Local doctors weigh in on Supreme Court's health care decision

BLOOMINGTON (MCT) — Now that health care reform has cleared the constitutional hurdle, political and financial hurdles remain as the law takes effect.

“The decision handed down today increases access to thousands of residents through private insurance and Medicaid,” said Mike Tate, CEO of the Independent Insurance Agents of Illinois. “But it doesn’t do anything to address the cost of health care.”

Ken Natzke, OSF St. Joseph Medical Center’s president and CEO, was “somewhat surprised” by the U.S. Supreme Court ruling Thursday that largely upheld the constitutionality of the Patient Protection and Affordable Care Act. He said the ruling leaves unanswered questions.

But Natzke said the ruling will have little immediate impact on St. Joseph. Illinois hospitals — including St. Joseph and Advocate BroMenn Medical Center — already have been implementing quality improvement and patient safety programs.

Advocate Health Care said in a statement, “We believe focusing on care coordination, prevention, early detection and education is critical to improving health outcomes and reducing costs.”

Dr. Larry Nord, a Bloomington-based orthopedic surgeon, noted health care reform will add 30 million people to Medicaid.

“There is no way that doctors can afford to see 30 million more Medicaid patients,” said Nord, physician representative for 14 Central Illinois counties to the Illinois State Medical Society.

Primary care doctors’ offices are reimbursed $28.35 to see a Medicaid patient for a routine follow-up visit, Nord said. By contrast, doctors’ offices break even when they are reimbursed $67.64 to treat Medicare patients.

Doctors won’t be able to afford to see more Medicaid patients, so they will end up in hospital emergency departments, where care is more expensive, adding to bills that the government and taxpayers pay, he said.

Jim Duffett, executive director of the Campaign for Better Health Care, applauded the court decision, saying it “helps to strengthen our nation’s tattered social fabric and provides hope that constitutional law and democracy matters.”

Duffett noted that an individual can no longer be denied coverage because of a pre-existing medical condition and that young adults may remain on their parents’ insurance until age 26.

Duffett said it’s time for “obstructionists” to “stop their crusade against Obamacare” and begin implementing insurance exchanges.

Tate urged the General Assembly to establish the exchanges, where people may shop for private coverage. “If we don’t do it, the feds will,” he said.

Tate said he hopes exchanges have a role for independent agents.

The law includes funding clinics focused on serving Medicaid patients. That includes the Chestnut Family Health Center, 702 W. Chestnut St., Bloomington.

A part of Chestnut Health Systems, the center last week received a $595,833 grant as a result of the health care law. Chestnut Chief Operating Officer Alan Sender called the Supreme Court’s decision “encouraging.”

Noting that one in five Illinoisans, including one in three Illinois children, may be on Medicaid, Sender said, “When you cut away all the political ranting over this issue, these statistics, which translate into real people who are so often not getting quality health care in our community and our state, is why health providers are glad that the Supreme Court decision will pave the way for continued funding for clinics like Chestnut’s.”