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“People are going to suffer and people are going to die”

Wednesday, Jul 31, 2019

* This bill passed both chambers on unanimous roll calls

Hospital corporations in Illinois now have to jump through more administrative hoops before they will be allowed to close or downsize a health care facility.

A new law that took effect this month requires the owners of those facilities to obtain a permit from the state’s Health Facilities and Services Review Board before they can close a hospital, ambulatory surgical treatment center, nursing home or other health care center. It also limits the number of times they can apply to discontinue a category of services to just once every six months. […]

The bill was prompted by a controversy in Cook County earlier this year when California-based Pipeline Health announced plans to shut down Westlake Hospital in Melrose Park, a hospital that serves a large number of low-income patients. […]

The new law took effect as soon as Pritzker signed it, but state officials were not immediately able to say whether it would affect the proposed Westlake closure.

* Another example

Warnings that “people will die” should a Blue Island hospital close punctuated a state panel’s hearing Wednesday in that city. […]

Dr. Annie Sinnott, who oversees MetroSouth’s emergency department, and fire chiefs from communities including Blue Island and Riverdale testified that ambulance transport times for critically ill patients will increase, possibly jeopardizing patient outcomes, should the hospital close.

“Real people with real problems are going to suffer,” said Sinnott, with other MetroSouth doctors standing with her. “People are going to suffer and people are going to die.” […]

[Dr. Henry Shin, the hospital’s medical chief of staff] blamed ownership changes in recent years, which have resulted in “services and staffing” being “gradually degraded” as a key factor in why people are seeking care at other area hospitals.

* But keeping the doors open will not be easy for some

Shrinking subsidies are pushing hospitals that serve the poorest communities in the Chicago area to the financial brink, and potentially threatening patient safety.

Hospitals are getting less money from various federal and state programs intended to offset the cost of treating poor and uninsured patients who can’t pay for care. At the same time, the number of people without health insurance is rising, due partly to the elimination of the Affordable Care Act’s individual mandate and high insurance premiums. Even patients with insurance are struggling to cover out-of-pocket costs they incur under increasingly prevalent high-deductible insurance plans. […]

Cuts in Medicaid disproportionate share payments are set to take effect Oct. 1, but lawmakers are pushing for at least a two-year delay. An initial $4 billion reduction—to be followed by additional cuts—was mandated by the ACA under the assumption that Medicaid expansion and health insurance exchanges would reduce unpaid medical treatment. But uncompensated hospital care is rising again as court rulings and the Trump administration chip away at the landmark health care law. […]

Changes to the state’s hospital tax assessment program expected next year also worry some safety-net CEOs. They say they could lose tens of millions of dollars in funding if rates are more closely tied to patient volume, which has decreased across the board, or costly transformation efforts.

* Then there’s this problem in rural areas

“We have been without a physician position being filled for about a year now and it only had three candidates two of which surfaced lately,” says Administrator of Genesis Medical Center Aledo Ted Rogalski.

And patients can feel the difference and it presents a challenge to hospital administrators.

“We see our patients leaving our communities and going elsewhere because our wait time for our two and physicians can be up to 8 weeks at a time so those patients will travel elsewhere to seek care,” says Rogalski.

The shortage of rural healthcare providers is about four times that in metropolitan areas. […]

“It’s a negotiation between the manage care company (insurance) and the local entity. If you’re part of a larger organization you’re going to have more power at the bargaining table than if you’re just a standalone where that managing care company might say this is all we’re paying you, take it or we’ll send our patients elsewhere,” Rogalski adds.

* And the rich get richer

Northwestern Memorial Hospital is the only Illinois medical center to land among the 20 best hospitals nationwide, moving up three spots to No. 10, according to new rankings by U.S. News & World Report.

The academic medical center in Streeterville—which is nationally ranked in 12 specialties, including neurology and geriatrics—also topped the list of Illinois hospitals. Rounding out the top 5 in Illinois are University of Chicago Medical Center at No. 2, four-hospital NorthShore University HealthSystem and Rush University Medical Center, which tied for third, and Loyola University Medical Center at No. 5.

- Posted by Rich Miller        

29 Comments
  1. - NeverPoliticallyCorrect - Wednesday, Jul 31, 19 @ 12:21 pm:

    Another example of pandering by government. No business closes if they can afford to stay in business and they are making a profit. Care will be impacted by substandard hospitals that are forced to stay open. If the government thinks they know where hospitals should be located then they should just take over health care and run things.


  2. - Hermosa - Wednesday, Jul 31, 19 @ 12:27 pm:

    @NeverPoliticallyCorrect - I couldn’t agree more. Government should take over healthcare. Winners and losers are decided on zip codes driven by corporate profit. That can’t happen when we are talking about the livelihood of a human being.


  3. - Dotnonymous - Wednesday, Jul 31, 19 @ 12:27 pm:

    Don’t people who live in the greatest country on Earth deserve health care?…I often wonder…when America will join the rest of the civilized World?


  4. - City Zen - Wednesday, Jul 31, 19 @ 12:31 pm:

    ==Winners and losers are decided on zip codes driven by corporate profit.==

    Might want to choose a different ER.


  5. - Dotnonymous - Wednesday, Jul 31, 19 @ 12:31 pm:

    Geography is destiny…in America.


  6. - train111 - Wednesday, Jul 31, 19 @ 12:38 pm:

    That rural thing is sure correct.
    The Central Wis. town I grew up in had a hospital, a clinic, and 3 full time doctors when I lived there 30 years ago. Now there is only a clinic with two or three part time doctors that come to town 1 time per week each. My parents have to wait an incredibly long time to see a doctor unless they want to drive to a neighboring town.
    I often think that those of us in the burbs or city don’t realize just how bad it is in rural areas.

    train111


  7. - Shemp - Wednesday, Jul 31, 19 @ 12:43 pm:

    Illinois: Don’t close your medical facilities just because it doesn’t make financial sense
    Also Illinois: Your medicaid and state insurance reimbursement checks will arrive some time next year, maybe.


  8. - Amalia - Wednesday, Jul 31, 19 @ 12:46 pm:

    what you might call a rich hospital is also a place that for 30 years took adult trauma patients in while U. of C. did not. and which takes in patients of all income levels while the state has been behind on paying the hospital for services rendered.


  9. - Dotnonymous - Wednesday, Jul 31, 19 @ 12:51 pm:

    For profit medicine is a disgrace.


  10. - Dr. Frankensteen - Wednesday, Jul 31, 19 @ 12:52 pm:

    Won’t this negatively impact the the number of entities willing to purchase an existing hospital in a rural or impoverished area? I’m no health administrator, but I imagine prices might be dropping significantly as a result of this action.


  11. - 47th Ward - Wednesday, Jul 31, 19 @ 12:59 pm:

    Health care providers, especially hospitals, are like any other high-tech industry: they thrive where there are clusters of other high-tech workers and companies. That’s key to Northwestern’s story, and that’s why the best hospitals in the world are located in urban America. That’s not going to change.

    Rural healthcare is a troubling issue with no good solutions on the horizon. Without major incentives, it’s hard to imagine talented health care professionals moving to rural Illinois communities.

    Unless the state is prepared to go into the hospital business, we’ll see more and more struggling hospitals close their doors. That’s the thing about private health care: there are always winners and losers in the free market.

    Everybody who opposes Obamacare can take solace in the fact that health care is not a right in America, it’s a privilege reserved for the wealthy and for those who qualify for Medicaid/Medicare. Everyone else is on their own.


  12. - JAH - Wednesday, Jul 31, 19 @ 1:06 pm:

    We are a Capitalistic Society…. Which by definition is an economic system based on the private ownership of the means of production and their operation for profit.


  13. - Dotnonymous - Wednesday, Jul 31, 19 @ 1:09 pm:

    - JAH - Wednesday, Jul 31, 19 @ 1:06 pm:

    We are a Capitalistic Society….

    Capitalism is one economic strategy…by actual definition.


  14. - Dotnonymous - Wednesday, Jul 31, 19 @ 1:12 pm:

    - JAH - Wednesday, Jul 31, 19 @ 1:06 pm:

    We are a Capitalistic Society….

    Who are we?…are we Royal?


  15. - Demoralized - Wednesday, Jul 31, 19 @ 1:16 pm:

    ==For profit medicine is a disgrace.==

    Amen. I’ve always thought that a for profit healthcare model was a disgrace. Healthcare decisions shouldn’t be made based on a bottom line. Companies that make a profit off of the healthcare industry make me sick. People are entitled to good healthcare. The fact that one of the richest countries on earth cannot guarantee that is unacceptable.


  16. - Cook County Commoner - Wednesday, Jul 31, 19 @ 1:34 pm:

    A for profit hospital cannot operate unless its client base leans towards those paying from more profitable insurance pools.
    Hospitals favoring poor clients are essentially dedicated to adverse selection of patients, so government must vigorously intervene.
    Illinois and its local governments have decided to dedicate resources elsewhere.


  17. - Skeptic - Wednesday, Jul 31, 19 @ 1:42 pm:

    [..] the number of people without health insurance is rising, due partly to the elimination of the Affordable Care Act’s individual mandate and high insurance premiums.

    [..] But uncompensated hospital care is rising again as court rulings and the Trump administration chip away at the landmark health care law.

    Rodney Davis, are you listening?

    “We are a Capitalistic Society….” and…? We subsidize farmers too. You’re saying we should stop doing that too? And if a company can’t make money building a factory someplace, why are we subsidizing that too? Shouldn’t the marketplace decide?


  18. - Earnest - Wednesday, Jul 31, 19 @ 1:49 pm:

    >If you’re part of a larger organization you’re going to have more power at the bargaining table than if you’re just a standalone

    It doesn’t have to be this way, whether healthcare or social services, though it keeps going that direction. I’ll return to my broken record:
    rather than send our tax dollars to out-of-state organizations to manage people on Medicaid, hire more cost-effective Tier II state employees who pay state and local taxes. Create cost-effective college paths doctors and couple with loan forgiveness for service in needed locations.

    The state (OK, world) seems to be creating a system where they deal with one or two large contracts instead of more contracts with smaller organizations based in their local communities. Unlike the past, it’s very possible to create easier and more automated ways for the state to deal with contracting and level the playing field between smaller organizations and huge corporations. I return to the fact that we have a Governor with a business incubator mindset, evident even in the way he made his comments on Alton. There are better ways to find efficiencies and foster innovation and entrepreneurship.


  19. - Dotnonymous - Wednesday, Jul 31, 19 @ 1:54 pm:

    Companies that make a profit off of the healthcare industry make me sick. - Demoralized

    This “for profit” system actually makes people more sick…especially those persons unable to access health care…and/or… afford to pay criminally inflated drug prices.


  20. - The Way I See It - Wednesday, Jul 31, 19 @ 2:46 pm:

    Shemp hit it right on the state’s approach to medicine. We want it delivered but don’t want to pay reasonable amounts or in a timely fashion.


  21. - Last Bull Moose - Wednesday, Jul 31, 19 @ 3:02 pm:

    I understand the belief that health care and profit do not mix well. But no system seems perfect. We used to have religious charities as major players in healthcare. They are less important now and some object to the religious beliefs that come with religious healthcare.
    The thought of state run hospitals is scary. Look what happened with nursing homes for veterans. And the IT system my medical group uses actually works.
    I do like the capitation models like HMO’s where the provider makes money by keeping people healthy. But the biggest contributor to good health is the patient. I don’t know of an HMO that refuses to treat smokers or fat people.


  22. - Shemp - Wednesday, Jul 31, 19 @ 3:48 pm:

    The reality is there are winners and losers in health care. Always will be. There are not enough resources (human and cash) to give everyone the platinum treatment. We can’t all have access to the Mayo Clinic tomorrow morning. Either government gets to pick and choose who gets what care, or people can choose how best to use what resources they have. Pure fantasy that somehow we can all have it all and equally. You can’t force someone to lose money and operate. You can’t make every doctor a top performer and put a top performer in every market. You’re not going to get a top doctor to work for peanuts in shabby conditions.


  23. - Skeptic - Wednesday, Jul 31, 19 @ 4:25 pm:

    “I don’t know of an HMO that refuses to treat smokers or fat people.”

    Keep in mind, that’s not entirely because of the free market. There is an entire State agency devoted to regulating HMOs.


  24. - Dotnonymous - Wednesday, Jul 31, 19 @ 4:38 pm:

    - Shemp - Wednesday, Jul 31, 19 @ 3:48 pm:

    The reality is there are winners and losers in health care. Always will be.

    You mean entitled and disenfranchised?


  25. - Dotnonymous - Wednesday, Jul 31, 19 @ 4:41 pm:

    Pure fantasy that somehow we can all have it all and equally. - Shemp

    Republican talking points are easily mimicked…obviously.


  26. - 47th Ward - Wednesday, Jul 31, 19 @ 5:01 pm:

    The reality is the US spends more than any other country on health care yet lag behind many nations in terms of outcomes. The money we spend, if allocated well, is more than enough to provide every American with health care.

    Winners and losers? That’s BS. Nobody should go bankrupt because they get sick. We all lose when that happens.


  27. - Yellow Dog Democrat - Wednesday, Jul 31, 19 @ 7:25 pm:

    Let’s also remember that there used to be plenty of publicly-owned hospitals in Illinois, but private providers told us they could deliver health care more cheaply and city hospitals were redundant.


  28. - Blue Dog Dem - Wednesday, Jul 31, 19 @ 7:27 pm:

    ….when will America join the rest of the civilized world.

    Prolly when we enact a 18% VAT. Or better yet. When we eliminate youth,grade school, high school sports like the rest of the civilized world.


  29. - Odysseus - Thursday, Aug 1, 19 @ 7:14 am:

    “Won’t this negatively impact the the number of entities willing to purchase an existing hospital in a rural or impoverished area?”

    Nah, I was already of the opinion that healthcare as an industry needs an enema.


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