Senator seeks health-care diagnosis

Sen. Jon Tester, D-Mont., visited North Valley Hospital and Kalispell Regional Medical Center on Tuesday seeking a diagnosis for health-care problems as well as cures to make the reform law better.

Stopping first at North Valley, Tester met with a group of administrators, medical staff and board members.

“The best input comes from people in the business,” Tester said.

The senator said that the changes will “come from the ground.” Tester said that people in Congress, particularly the Senate, want to make it work because it impacts everybody.

He added that health care affects the economy as a top job producer in the Flathead Valley, according to a recent economic summit.

When Tester asked about health-care challenges, North Valley Chief Executive Officer Jason Spring said the hospital had seen an increase in Medicaid patients in recent years while Medicare patients have remained stable.

“Medicaid is not our best payer,” he said.

Spring also was concerned about significant cuts to Medicare in the president’s budget as well as about the future of the local economy. He said people eventually lose COBRA health-care coverage from previous jobs.

“There aren’t a lot of jobs being added in the valley,” he said.

 According to Spring, North Valley Hospital has higher-than-normal private-pay patients and growing numbers of underinsured patients.

He cited a person recently in the emergency room who was shocked to learn the size of his co-pay and deductible. Spring said people get a thick book with their insurance policies but many never read it.

In the quest to make reform legislation better, Tester said he was looking for ideas for “bending” the ever-growing cost of medical services.

“I’m not sure that was addressed in the health care bill at all,” he said.

Spring said that he saw some opportunities for reducing duplication of services, such as two doctors ordering the same lab test, with electronic health records. He said that North Valley Hospital has done a lot of work to convert to the electronic records, but has more to do. It’s a labor-intensive process, he added.

“I think that will help to some degree,” Spring said. “We also need to move from taking care of sick people to keeping people healthy.”

Dr. Kenneth McFadden, an internal medicine and emergency care specialist, said preventive medicine gives people an extra 10 years of health. But he said eventually their health declines and they still end up at hospitals.

Brian Long, interim chief financial officer, pointed out that the largest percentage of health-care costs occurs in the last few weeks and hours of a person’s life. It becomes a moral and ethical question regarding rationing health care, he said.

Spring added that preventative care such as immunizations and accident prevention, directly lowers the cost of health care.

He questions the sense of hospitals spending $500 million in documentation to prevent $100 million in mistakes or to uncover fraud.

Tester also discussed the high cost of malpractice insurance with several at the meeting. He agreed that problems exist but said patients must have a way to seek compensation if injured.

McFadden suggested a look into a “no-fault” system that would take care of the injured parties, but provide rewards for those giving quality care.

Asked about his outlook on opportunities for economic activity in the Flathead, Tester cited the health care sector. He said he still thinks timber offers opportunities and he named Flathead Valley Community College as a major asset to the valley.

The senator said he was very impressed by the work of college President Jane Karas.

“She responds to the business community very well,” he said.

Tester did more touring than talking during his visit to Kalispell Regional Medical Center. Chief of Staff Craig Eddy started the tour in the emergency room, saying the facilities were designed to serve far fewer patients than today’s demands.

According to Eddy, the hospital hopes philanthropic giving will provide the money for an expansion of the ER, which remains several years away, following completion of the surgical tower. Tagen Vine, executive vice president of Northwest Healthcare Foundation, said the cost of the expansion has not been determined but will include two additional trauma bays.

Next, Tester donned a sanitary cap, gown and foot coverings to tour the operating rooms that will be replaced, and then visited the neonatal unit that cares for premature and other ill babies. Eddy told him that the unit now allows families with struggling babies to stay home instead of traveling to a distant medical center.

Neonatologist Judy Rigby told Tester that the hospital even provides a room so parents can stay near the baby.

“And they have a grandmother hovering over the baby,” she said with a laugh, referring to herself.

At the end of the tour, Tester spoke to the question of budget cutting. He said that some people cut arbitrarily and don’t understand how it affects people.

“You have a lot of cuts in the House with some consequences intended and a lot unintended,” he said. “That’s what you have to be very careful of. What’s the impact of the proposed cuts? Is it tolerable or intolerable?”

Tester asked for honest assessments from the health-care industry and said he would do the best he could to minimize negative impacts. He said the debt and deficit are the most important areas that need attention.

He said that Congress must “not overreact now or underreact in the future.”

Velinda Stevens, CEO of Northwest Healthcare, said that her organization would be “brutally honest” about the effect of proposed health-care cuts.

She asked Tester to consider Kalispell Regional Medical Center as a testing ground for new programs.

“If you’re doing pilots, do them here,” she said. “Don’t do them all at Mayo.”

She then presented the senator with a copy of “The Sublime Engine” written by a Kalispell cardiologist and his brother.

Tester ended the session by complimenting Northwest Healthcare on its partnership with hospitals on the east side of Montana. Stevens told Tester the hospital has a long history of helping smaller hospitals around the state.

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com.