Doing the right thing for all patients

By Ted Townsend / Guest Editorial

Personally, I’m tired of hearing, reading and talking about the Affordable Care Act.

Obamacare, as it is colloquially known, continues to roll through new phases of its implementation, with seemingly more glitches than selections and solutions, but roll forward it does. Most of the recent attention has gone to the foul-ups in the website, where individuals were supposed to be able to find easy-to-use insurance options, prices, subsidies and out-of-pocket costs. As ugly as that’s been, I don’t think it comes close to what we’re about to come to grips with in 2014. Whether you are a provider, employer, employee or patient, the greatest challenge will be sorting out who is covered for what and how any of the services people will want or need in 2014 will get paid for and by whom.

If you’re on a group plan with an employer, and that plan hasn’t changed in the last year, you will be among the fortunate, but for millions of others, I expect more than the usual confusion. Here in Iowa, the problem will be somewhat muted by Wellmark’s (our largest commercial insurance company) decision to allow individuals to carry forward their 2013 policy for another year and the state of Iowa’s belated, but welcome, decision to auto-enroll roughly 100,000 Iowans who had previously been covered by the Iowa Care program, versus having to re-apply for the Iowa Health and Wellness plan. In other states, many insurers cancelled millions of 2013 individual insurance policies because they didn’t comply with 2014 requirements of the Affordable Care Act.

Then the president said they didn’t have to, but state-by-state, insurance company-by-insurance company, and literally plan-by-plan, people had to go through a possible re-do of which plans could even be offered in which state, which year, all in a month’s time for a process that each year takes, well, a year. You get the idea. After Jan. 1, the first big problem will be even more confusion and the second big problem will be the money. Who has it, who’s responsible, how and who do you ask for it and will it ever get paid?

All of which sounds terrible and perhaps depending on your point of view, terrifying as well. The good news is there’s good news. At least here in the Corridor, here in Iowa, you can rest assured that people will get the care they need, when they need it. Partly that will be because it’s part of Iowa’s culture. Ours is a long and illustrious legacy of taking care of each other in times of need and that is exactly where we will find ourselves in 2014 when many are unsure about who has insurance coverage for what. That doesn’t mean everyone will get everything they want when they want it, but it does mean cases of real need do not need to worry about being abandoned.

Beyond the culture, it is also the principle business model that has evolved here. St. Luke’s Hospital, both Mercy hospitals, and the University of Iowa not only have emergency rooms always open to anyone in need, but even more important, all employ primary-care providers who continue to take patients from all government-payment programs and the new health insurance exchanges. That is access that is rare in many parts of this country and the same is true for any specialists we employ.

We can also be proud in this region that virtually all our private, independent physicians, specialists and associated providers also continue to see patients from government payers. Again, this is less and less true in growing sections of the U.S. We in the Corridor are among the fortunate.

We are not perfect, and none of us would claim health care is as affordable or accessible to all as we would like. But whatever Obamacare brings to us as a nation over the next few weeks and months, whatever the changes the president or Congress, or the states come up with to help an incredibly complex and increasingly expensive health-care system, the businesses and residents of our community can be assured your local providers will continue to meet these needs to the best of our ability.

Even when there is great confusion and uncertainty, you can count on us do the right thing.



Ted Townsend is president and CEO of St. Luke’s Hospital in Cedar Rapids.