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A Denney for Your Thoughts – Prescription remains unfilled (April 1, 2015 issue)

Recently I heard a bit of conversation in which one person mentioned the Affordable Care Act and another asked what that was. The answer: “ObamaCare.”
That’s probably enough said about whether health care has become a political issue. It is also a business issue, an economic issue, a social issue. Important to each of us, individually, and all of us corporately, health care was a topic at last Friday’s Annual Chamber of Commerce Legislative Breakfast held in Erwin. (See Curtis Carden’s coverage on the front page of this issue for an update on the status of Insure Tennessee, as presented at this meeting.)
Over the last several years we’ve heard the term, “our ailing health care system.” Our own Unicoi County Memorial Hospital (UCMH) has not been spared its share of obstacles to overcome. In the interest of disclosure, several years ago I was a member of the hospital’s Board of Control, as a representative of the Erwin Board of Mayor and Aldermen. This was before negotiations with regional hospital organizations about the future of our small independent hospital.
With 15 years of experience in rural hospitals, Tracy Byers came in September 2013 to run the local hospital, after it was purchased by Mountain States Health Alliance (MSHA). Regarding the affect of changes on small, independent hospitals, he tells me, “Economy is always a huge factor. I have been in communities where the local economy was heavily dependent on coal, oil, the military and textiles.
As those industries experienced ups and downs, so did the viability of the local hospital. Government changes have the most impact, however. Whenever the government changes and usually lowers its Medicare reimbursement, smaller hospitals feel the impact as they are more heavily dependent on Medicare patients. Whenever the government enacts any type of new regulation that requires a hospital to invest in more infrastructure—whether it’s technology or security—it impacts a rural facility that much more, because those facilities usually do not have large cash reserves and run on tight margins.”
Referencing the failure to expand Tennessee’s Medicaid (TennCare) program under the Affordable Care Act, Byers told me last year, there was “…a very negative impact on all hospitals and health care providers in the state. …All hospitals are seeing reimbursement cuts, meaning we are being paid less and less to provide the same care. The provision of health insurance coverage for the working poor in Tennessee would have helped to bridge that gap, but because our lawmakers have decided not to provide that coverage, all hospitals in the state are struggling. Mountain States is not immune to these pressures by any means, but because UCMH is now a part of that larger system, we are much better protected than we would have been on our own. I would encourage residents to contact their state legislators and urge them to accept the federal dollars that have been offered to Tennessee to provide coverage for the working poor.”
With no resolution still, this remains apt advice.