07/01/12 — Local health professionals take wait-and-see attitude

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Local health professionals take wait-and-see attitude

By Phyllis Moore
Published in News on July 1, 2012 1:50 AM

Local health care professionals are taking a wait-and-see attitude about the Supreme Court's decision to uphold the national health care law.

William Paugh, president and CEO of Wayne Memorial Hospital, said he was one of many people confused when the news first broke.

"I happened to be at a place where I could watch it on TV, watching CNN," he said, referring to the news channel that initially -- and incorrectly -- said that the individual mandate had been struck down, but quickly changed its report to reflect the justices' true decision.

He said it will take "a little more time" to analyze the ruling before he feels comfortable making a statement about how it will affect the hospital and its delivery of care.

"I really want to sort through what this says and what it didn't say, and to be able to figure out how to appropriately respond," Paugh said.

One of his initial concerns, he said, relates to whether there will be adequate funding to support the president's proposal, and how that will be defined.

"What I saw is that a major funding source for the program was held to be constitutional. From what I can see at this point in time, it appears that a funding mechanism of sorts, that's still yet to be determined."

While the bill might eventually benefit those who before had been denied coverage because of a pre-existing condition, there are still questions that must be answered before that provision goes into effect in 2014, Paugh said.

"You have to have a vehicle in place that says you can't just buy health insurance when you're extremely ill or can see that you're going to need it next Tuesday," he said. "You've got to be able to spread the risk pool (to include) those that don't have any need for it. I think that's the itch that people were trying to scratch."

As a self-described "old finance guy," Paugh suggests there needs to be enough "healthy people in the pool" to balance the equation and keep insurance affordable.

The bottom line, he said, is that it will take some time to "drill down" to what this all means and how it will all play out as it unfolds.

"It's an interesting time in health care," he said. "Since it began, since the Affordable Care Act was passed, the devil's in the details as it relates to how it will be implemented."

Davin Madden, health director at the county Health Department, where a high percentage of the clientele are on Medicaid or have no health insurance, said the announcement is a "good thing."

"In the long-term, it will start a practice for people to start to be covered that have foregone insurance because of the cost," he said. "Having insurance is important for a lot of people because it allows them to go to a medical home and primary care for services."

Madden admitted that he is anxious to see what actually happens now that a ruling has finally been made.

"The interesting part for all medical providers, trying to understand what the true demand will be once this act goes into law and comes into place and will we have the supply of health providers?" he said. "That's always been my only real question. Until it becomes effective, then and only then will you be able to see what the real demand will be.

"Will it initially change anything? Probably not."