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Aging
population looms over health care costs
By Terry Rindfleisch
Lacrossetribune.com
, April 16, 2003
Addressing rising health-care costs
takes on a new urgency with the aging of the baby boomers. By the year
2020, the number of Americans 85 and older will more than double to 6.4
million. The number of people 65 to 84 will almost double to 47.1 million.
Baby
boomers entering their senior years will increase costs at an alarming
rate because the elderly traditionally use a larger share of the
health-care dollar. And if we can't control rising health-care costs now,
how are we going to do it in the future?
"Federal
and state governments are not dealing with the issue," said Dr.
Jeffrey Thompson, Gundersen Lutheran Medical Center chief executive
officer.
Inadequate
Medicare and Medicaid reimbursement to health-care providers only will get
worse without good solutions and could put some providers out of the
business in the future, Thompson said.
Medicare
and Medicaid programs are in financial trouble, and the cost of long-term
care and nursing home care is increasing, he said.
"We
survive because we share the Medicare and Medicaid patients with
Franciscan Skemp," Thompson said. "Our plan for the future is to
be organized and efficient and try to get the best reimbursement.
"The
path to thriving for providers is squeezing out the best efficiencies
while maintaining the best quality," he said. "A lot of people
are trying to fix the problem. I can't fix Washington. I can only control
what I can control."
Dr. Glenn Forbes, Franciscan Skemp Healthcare
chief executive officer, said health care providers need to be driven by
quality and efficiency, the public needs to become better educated to make
better health choices, and government needs to set priorities but can't
under-fund programs.
"The
long-term solution requires government, hospitals, doctors, the public,
insurance companies and all groups working close together," Forbes
said.
"The
re-engineering of medical care is a 30-year venture and won't be solved in
five to 10 years," he said.
Both
La Crosse medical centers have implemented cost efficiency and quality
measures in the last few years and are looking to do more. Gundersen
Lutheran has joined a statewide collaborative of health care providers,
employers and union organizations to report measures of health care
quality.
Forbes
said patients will pay more for their care in the future, and they will
have to accept more responsibility for their own health. He said he
expects people will have to make choices and will receive slightly less
health care in the future, but will be offered some catastrophic care.
Thompson
said rationing of health care is a possible in the future, "but my
hope is it doesn't get to that point."
A
recent survey conducted by the University of Wisconsin-La Crosse political
science/public administration department for the La Crosse Tribune and
WXOW-TV 19 showed 31 percent thought government could best control health
care costs, while 28 percent said health care providers could do a better
job.
Respondents
were split on whether the American health care system should be a private
or government enterprise. About 47 percent favored a private system and 43
percent preferred a national system operated by the federal government.
Many
more people (43 percent) preferred an employer-sponsored system over a
government-subsidized system (26 percent) to pay for health care .
"We're
going to have to find some politicians who will listen to their
constituents, so we can find some solutions to the health care
crisis," said Terry Hicks, president of the local AFL-CIO who favors
a national health insurance program.
Rick
Mickschl, president of Trane Co. machinists Lodge 21, said business, labor
and health care providers and payers will continue to look for ways to
work together. "We can't solve this alone," Mickschl said.
Jorge
Gomez, Wisconsin's insurance commissioner, said future challenges include
coming to grips with health care costs and how to expand health insurance
coverage for employees who can't get coverage. Gomez said Gov. Jim Doyle
has suggested small employer insurance pools to help small employers offer
affordable insurance to their employees.
"There
are solutions to rising health-care costs, but they're not all inviting,
and they're will be winners and losers," he said.
Third
District Congressman Ron Kind, a leader of the Rural Health Care
Coalition, said the Bush administration won't be focusing on health care
with the war in Iraq and a slow economy.
"It's
going to take sustained focus and leadership, and maybe the focus will be
come in the next presidential race," Kind said.
"Health
care is a political ping-pong ball, and it's going to take a political
coalition of business, labor, health care providers and consumers that
continues to grow and adding pressure on policy-makers to get off the
dime," he said.
Kind
also is emphasizing that people need to discuss end-of-life decisions such
as living wills and advance directives with their loved ones. Health-care
costs in the last six of weeks of life are significant, he said.
"We
all need a better understanding of our loved one's expectations at the
end-of-life," Kind said. "This is not about government
intervention but about individual empowerment. We need to think this
through. The implications could be costly."
Steve
Kunes, executive director of Franciscan Skemp's Health Tradition HMO, said
the health-care crisis is a perfect storm.
"Many
things are brewing," Kunes said. "We all have expectations -
people wanting the latest technology, treatment and cure and all the new
drugs - and then trying to figure out who is going to pay for them.
"It's
a swirling storm that could hit us anytime," he said. "There are
no easy answers."
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