UNC Hospitals need health care reform

UNC Hospitals is continuing to rely on health care reform as a way to reduce costs even though the legislation is being challenged and might even be repealed.

The hospital has been losing millions in uncompensated care costs and is counting on the provision in the reform that requires everyone to be insured by 2014.

But that specific provision is facing scrutiny nationwide in legislatures and in the courts.

Even legislators in North Carolina are looking to join more than two dozen other states in challenging the provision, meaning that UNC Hospitals’ chances for saving money could be jeopardized.

Health care reform is essential to the 50 million uninsured in the U.S., said Sandra Greene, a professor in the Department of Health Policy and Management. And this doesn’t include all the people who are underinsured, meaning they have such high co-pay and deductible payments that they cannot really use health care services.

Many think the challenge will go all the way to the U.S. Supreme Court, said Joan Krause, a professor in the UNC School of Law.

But UNC Hospitals is preparing to cut costs whether or not the reform sticks.

“We believe that health care reform is happening,” said UNC Hospitals spokeswoman Jennifer James. “And if it’s repealed, we wouldn’t change what we’re doing.”

She said UNC Hospitals is now planning to reduce costs with the implementation of electronic medical records, accountable care organizations and new partnerships — like the one with BlueCross BlueShield of North Carolina for a primary care facility.

“We will do this regardless of legislation,” James said. “As a system with or without health care reform, we will find a way to deliver the best health care for patients to reduce their costs and our costs.

“We will do better and do our best,” she said.

The expansion of primary care services is crucial because allowing the emergency room to serve as the location of primary care is becoming increasingly expensive, said Don Dalton, spokesman for the N.C. Hospital Association.

“What we’re going to see is hospitals all over the state continue to work with local networks to provide local access and improving quality of care so we are delivering cost-effective and cost-efficient care,” he said.

The cost-saving aspect of health care reform is giving people the ability to seek help when they first fall ill through primary care services as opposed to relying on emergency rooms when they are in a worse condition, Greene said.

“That’s more cost-effective,” she said.

“And I can’t imagine someone wanting to repeal the insurance reforms that are now preventing insurance companies from dropping people with pre-existing conditions.”

Although two court decisions have ruled the reform to be unconstitutional, it is too early to assume there will be any repeal, she said. Especially because two judges have also ruled the provision to be constitutional.

If the provision had been structured as a tax as opposed to a mandate, it might have been more difficult to challenge it in courts, Krause said.

The question is whether Congress has the power to mandate people to buy something.

However, not putting forth the provision in the form of a tax was a political compromise to avoid public dissatisfaction, she said.

Contact the State & National Editor at state@dailytarheel.com.