Forum focuses on quality of health care
By Scott Nicholson

A regional forum on health care issues held in Boone Friday revealed that rising costs should inspire changes in both personal behavior and approaches to health care delivery.

The forum, “My Health Is Your Business: Accessing Quality Health Care in Western North Carolina,” took place at the Broyhill Inn & Convention Center and featured about 150 leaders from across the region and was co-sponsored by the Institute for Emerging Issues. and Appalachian State University’s Institute For Health and Human Services. ASU chancellor Kenneth peacock led the meeting, saying the university is committed to meeting health care needs in the region through efforts such as its proposed bachelor’s degree program in nursing. Joe Damore, chief executive officer at Mission Hospital in Asheville, outlined some of the challenges facing modern health care providers, and hospitals in particular. He said the hospital receives about 85 percent of its Medicare billings, gets 75 percent back on Medicaid, and is lucky to collect 25 percent of billings from the uninsured or underinsured. He said Mission Hospital lost $73 million last year on those billings, and said those costs get shifted to all the other patients.

Damore said it was a common practice among hospitals, because though most are non-profit, they can’t afford to operate in the red for long. “Everybody else in America does it because our government underpays,” he said.

Damore also outlined some of the factors contributing to higher health care costs, including the rising costs of new technology, resources and professional salaries. Poor health behaviors of the public are also a major factor, with obesity, smoking, stress and lack of exercise contributing tot he need for more treatment. Unfunded government mandates also add burdens to hospitals.

He said over 20 percent of the population of western North Carolina is uninsured, even though half of those are employed. Retirees moving tot he area are also a factor, which causes an increase in the aging population. Health care costs double at age 65 and double again at age 85, he said, meaning increases in longevity add up to bigger bills.

“Our current trends are not sustainable,” Damore said. He said the region’s residents have a habit of not seeking health care until the problems become serious, which ends up being more expensive to treat. Magnetic resonance imaging and heart catheters are underutilized procedures, which means the equipment is not used much even though it is expensive. He said while most heart catheter procedures nationwide are scheduled in advance, 75 percent of those procedures at his hospital are for urgent care, often in an emergency. “That means people are waiting longer to get care, and that’s not good,” he said.

Damore said a lack of health care education and economic concerns also contributed to delays in seeking treatment. Some areas have a lack or primary care availability, too.

He listed health education leading to a change in personal behaviors as a key way to reduce health care costs. Tobacco was mentioned several times as an undeniable health risk, and Damore said the state had one of the highest gas taxes in the country but also one of the lowest cigarette taxes. Economic development is also important, as manufacturing jobs have left the state and smaller businesses have a tough time funding health insurance. Damore also said the government should adequately fund health care.

Ann Ashley, a human resources officer for the Biltmore Company in Asheville, offered advice on how her company keeps its insurance rates down. She said the company, which operates the famed Biltmore House and Gardens, focused on wellness in the workplace and home, health fairs, and employee programs that promoted weight loss, vaccination and personal responsibility.

By focusing on health awareness, the company has kept its insurance rate increases to two percent per year over the last three years, during a period when most companies are seeing double-digit percentage increases. Ashley expects no increase next year.

“You avoid claims by being preemptive,” she said. “Our belief is that you can get ahead of disease and have employees understand they are ultimately responsible for their health.”

Watauga Medical Center chief executive officer Richard Sparks discussed some of the business aspects of health care, saying there had been a nine-percent decline in employers’ insurance coverage over the last 10 years, and that it costs a family an average of $11,000 a year for health insurance. health care consumes 16 percent of the nation’s gross domestic product.

Sparks said employer-based plans were the backbone of health care coverage, but a service-oriented economy was less like to provide jobs with coverage. He said 43 percent of the state’s hospitals were losing money and 28 percent were breaking even, with $1.5 billion in hospital charges going uncompensated statewide each year.

Sparks also talked about the debilitating effects of stress, which weaken the immune system. He said people live in an individualized but competitive environment, and often live beyond their financial means. He said while universal health care coverage was a timely topic, the immediate steps to lower costs would target specific plans for specific chronic diseases, promote more education and make wise individual health and lifestyle choices.

I believe individual employers, insurers and the health care systems can work together,” he said, urging the audience to “seize the day” and improve their own health.

•Scott Nicholson can be contacted at nicholson@wataugademocrat.com