From Harford County Councilman Mike Perrone Jr.:
At our March 8th meeting, the County Council voted to approve letters of support to the Maryland House and Senate regarding University of Maryland Upper Chesapeake’s intentions to eventually replace Harford Memorial Hospital with a “Free Standing Medical Facility” near the intersection of I-95 and route 155. To do this, Upper Chesapeake needs enabling legislation passed in Annapolis. This matter has generated a fair amount of controversy, so I figured an explanation of my “aye” vote would be appropriate.
Much of the opposition to this legislation revolves around the fact that a Freestanding Medical Facility is not a hospital, and is thus not regulated as such. People are ultimately concerned that quality of healthcare will go down, and/or that costs will go up, if a Freestanding Medical Facilities is “allowed” to replace a hospital. This leads us to the question of why it is that Upper Chesapeake feels the need to do this in the first place.
Health care providers are being squeezed and are being forced to alter the way that they provide care; many times in ways that do not benefit us as patients. But before we seek to place any blame upon the shoulders of health care providers (or try to block their plans with regulatory or legislative action), we need to understand why they are being squeezed. That’s an easy one – they’re being squeezed by insurance companies and Medicare/Medicaid.
It might be tempting to end the analysis by blaming insurance companies, but yet again, we need to dig deeper. We as a society generally agree that we can’t put a value on human life, nor human health for that matter. If for example, a new medical procedure is invented that is only marginally more effective than the one it replaces but is significantly more expensive, we fully expect insurance companies to cover those increased costs. On top of that, states are constantly passing legislation that expands the scope of what insurance companies must cover. But at the same time, states will often reject the premium increases that insurance companies file for in response to their increased costs. So the insurance companies do the only thing that they can under the circumstances…they reduce what they pay to providers.
Nobody has a comprehensive solution to this problem. But there were steps that could have been taken at the time the “Affordable Care Act” was passed that could have moved us in the right direction instead of the wrong one.
Being surrounded by countless examples of how well the free market works in terms of the delivery of the majority of the goods and services that benefit our lives, we could have tried the same thing with health care. We could have undertaken legislative efforts to make health care providers disclose the rates they charge for their services. We could have encouraged the expansion of Health Savings Accounts which incentivize people to be cost-conscious when it comes to shopping for health care services. And a network of independent consumer advocacy groups could have arisen to take this newly available information and help us get the best value for our health care dollar, thus setting the stage for health care providers to actually compete with one another. But we didn’t do any of this.
Instead, we went off in the other direction. We put in place a system that is built on the idea that government action could somehow give us “cheaper” and “higher quality” at the same time. We continue to confuse risk sharing with cost sharing; dumping matters of cost sharing into the lap of insurance companies so we can avoid the difficult policy decisions of who should subsidize whom. And we continue to fall into that trap where we convince ourselves that we simply need to “do something”, without considering the possibility that the “something” that we are doing might end up making our situation worse.
My point is that the “Affordable Care Act” and Upper Chesapeake’s need to adapt are inextricably linked. Replacing Harford Memorial with a Freestanding Medical Facility may well lower our standard of medical care here in Harford County. I suspect that more and more fingers of blame will be pointed at Upper Chesapeake as this story unfolds, and with that will come the calls for more government pushback against Upper Chesapeake. But we need to ask ourselves the question: if excessive government intervention put us into this position in the first place, do we really think that more government intervention will get us out?
Even more reason to change out our elected officials in Harford county.
Agree – all districts regardless of party plus the executive. Throw them all out.
Phil elected officials has nothing to do with IT!
Recently, a close relative with a visit to Upper Chesapeake ER waited for almost 10 hours in the ER for a room to open up. Upon this relative leaving the hospital a few days later, staff voiced the need to get the room ready for patients waiting in the ER to be admitted. NO JOKE!
That’s what happens when big conglomerate’s spend big money to have their name infront of everything else.
More paperwork, changes for the worst, and quality decline.
There’s so many issues with this, whether you have this letter explaining his flawed vote, or other representatives who resorts to fear-mongering and posts pictures of the hospital status screens in an attempt to scare the populace. If we were to continue in this line of thinking, then why not push to build a 3rd hospital? The thought process displayed in this letter and other representatives’ posts show an ignorance of the root causes, which can be likened to putting a bandaid on the wound that needs cleaned and sutured.
The first issue is the never-ending abuse of the healthcare system. EMS units are delayed in hospitals for a multitude of reasons. Primarily, you have people calling 911 for things such as stubbed toes, headaches, the sniffles, etc. These are the ones who should be seeing a family physician or urgent care center- and a freestanding ER would be the perfect place for this nonsense. It is understood that those without insurance use the ER as their first access to the healthcare system, maybe UM should take some of the money saved by closing a full-service hospital and investing that into free community-centric clinics for those in distressed socioeconomic situations.
Next, you have a lack of coordination in bed management and patient flow from top to bottom. Johns Hopkins has an awesome program of a centralized command center to monitor real-time the status of their facilities. They broke down common barriers to communication between departments and more effectively can manage the resources they have or realize are necessary at given points of time.
Ambulances waiting for an hour or more at Upper Chesapeake is nothing new. This has been going on for many years, where EMS providers were told by the ER charge nurse that the hospital’s administration would not allow them to go on Red or Yellow alert, so EMS had to put the hospital on bypass. This was before UM took over operations of the hospital. Where was the outrage by those elected then?
A final component to this is that with so many people who are looking for an easy lottery (aka lawsuit), physicians and other advanced practitioners are forced to order a slew of tests and diagnostics “just in case”. Not only does this cost an excessive amount of money, especially if that patient has no insurance or means of payment, but it ties up a bed unnecessarily.
If UM is to be successful in this venture, they need to drastically improve upon their current method of operation. They are a wonderful resource for Harford County citizens, with a few changes in management and operating guidelines, this could be very beneficial to the county.
Personally, I think the idea of expanding mental health services and a freestanding ER facility could work in Harford County. It would be great if those in positions of power could help this process succeed instead of playing into the easy argument of “we’re losing something” and rallying their constituents’ emotions. Arguments made on emotions and preconcieved thoughts won’t work in this situation, it has to be based in fact.
Very well thought-out and well-reasoned reply.
Isn’t this guy a teabagger? If so, I wouldn’t believe him if he told me the world was round.
The lot of you are fool’s…. A freestanding medical center would be cheaper care….. Stop worrying about your party lines, and worry more about what is happening nationwide….. Fix things that need to be fixed…. Not blame people that are trying to actually listen and help to you the people.