,
>>>
>>> Thank you for summarizing so well the very complicated issue
hospital and
>>> new surgery unit issues.
>>>
>>> I have a question (one of many) about the proposed surgery
unit in the
>>> corridor - how can it promise to offer surgery at a lower
cost if it needs
>>> to recoup the expense of building a new facility? Am I
missing something
>>> important here?
>>>
>>> Lori Keenan
>>>
>>>
>>> At 09:23 AM 12/17/1999 -0800, you wrote:
>>> >Based on what I have read and heard, it seems to me that
there are two
>>> >issues to be debated.
>>> >
>>> >First is should the two communities consolidate the
regional medical
>>> >facilities into one in the corridor at a cost of $34
million dollars.
>>> >Certainly Pullman needs to replace its failing
facility. Unfortunately,
>>> >local voters turned down bonds that would have provided
relief from their
>>> >current situation. Moscow does not need to replace
its current facility,
>>> >however, expansion seems to be severely limited unless
Gritman can
>>purchase
>>> >more of the downtown area.
>>> >How to finance a proposed merged medical facility in the
corridor has not
>>> >been fully explained. Gritman is a non profit
private enterprise, as
>>such
>>> >it has, I believe, no taxing authority. Any part
of the $34 million it
>>had
>>> >to pay would have to come from somewhere. Pullman
apparently does have
>>some
>>> >taxing authority and can ask for financial help from its
voters. The two
>>> >states have very different tax based structures and I do
not see how we
>>can
>>> >create a merged financial package that is fair to
all. Also a merged
>>> >facility in the corridor presents transportation
concerns to all. From
>>my
>>> >perspective, the city of Moscow would soon see bypass
roads developed so
>>> >patients could get to the merged facility without having
to traverse
>>> >downtown Moscow. This creates secondary negative
impacts to the downtown
>>> >community.
>>> >The idea that the two communities merge into Gritman
seems to have merit
>>up
>>> >front. Pullman however, does not want to transport
across the corridor
>>and
>>> >really does not want to lose some of its identity.
Clarkston is a
>>separate
>>> >city, but often seems a suburb of Lewiston.
Pullman does not want to end
>>up
>>> >the same. Again too, Gritman would need to expand
its facility,
>>something
>>> >that at present it is unable to do, unless it creates a
satellite
>>facility
>>> >in another location, but then we are back to the $34
million dollar
>>> >question.
>>> >
>>> >The second issue that has surfaced is the questions of a
group of local
>>> >doctors building a private out patient surgical facility
in the corridor.
>>> >This facility would offer lower cost out patient
surgeries, be run as a
>>for
>>> >profit private enterprise, and give the medical
professionals some
>>freedoms
>>> >in their practice. This would operate by taking
the "cream" of local out
>>> >patient surgeries from the local hospitals, offering
them at a "lower
>>cost"
>>> >since they would not have to subsidize higher cost
surgeries, leaving the
>>> >hospitals with no choice but to raise charges for what
is left.
>>> >At first glance, this seems to be a neat idea. It
would create
>>competition,
>>> >and lower medical costs to consumers, but I remind
everyone of Robert
>>> >Heinlein's TANSTAAFL There ain't no such thing as
a free lunch. Lower
>>> >costs for some out patient surgeries just means higher
costs for others.
>>I
>>> >would also wonder how the medical insurance industry
would view this.
>>> >Having some experience crossing state lines with
insurance companies, it
>>> >does seem to severely complicate an already complicated
system.
>>> >
>>> >Just some thoughts
>>> >
>>> >John
>>> >
>>> >John and Laurie Danahy
>>> >jdanahy@turbonet.com
>>> >>
>>> >
>>> >
>>>
>>
>>
David Nelson
Nelson & Roseme, Inc.
Phone 208 883-7699
FAX 208 882-8143
Email dnelson@dnai.com
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