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Published - Friday, July 03, 2009
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Area health care panel addresses insurance, reimbursement concerns

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Todd Ondell can’t afford health insurance for his employees at Grounded Speciality Coffees.

Part of the reason insurance is out of reach might have to do with how the federal government reimburses health care institutions for Medicare.
A recent story in The Washington Post compared Medicare reimbursement rates in La Crosse and Miami.

The story said Medicare paid an average of $5,812 for each beneficiary in La Crosse in 2006, while the average was $16,351 in Miami.

Franciscan Skemp Healthcare chief executive Dr. Robert Nesse told more than 100 people in the La Crosse Public Library basement auditorium Wednesday there was no evidence Miami residents got better health care for three times the cost as La Crosse.

Nesse, part of a panel discussion organized by Congressman Ron Kind, said Franciscan Skemp lost $43 million last year as a result of low Medicare reimbursements.

“We transfer $43 million in costs to the insurance policies Todd tries to buy,” Nesse said.

Gundersen Lutheran chief executive Dr. Jeffrey Thompson said Gundersen Lutheran’s shortfall was $143 million.

“How do we make up that difference?” he said, pointing to Ondell, “We charge businesses more.”

Whatever the reason, small businesses often have trouble getting and affording health insurance for their employees.

Health insurance premiums for his 13 employees would cost $1,200 a month, Ondell said.

“We can’t afford that,” Ondell said.

He has trouble getting quotes from insurance companies.

“Because of the few employees we have, people are not willing to take a risk with us,” he said.

Bill Brockmiller, a County Board member, labor analyst with Wisconsin Job Service and member of the Wisconsin State Employees Union, said the United States spends more on health care than any other country. It also is the only industrialized nation that doesn’t provide health care to all its citizens.

He said the United States does well on life expectancy and infant mortality, compared with the world average.

The life expectancy average for the world is 66, while it is 77 to 79 in the United States. Infant mortality average for the world is 42 deaths per 1,000 babies, while it is 6 per 1,000 for the United States.

Unfortunately, 38 to 40 other countries do better.

“In both lists, we’re just behind Cuba,” Brockmiller said.

Kind said members of Congress hope to have bills passed in both houses by the end of August. They would address universal coverage, quality and cost issues, he said.

Kind and Minnesota Congressman Tim Walz also have a bill to base Medicare reimbursements on health outcomes rather than just specific procedures.
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