NCB: Remember The Big Picture
Providers must keep in mind why competitive bidding is such a backward move for America.
Competitive bidding is projected to save less than two-tenths of 1 percent
in healthcare costs within our current healthcare system. While
any savings in our healthcare system appears good on the surface,
studies released by The VGM Group indicate these savings will come at an
estimated cost of 10,000 businesses and 100,000 taxpaying jobs in the DME
industry alone — before accounting for losses within the communities that
these jobs are supporting.
Job loss is only the tip of the iceberg. This planned attempt to save the
American healthcare system — a $2.5 trillion train wreck — by trimming two
tenths of 1 percent will not alter the course of economic history in a positive
way, but instead continue the downward pressure on our middle class,
which has suffered the economic contradictions of the past several decades
most keenly. Four billion eight hundred million is to $2.5 trillion, what less
than one half of one penny is to $25.00. Let’s just stop for a moment and ask
ourselves this question as a society, economists, social scientists and healthcare
professionals: “Will that half of one penny save our healthcare system or
will it contribute to a larger problem and cost us more in the long run?”
Why would Congress institute and support a program that will eliminate
100,000 jobs that are held by heads of households who pay taxes, fund their
own retirement plans, contribute to Medicare and Medicaid, and financially
support the local communities and its social networks? Not only is it a simple
case of bad math to anticipate a reduction in Medicare and Medicaid cost;
housing subsistence; the Special Supplemental Nutrition Program for Women,
Infants and Children; and food stamp programs by cutting jobs, but also,
and more importantly, we are missing the big picture. Looking further ahead,
perhaps into their retirement years, those same once-employed, once-productive
workers will be forced to tap into that very same financial support again
without the benefit of their contributions to the system!
Wouldn’t the projected savings of two-tenths of 1 percent be better applied
to keeping our workers employed in the jobs that our industry trained them
for in the first place? How about supporting an industry that serves a real
purpose, rather that promoting dead-end jobs in the food industry or within
the underground economy mowing lawns? Our lawmakers and healthcare
policy experts need to consider occupational inheritance, as well as the rate
and direction of social mobility, not just the cost of a walker.
The home medical equipment and home healthcare industries were created
to solve a problem — a function we still serve well. Altering the one solution
that is working within a system that is in crisis would be synonymous to
reducing the size of the patch on a leaky dam. Competitive bidding will prove
to be yet another unsustainable model that will only continue to accelerate our
debt burden — costing not only the HME industry, but also the entire nation
much, much more.
Take a look below the surface of this frightening iceberg. Every time a
worker loses a job, his or her personal health is impacted—emotionally,
mentally and physically. A person’s health is as much a product of education,
financial resources and social status as it is of genetic make-up, personal
habits and exposure to disease. The latest research clearly establishes that
policymakers need to address social inequalities in order to reduce health
For instance, psychological stress, caused by job loss, is a documented factor
in numerous disorders including cardiovascular disease, which is one of five
major conditions from which the Department of Health and Human Services
claims 25 percent of our population is reported to suffer. Other major and
costly diseases include heart disease, mood disorders, diabetes, asthma and
hypertension. Nationwide, spending to treat these five conditions accounted
for the largest increase in total healthcare spending between 1987 and 2000,
with total expenses accounting for 49 percent.
It is not difficult to connect the dots and conclude that the killing off of
10,000 businesses and the 100,000 jobs they provide will come at a tremendous
expense to our nation — not a savings. If we eliminate the jobs as the
lawmakers say we should, rather than reducing healthcare costs by a more
rational means we will instead increase the burden on our nation.
Competitive bidding will only perpetuate this crisis; ultimately, the longterm
health of our society will be paid for in healthcare dollars. We need to
call on a group of representatives in Washington who operate on a higher
level of understanding and can see the bigger picture. It is no longer sufficient
to tell people to pull themselves up by their bootstraps, or suck it up, when
our lawmakers legislate the elimination of the very jobs that would otherwise
allow our workers to stand on the shoulders of their parents.
Eliminating 100,000 jobs in our industry will turn current tax base contributors
into tax base consumers, economic contributors into state and federal
burdens, and healthy workers into patients. For the bean counters, pencil
pushers, mathematicians and politicians the equation looks like this: Every life
lost to cancer, mental health, pulmonary or circulatory disorder multiplied by
the cost of treatment plus the loss of tax base equals the true cost to the nation
Take competitive bidding out of the equation to solve the American healthcare
crisis and let citizens remain in their own homes during times of illness
or recovery. Let DME providers do what we do best — hire and maintain
qualified employees to deliver quality services at reasonable prices — and alleviate,
not contribute to, our nation’s debt burden. Four billion eight hundred
million dollars in savings will ultimately cost us tens of billions more in social
and healthcare problems that we don’t want or need to create. Look below the
surface and you will see that the health implications and related social issues
by eliminating 100,000 jobs will cause us ruin, not national prosperity.
This article originally appeared in the April 2012 issue of HME Business.
Michael Schleipfer, ATP, is the owner of Alternative Care Providers Inc. and can be reached at email@example.com.