About Amy Umble:
Amy Umble is health reporter for The Free Lance-Star
Government-run health care
Both reform bills now being debated in Congress will expand the federal role in health care. Just how big that role already is can be seen in these numbers from Mary Washington Healthcare.
Fred Rankin, president and CEO, used this breakdown of his company’s revenues in a recent talk to the Fredericksburg Rotary. The breakdown shows that the federal government is Mary Washington’s largest customer by far. Nearly 50 percent of company earnings come from three federal health insurance programs: Medicare, Medicaid and Tricare. (States help fund the Medicaid program.)
Medicare, the program for the elderly and disabled, is the largest of these, and as Rankin pointed out, its influence is far-reaching. Medicare tells hospitals and doctors what it will pay; there are no negotiations. This amount is less than the cost of care, so hospitals charge private insurance plans more to make up the difference. And what it pays is usually the starting point for what private insurance companies pay.
Since it is such a big player, Medicare can require hospitals to practice medicine in certain ways. A recent example, according to Rankin, is the possibility that hospitals and doctors will have to use electronic medical records if they want to be paid.
If local doctors did a similar revenue breakdown for their practices, it would look a lot like Mary Washington’s. Many doctors don’t participate in the Medicaid and Tricare programs, but most of those who treat adult patients take Medicare. It’s an important source of revenue for them.
So why the fear that the reform legislation will lead to government-run health care? Don’t we already have government-run health care?
This is where Mary Washington Healthcare’s revenue comes from:
Medicare-31.5 percentAnthem-22.1 percentMedicaid-13.2Managed care-7.4Aetna-6.5Self-pay-5.9United Healthcare-5.2Tricare-5.2Cigna-1.7Commercial insurance-.9Kaiser Permanente-.4Charity care-.2