ASHEVILLE, NC – August 4, 2024 –
Dear Representative Edwards:
In your recent August 4th opinion piece in the Asheville Citizen-Times, you said that “The American people deserve affordable, accessible, and high quality health care options, but that’s not what Western North Carolina residents are receiving today.” Your proposed solution was to leverage your position on the Congressional House Budget Committee to promote federal policies that address these deficiencies. This assessment sounds quite reasonable. However, this approach does not provide any details of how to fix health care in western North Carolina.. Therefore, I would like to offer some additional measures to achieve these lofty health care goals.
In your article, you mentioned that there is a surge in hospital mergers in the United States, “resulting in increased federal spending and higher costs for patients.” You said that after the Hospital Corporation of America acquired Mission hospital system in 2019, the average list prices in this region doubled to an average of 33% a year.
A recent landmark North Carolina Medicaid expansion bill supported by Governor Cooper and the General Assembly has made health care more accessible in North Carolina. Since it took effect on December 1st, more than 500 thousand people have access to health care so far, according to the latest update of the NC Medicaid Expansion Enrollment Dashboard on July 3rd. According to the 2022 U.S. Census Bureau American Community Survey, and prior to Medicaid expansion, there were almost 1 million uninsured North Carolinians, more than 9% of the population and higher than the national average of 8%.
Measuring quality of care is very difficult. As you know, our regional health care system is monopolized by the Mission Hospital Health Care System, which is owned by the Hospital Corporation of America, the largest for-profit health care system in the United States. The hospital’s quality of care was questioned by the Centers for Medicare and Medicaid Services (CMS). Mission Hospital was warned that it would no longer be eligible to participate in the care of Medicare and Medicaid patients until it addressed certain stipulated deficiencies in meeting quality of care standards. Loss of CMS certification would be catastrophic for health care in our community.
As our district’s representative in the House of Representatives, you feel that the solution is to use your position to promote “policies and funding that disincentivize consolidation and promote greater choice, more affordable access and better quality of care for the citizens of NC-11 and beyond.”
While your assessment seems reasonable, I would like to make some additional suggestions to make health care more affordable, accessible, and of high quality. Some of these measures can be achieved through federal regulations; others may require state legislation. However, through your leadership, they can be attained. Here’s my list:
- Rescind the Certificate of Need (CON) laws to encourage competition (as you have suggested as the solution to reach affordability)
- Close the health care access gap between persons eligible for Medicaid Expansion and the Health Insurance Marketplace by increasing the federal subsidies to the latter program so that more people can afford to enroll
- Expand federal subsidies for medical provider training programs, like physician residency programs that already receive federal grants, so that there are more high quality and well-trained providers for health care
I hope that these 3 specific suggestions can help you to help create a healthier region.
Regards,
Dick Needleman, M.D., M.P.H.
Health Reporter, 103.3 Asheville FM
Retired orthopedic surgeon
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Contact: Dr. Dick Needleman, Health reporter, 103.3 AshevilleFM, [email protected]
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