Badin vs. Fredericktown
Miamisburg graduation 2012
Valley View vs. Greenville
Ellen Belcher is the Dayton Daily News opinion pages editor. She writes about state government, education, the environment, higher education and all things Dayton.
Martin Gottlieb is an editorial writer and columnist for the Dayton Daily News opinion pages. He focuses on the political process itself and does such national issues as war, the economy, taxes and Social Security, as well as a hodge-podge of local and state issues.Home > Blogs > A Matter of Opinion > Archives > 2009 > April > 19 > Entry
Guest column: Where’s debate on Dayton’s health care?
By Lawrence E. Mieczkowski, an internist who specializes in cardiovascular disease prevention. From 1994-96, he was director of clinical information services for Kettering Medical Center.
Re “Hospitals playing with babies’ lives,” April 5: Editorial Page Editor Ellen Belcher’s column regarding neonatal intensive care in the community spoke to one of the core problems relating to health care locally.
Why is there no outrage over these issues, not the least of which is the pediatric delivery system?
A few points to consider:
• Duplication of services continues to grow, and money drives the delivery system. The Greater Dayton Area Hospital Association has been an abysmal failure in the last 20 years in overseeing health care. For instance, Kettering Medical Center is going to build a hospital-like campus in Beavercreek to compete with Miami Valley Hospital’s south campus on Wilmington Pike.
Kettering and Miami Valley are each building new cardiac service “hospitals.” Does the Dayton community need these facilities? Where was the debate? Why weren’t community leaders involved? Most physicians see these facilities as competing monuments.
• Do the math on executive compensation.
We’re paying $2 million dollars for the region’s two health systems’ leadership. The CEOs of Kettering Health Network and Premier Health Partners (Frank Perez and Tom Breitenbach) each receive more than $1 million in compensation. Each hospital president (Kettering, Sycamore, Grandview, Miami Valley, Good Samaritan) probably receives $500,000 or more. That’s at least $2.5 million.
Meanwhile, each hospital has four to five vice presidents probably making $200,000 to $300,000 each. That adds up to possibly another $4 million. Now add in directors of cardiac services, obstetric services, orthopedic services. They usually command $70,000 to $100,000.
In the end, executive hospital leadership in Dayton may approach $10 million annually.
That’s a lot of money, especially for a medium-sized city.
Instead of laying off nurses as the bottom line gets tight, what if each hospital cut executive compensation or positions? Of course, that’s unlikely to happen.
Physicians are increasingly being squeezed financially. Realize that the radiologist reading a CT scan of your abdomen may receive $165 from Anthem, Cigna, or UHC for the five minutes it takes to read the X-ray.
On the other hand, your family physician gets about $60 for a 30-minute session dealing with your diabetes, hypertension and cholesterol problems. We often have to jump through paper trails and online approval screens to get prescriptions or X-rays approved.
Seriously, do you want your plumber making more than your physician? This disparity can be fixed pretty easily. But it requires paying primary care physicians 40 percent more and cutting reimbursement for some specialists.
• The practice of “managed care” puts insurers’ interests over patients’. Specifically, Dayton has allowed UHC and Anthem to run the region’s health-care delivery. These insurers have been especially successful in playing Miami Valley and Kettering hospitals against each other.
Managed care will pay the $4,000 monthly cost of a new cancer drug to prolong someone’s life by three months, but often it will not cover specific diabetes or cholesterol medications.
The other day, I tried to go through Anthem’s prescription services utilization to get a medication covered for a patient. The clinical pharmacist in charge would not even speak to me on the phone. Is this the system we want? And how did we get to this point?
I challenge the leaders of the hospitals and the local managed care plans to debates on these issues. We could do three or four of them. Count me in.
Permalink | Comments (2) | Post your comment | Categories: Guest Columns, Local Business, Montgomery County, Social Services
Comments
By Janice Orum
April 19, 2009 6:08 PM | Link to this
Brilliant Column! Wouldn’t it be wonderful to focus on patient care instead of Paperwork, politics, market share, and Press Gainey Surveys?By RAW
April 20, 2009 11:22 AM | Link to this
Hospitals are businesses, be they non-profit or for-profit. The recent mass expeansion of local hospital facilities is product of business development. Competition breeds success. That being said, the real issue is societal. We need to evaluate our healthcare culture as a nation. We need to focus more on prevention than cure. This needs to be undertaken by all Americans. Healthier lifestyles lead to reduced costs. Businesses have caught on to this and many offer gym facilities at work, reimburse gym costs or reward healthy lifestyle practices. We as a nation need to get off of the insurance mindset that it does not matter how I live, I have health insurance, that will pay for medical costs. This is the “other people’s money” syndrome that has plagued all aspects of healthcare for several generations. There does need to be a serious discussion about this topic, but it needs to address more than just how many hospitals are located in Dayton , and how much local CEO’s are making. Those are surface issues and not at the root of the problem.