Posted by: rotenochsen | November 25, 2009


Wednesday, November 25, 2009

EM crews that respond to emergency 911 calls will only take you to he nearest hospital. Even if you travel to the city to see an internist or cardiologist who is affiliated with a major metropolitan hospital for a chronic medical condition that suddenly becomes acute. The EMT crews who man the ambulances are required to take you to the nearest hospital.
This is a good idea if you are suffering a heart attack, but if you end up in the emergency room of a rural or small city hospital, you better have them transfer you to the Big city hospital as soon as you are stabilized. If you do not the “TAB” for your treatment will cost you very much more because of provisions in the Pelosi House Health Care Bill.

A rural town’s only hospital very likely has the only outpatient surgery unit, the only radiology unit and the only clinical laboratory. Its outpatient clinic may be the only primary care practice in town, and it may have the only ambulance service and the only home health agency.

If the House health care bill becomes law, the Democrats’ plan stipulates below-market payment rates and a new government-run insurance company that would compete with cash-strapped rural hospitals.

Rural hospitals, which are normally small and operate on a tight budget, could be put in further financial jeopardy because the House-passed version of health care reform does not fix the disparity in Medicare reimbursements between rural and urban hospitals. Rural hospitals usually are paid far less than their urban counterparts, despite facing comparable rates of chronic illnesses such as heart disease or diabetes.

Currently, Medicare reimburses hospitals based on how their average labor costs – adjusted to account for the hospital’s geographic location – relate to the national average. This geographic location adjustment is supposed to represent an area that has relatively uniform costs.

However, if a hospital’s geographic area does not have uniform costs, hospitals can be short-changed and may end up having to pass the excess cost on to patients who carry private insurance.

The disparities are caused by Medicare’s “metropolitan/non-metropolitan” classification system. Under this system, hospitals located in metropolitan areas are paid at one rate and hospitals in non-metropolitan areas – usually the entire area of a state that is not within a particular city’s limits – are paid at a lower rate.

Rural hospitals are often placed in financial straits because costs in the non-metropolitan areas, and financial difficulty translates into shoddy care and the transfer of the lost reimbursement from the Federal government to the patient. This is a double “whammy” courtesy of the Democrats and Rhinos who eventually will pass this travesty if Americans do not wake up and stop it!!

Maggie Elehwany the VP for NRHA told; “Because these are small facilities, they often operate at a very narrow margin. Many of them are the only access to care for patients within miles and miles and miles,” she said. “They generally have a low [patient] volume but they still have to have a basic level of equipment and update their HIT [Health Information Technology] and things like that.”

“Medicare’s way of saving money is sort of bit like a Costco purchase – the more you do, you’ll make out okay because you’re doing such a high volume of business – that just doesn’t work in rural areas,” she said.

These disparities mean that rural hospitals are forced to pass the costs of Medicare patients not covered by government on to patients with private insurance, a system put at risk by a government-run public option, one that could siphon off those privately insured customers.

If this does not convince you people, who like I do, live in a small city not close to a BIG crime ridden city that the politicians consider US as only “fly over” communities. This provision in the Pelosi Bill should awaken you to the fact that they do not care about us except at election time when they beg for our votes!


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