U.S. Sen. Edward M. Kennedy’s death last week came at a critical time for Massachusetts hospitals, as they battle attempts to strip away as much as $1 billion they get from the federal government’s Medicare program.
After the coming Labor Day break, Congress is expected to take up again the hotly debated issue of health-care reform and a possible restructuring of the nation’s medical system.
But some leaders from the Midwest and Western states are also inserting into the overall debate a long-running dispute over how Medicare funding for the elderly is distributed to states.
Those in more rural areas say urban and some suburban areas get more money via Medicare’s complex funding formula – and they want the formula either changed or funds slashed to reduce overall health-care costs.
Those in more densely populated regions say they need more money because they serve more poor residents and have higher cost-of-living wages and expenses. They also noted they have more teaching hospitals, where new doctors are trained, to support.
U.S. Rep. Michael Capuano (D-Somerville) said he’s worried that Medicare funding could be a major stumbling block to reaching an overall consensus on health-care reform.
One plan to change Medicare funding could cost Massachusetts nearly $1 billion, leading to possibly thousands of local layoffs, Capuano said.
“Some critics (of the current Medicare funding formula) are basically saying, ‘We want a bigger slice of the pie – or else,’ ” said Capuano, who says his district has tens of thousands of people working in hospitals.
“We have to be very vigilent moving forward,” said U.S. Rep. Edward Markey (D-Malden).
Massachusetts’ congressional delegation last month held a meeting in Markey’s office to discuss strategies on how to beat back threats to the current Medicare funding sytem. Efforts to change Medicare funding were defeated earlier this summer in the House, but the battle is expected to resume later this year, he said.
Local hospitals are monitoring the situation closely.
“There are a lot of different forces in Washington trying to take advantage of the health-care debate in order to get other things,” said Dr. Peter Slavin, president of Massachusetts General Hospital.
One proposal he’s seen could lead to Mass. General annually losing about $50 million in Medicare dollars, or about 2 percent of the Harvard-affiliated hospital’s operating budget. A loss of $50 million could cost the hospital about 1,000 jobs, he said.
“It’s a very big issue for us,” said Tom Glynn, chief operating officer for Partners HealthCare, the parent company of Mass. General, Brigham & Women’s Hospital and other institutions in eastern Massachusetts.
Medicare cuts could be even more devastating at Boston Medical Center, which is already suing Massachusetts for what it says is underfunding of its services via the state’s new univeral health-care system.
Elaine Ullian, chief executive at Boston Medical, said in a statement that “proposals being discussed would have a profound, harmful effect” on her hospital, associated with Boston University Medical School, and other city teaching hospitals.
The showdown couldn’t come at a worse time for Massachusetts, with the passing away of Kennedy, considered a masterful behind-the-scenes legislator and a huge champion of the state’s health-care industry.
“He was working on this stuff right to the end,” said Glynn.
Glynn said he has confidence in Capuano, Markey and other delegation members, including Sen. John Kerry, head of the Senate’s health-finance committee.
“But, in the end, there’s only one Ted Kennedy,” Glynn lamented, reflecting the attitude of other hospital leaders.
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