Medical Care for seniors LRGH

[SteveA]

This story is disturbing.

http://www.wmur.com/newsarchive/29598468/detail.html

Having been in the medical biz for 30 plus years, I can tell you that this is a trend, that is happening more and more. States that failed to plan for the "Baby Boomer's" are running out of money. Sadly, many of these states find it easy to simply cut services to the poorest members of our population.

[ITD]

Isn't medical care for seniors provided by MediCARE?? Social programs are a huge portion of the federal budget now.

[NBR]

Medicare is for seniors, medicade is help for lower incomes. I am a medicare user but I don't consider it an entitlement. I paid for it with pay roll deductions and still pay a monthly premium.

My medicare monthly payment goes up annually. If that doesn't cover the cost increases I'd call that poor management. Wait poor management and goverment different ways of expressing the same thought.

[Winnisquamguy]

This is wrong on so many levels! I hope the CEO and all others took a pay cut before doing this. As well as stopping there mailings and marketing programs.The one other thing about this that is bothersome is they will still except ER patients which is a lot more costly than preventive care.

[Janet]

Originally Posted by Winnisquamguy

This is wrong on so many levels! I hope the CEO and all others took a pay cut before doing this. As well as stopping there mailings and marketing programs.The one other thing about this that is bothersome is they will still except ER patients which is a lot more costly than preventive care.

Not sure about NH laws but in Texas law no-one can be turned away from treatment at an ER due to lack of payment. Might be the same for NH

[ITD]

There's a basic problem with these programs, the employee and employer each contribute 1.45% of their salary, up to about $106,000 of said salary. So if the average salary is about $60,000 then the combined average contribution per year is about $1,700. Not very much money compared to medical costs. One solution by politicians is to squeeze the medical community via reductions in payments for services. So if you are a doctor, you either decide to accept payments at a loss, or you stop accepting mediXXXX patients. It's a huge problem.

[rrr]

Originally Posted by ITD

There's a basic problem with these programs, the employee and employer each contribute 1.45% of their salary, up to about $106,000 of said salary.

The cap applies only to social security, I don't think there is a cap for medicare it continues to be deducted.

[LIforrelaxin]

This is wrong on a variety of levels....

First I want to address a comment by Janet... In an emergency you are correct a patient can't be turned away... but they can do just enough to ensure the patient will survive. This is actually more of a federal thing then a state. Although the states try and regulate it...

What this move really effects, is people to seek treatment for non-emergency issues / non life threatening issues.

The medical system in this country is beyond broken.... Hospitals are run like business and expected to make profits... A hospital should be non-profitable and that is the bottom line. Beyond that you have Doctors, who feel they are entitled to make X number of dollars per year. While I agree that they deserve to be fairly compensated, I believe some of them are raping the system... I have meant many many Dr. dealing with various family members and health issues. You can tell the one that are in the business for the money and schedule. Whom don't deserve to be making the 200K dollars a year salary... and Those that do care about what they do and the people they help....

I personally think that the state and federal government need to take LRG Healthcare to task over this situation... LRG Healthcare no doubt is taking money from the federal Government in the form of Tax breaks, grants, and other misc. funding, if the can't also accept, medicade and help those that need it the most, they don't deserve any other assistance.

[ITD]

Originally Posted by rrr

The cap applies only to social security, I don't think there is a cap for medicare it continues to be deducted.

I stand corrected, you are right, but when you consider the average it really doesn't matter. And my average salary number may be higher than the actual. The problem with these programs is there is more money going out than coming in.

The problem is medical care is not free. Providing medical care requires highly trained professional people, expensive equipment and facilities, huge liability insurance costs and expensive research into new lifesaving techniques, machines and medicines.

Medical care is not a right, it's a service that needs to be paid for. Politicians have been monkeying around with the system for years and making it worse rather than better. Condemning a hospital for refusing to subsidize a government program is not the answer. Voting a clean sweep in congress and the executive branch may help........

[Greene's Basin Girl]

My medical plan is Blue Cross Blue Shield (BCBS). Several years ago LRGH and the doctor offices affiliated with LRGH discussed canceling their contract with BCBS. At that time I made the decision to transfer my primary care doctor from Meredith to Concord. I do not have any regrets. I like Concord Hospital and my doctor at Concord Internal Medicine. Community hospitals often struggle financially.

[SteveA]

Medicare is for the over 65 population, people on disability can access it before age 65.
Medicaid is, in each state, a state program that is partially paid for by the Federal Government. (Therefore, by all federal taxpayers.) You've been hearing about the various states complaining that the Federal government should just "block grant" the funds, rather than the current program that sets minimum standards that the states must follow for the use of the federal dollars. They want to use the dollars anyway they see fit.

https://www.cms.gov/MedicaidGenInfo/

Some states, like NH, are what is called "Donor States" we get back $.71 for every tax dollar we send to Washington. New Mexico gets $2.30 for every dollar they send. Medicaid payments to the various states makes up a very large part of these dollars. In effect, we are sending tax dollars to any state that is getting back more than they send in.

These data are from 2005, I've seen the 2009 data, but can't find the link.
http://www.taxfoundation.org/research/show/266.html

IMHO, NH needs to lobby very hard for a more fair share of those dollars.

But, by far, the largest contributor to more pressure on Medicaid is the unemployment problems in the country. Unemployed people are far less likely to have health insurance. No Insurance, get sick, Medicaid ends up paying, and taxpayers end up with the bill.

While I understand the gut level objection to a national health plan that is paid from general tax revenue, county's that have such programs spend far less on healthcare than we do per capita. (Many with better health outcomes...)


http://www.kff.org/insurance/snapshot/OECD042111.cfm

[webmaster]

Is this related to "Lakes Region tourism, activities or topics"?

[SteveA]

Originally Posted by webmaster

Is this related to "Lakes Region tourism, activities or topics"?

Beyond the orginal post on LRGH. No

Sorry for my part in getting it off track.

[ITD]

Originally Posted by webmaster

Is this related to "Lakes Region tourism, activities or topics"?

Nah, time to lock it....

[RLW]

Originally Posted by ITD

Nah, time to lock it....

The above mean that you are not a senior and live in the lake region????

[LIforrelaxin]

Originally Posted by webmaster

Is this related to "Lakes Region tourism, activities or topics"?

This very much concerns the lakes region.... If medical services become unavailable to people because, various insurances and government subsidized programs are no longer viable in the area, the economic consequences could spell trouble for small business in the area...

The actions taken by LRG Health care, are the the first step down a road that could have extremely negative impacts on the regions....

[ITD]

Originally Posted by RLW

The above mean that you are not a senior and live in the lake region????

Not a senior yet, though my kids probably think so, and a part time resident.


To LI's point:

This is actually an extremely important topic, but I don't see how we can really discuss it without getting into the nitty gritty of the politics behind it. I think our webmaster is right to be concerned as to the eventual trajectory of this thread not being very good. Good subject, wrong venue to discuss in.

[LIforrelaxin]

Originally Posted by ITD

how we can really discuss it without getting into the nitty gritty of the politics behind it. I think our webmaster is right to be concerned as to the eventual trajectory of this thread not being very good. Good subject, wrong venue to discuss in.

So far this discussion really hasn't gotten into the Nitty gritty politics behind it.... everything I have seen thus far is more informative in nature.

Now if we want this forum to be strictly about only the fun topics that effect the lakes region then I agree this topic doesn't need to be here. As this is a depressing topic. However if the idea behind this forum is to help educate people and provide information on topics that can have an impact on the area, and economy then this is very much the place to be having this conversation.

Now if people can't keep the politics out of the discussion then by all means shut this down... However if informative information can flow, then it should be allowed.

But really at this moment the argument is not really about the issue, but rather if this is a good place to have the discussion...

[ITD]

Originally Posted by LIforrelaxin

So far this discussion really hasn't gotten into the Nitty gritty politics behind it.... everything I have seen thus far is more informative in nature.

Now if we want this forum to be strictly about only the fun topics that effect the lakes region then I agree this topic doesn't need to be here. As this is a depressing topic. However if the idea behind this forum is to help educate people and provide information on topics that can have an impact on the area, and economy then this is very much the place to be having this conversation.

Now if people can't keep the politics out of the discussion then by all means shut this down... However if informative information can flow, then it should be allowed.

But really at this moment the argument is not really about the issue, but rather if this is a good place to have the discussion...

I hear you LI, but the subject of non profit versus profit was brought up and honestly, even a non profit still must be cash flow positive ( or profitable) otherwise it can't survive. But I digress, I see the hospital being taken to task here for an issue that is absolutely political because we are talking about tax funded payments that the hospital can't accept and stay open. It's as simple as that but how it gets resolved is very complicated.

Anyway, the steps taken by LRGH were precipitated by steps taken by politicians far away, trying to separate the two is impossible, at least for a rational conversation hence my thoughts that this should end.

[CateP]

The lakes region is indeed being affected by national events, maybe more so than in other years. I think this just goes to show how interconnected things are. Just like the NH Lowes closing and now a local hospital not being able to afford taking Medicaid patients.

As a future resident who is planning to retire in the region, I find this discussion to be very interesting and informative.

But perhaps it will be moved to that other place on the forum

[Rusty]

"Gov. John Lynch called the decision irresponsible and said it would be appropriate for the attorney general to review whether the network and its associated primary care practices still warrant nonprofit status."

“It seems LRGHealthcare is punishing patients to advance its political and legal case,’’ Lynch said in a statement. “It is completely irresponsible for LRGH to deny access to health care to those citizens who can least afford it — and it is contrary to its mission as a nonprofit.’’

http://articles.boston.com/2011-10-2...re-budget-cuts

[Averial]

This is all wrong, all wrong, I have called the hospital and my representative Jeanne Forester here in Meredith. This needs to be corrected. The Governor is right. We have no right to deny any one care. Doctors and nurses take an oath to do no harm to any human being. This is going to create harm for many emotional , mental and physical disabled in New Hampshire.

[secondcurve]

[QUOTE=NBR;171024]Medicare is for seniors, medicade is help for lower incomes. I am a medicare user but I don't consider it an entitlement. I paid for it with pay roll deductions and still pay a monthly premium.


The underlined sentence above underscores a big problem in this country, which is benefits due me are not entitlements but rather a God given right while benefits due you are expendable and should be cut. Unfortunately, it doesn't work that way. I continue to wish for a leader who will stand up and explain to the American people that shared sacrifice is necessary to solve this country's problems.

[codeman671]

Originally Posted by Janet

Not sure about NH laws but in Texas law no-one can be turned away from treatment at an ER due to lack of payment. Might be the same for NH

I saw the segment on WMUR the other night. They stated that LRGH would still handle ER patients with Medicaid.

[Mr. V]

Hello, Occupy Laconia!

Time for some protesters to set up a tent city outside LRGH ...

[Gearhead]

I frequently drive past Huggins Hospital in Wolfeboro and there's never anyone there. I don't know how a company can operate like that and still keep the heat on.

[Heaven]

If I was on the Board of Directors of Lakes Region Hospital I would wonder why my CEO who is earning in excess of $3,000 a day can't figure out how to bring health care to local families who are living on $30 a day. Go figure.

[ITD]

Originally Posted by Heaven

If I was on the Board of Directors of Lakes Region Hospital I would wonder why my CEO who is earning in excess of $3,000 a day can't figure out how to bring health care to local families who are living on $30 a day. Go figure.

Ok, so I guess we can still discuss this.

A family can't live on $30 a day, period. I guess the question becomes, why is this CEO, or anyone else for that matter, required to take care of that family? Note, the key word in my question, REQUIRED, which is being implied here.

How is it a right to go to a doctor or hospital and demand free medical care? What about the doctor's or the hospital's rights? Are they slaves to be forced to work for nothing, actually they're forced to work for less then nothing, they have to pay to work on these cases.

I'm not affiliated at all with the medical field, but I find these demands and questions and trends troubling.

[NoRegrets]

I have used the LRGH a few times and found them to be excellent in their ER service. I believe they had a four million dollar budget deficit this year. They do alot of "charity" services so I feel they are a great Lakes Region resource.

The Medicare payments or fed. reimbursement is being cut in half so many places are refusing to take it. Congress is currently trying to revamp this section of "The Health Care and Education Reconciliation Act". The bill will not work in its current state.

The doctor visit was worth 75 dollars and now Medicare will only pay 35 dollars. That does not even cover the business cost for the receptionist at the front desk. You cannot run a business with this limit. The direct result of this bill is to have doctors stop seeing people covered by this program.

A major issue that has driven the medical cost through the roof is legal liability and lawsuits. This issue was not addressed anywhere in the legislatures chambers.

[RailroadJoe]

Does he really get a million a year?

[barefootbay]

These hospitals somehow continue to construct these grand and hugely expensive edifices ie; LRGH and Huggins.

[Heaven]

Originally Posted by ITD

Ok, so I guess we can still discuss this.

A family can't live on $30 a day, period. I guess the question becomes, why is this CEO, or anyone else for that matter, required to take care of that family? Note, the key word in my question, REQUIRED, which is being implied here.

How is it a right to go to a doctor or hospital and demand free medical care? What about the doctor's or the hospital's rights? Are they slaves to be forced to work for nothing, actually they're forced to work for less then nothing, they have to pay to work on these cases.

I'm not affiliated at all with the medical field, but I find these demands and questions and trends troubling.

I guess our ideas of "working for nothing" are quite different. A million plus isn't "working for nothing". Basic health care IMHO SHOULD BE obtainable for everyone and that SHOULD BE our united goal. I am fortunate enough to pay for good health coverage, and I will take my business to a hospital which includes the care of those less financially fortunate, financed partially by my tax dollars and my insurance costs.

[jrc]

Originally Posted by Heaven

... Basic health care IMHO SHOULD BE obtainable for everyone and that SHOULD BE our united goal.

How do you define "basic" and "obtainable"?

Remember it was supposed to be "care" for elderly and "aid" for the poor. Medicare and Medicaid.

[ITD]

Originally Posted by Heaven

I guess our ideas of "working for nothing" are quite different. A million plus isn't "working for nothing". Basic health care IMHO SHOULD BE obtainable for everyone and that SHOULD BE our united goal. I am fortunate enough to pay for good health coverage, and I will take my business to a hospital which includes the care of those less financially fortunate, financed partially by my tax dollars and my insurance costs.

I guess that is why the ceo makes $1 million, he is smart enough not to allow his hospital to be bankrupted by politicians, most of whom have never worked a real job never mind been responsible for making a payroll for hundreds if not thousands of people.

If you want a villain in this mess look to Washington DC, then you will be getting to the root of the problem.

Think of it this way, you are obviously employed, think about what you would do if someone asked you to do your job, whatever it is, but because the politicians decided to cut rates the government pays, you will need to work for nothing and you will need to pay your insurance and overhead out of your own savings account when you do your job. Per your comments, you should accept this arrangement, work and pay, how long do you think you would be able to do this?

[Argie's Wife]

Link: http://www.nhbrnetwork.com/profiles/...shire-medicaid

The fundamental promise of Medicaid is that it is a partnership between the state and federal government to take care of the neediest in our society. But the budget that is about to be adopted by the Legislature turns that promise on its head and is a betrayal of the commitment the State of New Hampshire has made to the people we serve in the Medicaid program.

Many proponents of the budget will argue that it has been balanced without raising any new taxes, but nothing could be further from the truth. The budget that was adopted by both the House and Senate, although in slightly different forms, has the effect of imposing a massive new tax increase on hospitals through the imposition of something known as the Medicaid Enhancement Tax, or MET. While those same proponents of the budget will argue that the MET has been on the books since 1991, what they won’t tell you is that the MET was never intended to be a ‘real’ tax and, until just last year, no hospital ever paid more in their MET than they received in a Medicaid disproportionate share hospital (DSH) payment.

For the past 20 years, hospitals have paid the MET as a means of helping the state generate additional federal revenue that could be used to fund state government and received uncompensated care payments in recognition of their care for patients who have no insurance or who are covered by the Medicaid program – a program that only pays about 50 cents for every dollar of the cost of taking care of Medicaid patients. But hospitals are now facing the prospects of paying this tax and receiving very little, and most likely nothing, back in uncompensated care payments to offset those losses.

And to make matters worse, the State now intends to use the hospital tax revenue, not State General Fund revenue, to fund that portion of the budget that pays providers for serving Medicaid patients. In essence, hospitals will be paying themselves. And for almost every hospital in New Hampshire, the tax they pay will exceed the total amount of reimbursements they receive from the State for taking care of Medicaid patients.

That’s a tax increase, plain and simple. Don’t let anyone tell you differently.

And, as a result, hospitals all across the Granite State will be forced to deal with these increased taxes in one way or another: by trying to shift these additional costs to private insurers, the reduction or elimination of services in their communities and the loss of jobs. For businesses in New Hampshire, this budget will result in further cost-shifting to those with private insurance, meaning health insurance in New Hampshire—already one of the most expensive states in the nation for private health insurance—will only become less affordable.

While hospitals support the need for a balanced budget that helps spur economic growth, creates jobs and ensures that services to our most vulnerable citizens are maintained, this budget breaks the promise to the Medicaid program and the people it serves.

[Heaven]

Well that explains it, I am all for hospitals using patients as leverage in order to overturn the present legislature.

[fatlazyless]

http://www.laconiadailysun.com/story...nda-baer-10-28

is a letter to the LaDaSun from Laconia Ward 4 Councilor Brenda Baer, one of five Laconia city councilors.

This seems to be a very complicated issue that involves the state and federal governments and individuals who are looking to get some medical help, and the whole issue requires a lot more understanding of the issues than I have.

[Argie's Wife]

Heaven, with all due respect, I think you missed the fact that the NH legislation passed the bills that tax the hospitals that are operating as non-profits, thus putting the patients in the path or in the middle, of this.

Since the payments to most hospitals for their care to the Medicaid patients was at no profit - even a deficit to the hospital - yet the hospital was expected to run status quo, why did NH legislators see fit to try to get blood from a turnip?

You've posted that you have insurance. Are you aware that the services you receive from your healthcare provider are paid at a discounted rate than what a self-pay or out-of-pocket patient may pay? Healthcare providers negotiate a contact with the insurance company to pay pennies on the dollar of a bill.

For example, a service billed at $500 to the health insurance company may see just 40% of the payment because that's what was agreed upon in the contract between the healthcare provider and the insurance company.

That same $500 service will be billed at 100% to the self-pay patient. That includes the folks who aren't eligible for Medicaid but maybe can't afford insurance - like the small business owner.

That same $500 service may not bring in a dime from Medicaid - but that's not something the healthcare provider could negotiate with the government. Having done billing and managed a practice, I can tell you that many services are expected to be provided for "free" by the physician - some of those services are very costly.

So, is it fair that the tax payer has to make up the difference because taxes are placed on a hospital and the difference has to be passed on to the self-pay patients? Should the hospital be expected to cut back even further on staffing, supplies, equipment and maintenance just to make up the difference when they're already operating at a $4million deficit this year.

The hospitals and healthcare providers really have their hands in the air in a "hold 'em up" with the State of NH demanding a hospital tax. The hospitals and healthcare providers in this area have nothing left in their pockets now but lint. As the saying goes: You can't get blood from a turnip.

Really, couldn't the State of NH find a better way to make revenue? Is creating a tax off the back of the healthcare industry a prudent decision in these difficult economic times? I think not.

[barefootbay]

Both these hospitals have been significantly over reached and over built for the numbers and types of patients they encounter.
The competion of hospitals and the levels of care provided are in a large part responsible for the burgeoning cost of health care.

[Heaven]

Originally Posted by Argie's Wife

Heaven, with all due respect, I think you missed the fact that the NH legislation passed the bills that tax the hospitals that are operating as non-profits, thus putting the patients in the path or in the middle, of this.

No, I didn't miss the point, I was serious. It was brilliant of the 1M$+ CEO to throw the patients under the bus because it is the patients and their friends that can and hopefully will toss out the current legislators. Not that it matters, but I have only been insured for 5 years out of 35 that I have lived in NH, so I do know of what you speak. Also, just a side note that 4M loss is not a large amount compared with the total revenue.

[Argie's Wife]

I respectfully submit the following link about CEO pay in the area:

http://www.fosters.com/apps/pbcs.dll...S_01/704059845

The article is from 2009 but it mentions the CEO's pay about three quarters of the way down the page... Anyhow, it comes in at less than half of what you've quoted, I'm afraid. Maybe you have a better source for your information - I'm not saying I don't believe you, just that I don't know where you got your information.

Personally, I think CEO pay scale is fodder for a different discussion. Even if it was a million dollars and even if the CEO gave 100% of his pay back, the organization would then be $3million in the hole.

[Heaven]

Sorry I can't read a Fosters link.
I edited out the rest of my post as there was a link to a non-local article.