Horizon, Host: Ted Simons

July 15, 2009

Host: Ted Simons

Health Care Reform and Children

  • How will proposed health care reform affect children, and how will it address their needs? Bob Meyer, CEO of Phoenix Children’s Hospital, will address the issue.
  • Bob Meyer - CEO, Phoenix Children’s Hospital
Category: Medical/Health

View Transcript
Ted Simons:
Today a senate health committee pass add $600 billion overhaul of the nation's health care system, a major goal for the Obama administration. Recently Senator John McCain spoke at Phoenix children's hospital about health care reform. Children are a special part of the reform process, and we'll talk about that, but first, here's a look at some of the senator's comments.

Mike Sauceda:
Doctors, nurses, and other health care professionals gathered to hear Arizona Senator John McCain speak about health care reform at Phoenix children's hospital on a day President Obama was out selling his plan. McCain provided cautions about Obama's plan.

John McCain:
We're talking about health reform that could impact everybody in this room. And the democrats and President Obama want to move very quickly. That alone concerns me, whether we should move very quickly in four or five weeks on an issue that consumes one-sixth of our gross national product. I believe a government plan would be a big foot in the market, and would cause mass transfers from existing coverage to the government plan that will be artificially less expensive than current options. This is a step to a government-run single-payer system and controls prices and leads to rationed care. We need legislation as we all know, but we don't need to create another costly government program. We should allow people to go across state lines, and there's one other issue real quickly, and that is medical malpractice reform. I think there is -- I've not met a doctor in any specialty that hasn't told me in candor that they haven't prescribed additional tests and procedures simply for protection against a malpractice suit.

Mike Sauceda:
McCain also took questions about health care from the audience.

Audience Member 1:
Our emergency departments are flooded with a lot of unnecessary visits that could be tackled in primary care.

John McCain:
First of all, on the access to primary care, I agree with you, and it seems to me that community health centers could provide a significant portion of that. I believe that when you look at the incredible expenses associated with health care, one of them is the emergency room care, the most expensive of all. So if you have a community health center in larger numbers, I think that relieves that burden.

Audience Member 2:
I think if we want to make change, we need, and the government, through education and through programs, need to let the public know that they have a responsibility for their health care.

John McCain:
We all know a little straight talk that obesity and the rise of obesity in the United States of America is a huge problem. But I hope that this nation realizing what kind of crisis we're in, we can sit down together and work out an agreement that will at least begin to attack the problem. I don't expect it to be reversed in a year.

Ted Simons:
Here now to talk about health care reform and kids is Bob Meyer, C.E.O. of Phoenix children's hospital. Thank you for joining us on "Horizon." Health care reform. Is it necessary?

Bob Meyer:
I think it absolutely is. What the system that we put together and cobbled together over the last 50 years, has a lot of serious flaws, and it's fundamentally needs to reform. It's broke.

Ted Simons:
The special challenges for a children's hospital.

Bob Meyer:
Well, I think the special challenges for a children's hospital are pretty much for all hospitals. Its access to physicians, its access to Services, the senator referred to the overcrowding of emergency rooms because of a lack of the primary care physician access. Payment levels, obviously is a big issue, because we're very much at the uniqueness of a children's hospital's Medicaid payments.

Ted Simons:
Some of the things that are wrong with the system right now, you just touched on. What's right with the system? What can be built on?

Bob Meyer:
I think some of the programs have been put in place, there's a special program for children in adds called kids care, it's a national program, what it does is it expands coverage for children up to certain levels of the poverty level. Right now in Arizona it's 200% of the poverty level. It allows us to get more children, actually with insurance coverage regardless of their family situation and the parent.

Ted Simons:
There's an idea out there to cover kids from birth to the able of 21. Sounds like a mandatory insurance plan. But get every kid covered until the able of 21, does that make sense?

Bob Meyer:
It does. If you look at children as our future, so to speak, and you look at the challenges they face, I think the insurance from birth to 21 is important. It's also economically feasible because children fundamentally relatively well. They don't get sick very often. Unfortunately when they do, they can have very devastating diseases.

Ted Simons:
And kids as well, when they do have problems early on, some of those problems mean lifetime care. That's a concern as well.

Bob Meyer:
Yeah. The children develop some of these chronic illnesses that they carry with them, whether it's congenital heart disease, even kids with cancer treatments. Because some of the treatments will lead to other issues. Radiation, etc. So I think again, coverage for all these kids, there's a big issue with prosthetics for children. Children that need them, they grow, we need continued access to those types of prosthetics.

Ted Simons:
Expanded coverage and improved access. The dynamics there. Talk to us about it.

Bob Meyer:
Well, I think the biggest dynamic of that is going to be the cost of reimbursement issues. One of the things Arizona did right going back to your earlier question is, the Medicaid system in Arizona has paid reasonably well over time. Which has allowed to access. There's good access for primary care physicians for that Medicaid population in Arizona. But what's been proven across the country, as you start to reduce those payments, which is what's going on today in this economic environment we're on, the access starts to go away. Because as you cut those payments, all physicians are busy, you can always see X number of patients in a given day, and they'll take the ones with the higher payment rates. So it's a self-fulfilling profitability. Access is one, the education of physician, the supply of physicians, but it's also payment levels.

Ted Simons:
And payment levels back to hospitals, Medicaid payments, everything, you're seeing less of them, aren't you?

Bob Meyer:
Yeah, we're seeing very significant reductions. As recently as three years ago, there was some studies done by the state that showed we're being paid about 93% of our cost for treating Medicaid patients. That's a reasonable amount, not making any money, but reasonable. That same number has shown falling into the high 70%. And this is why I talked about earlier, those payments start to go down, and it's affecting physicians as well, we have 200 employed physicians. So we're very aware of the physician payment levels too.

Ted Simons:
The Obama plan in general, it's awfully complicated, we don't have time to get too deeply into it, but in general, your thoughts?

Bob Meyer:
I think it's a very well meaning plan. The idea of the public plan gets concerning to a lot of us that would -- are fearful of movement of any of the insured patients that are currently in the commercial or private payers into a plan that pays Medicaid or Medicare levels that don't cover our costs. Which would also give those plans an unfair advantage in the marketplace against the private insurers.

Ted Simons:
Real quickly, critics would say it would be hard-pressed to be worse than the system is now. Would you disagree with that?

Bob Meyer:
No, would I disagree to some extent. It goes back to the payment levels. If everything moves to the lower payment levels, I think the quality of the care will degrade over time.

Ted Simons:
All right. We have to stop it there. Good discussion. Thank you so much for joining us. We appreciate it.

Bob Meyer:
Thank you.

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