Healthcare vs. “Sick” Care

“Since both in time and importance health precedes disease, so we ought to consider first how health may best be preserved, and then how one may best cure disease.” – Galen, 170 AD

This is one of my favorite quotes and one I often referred to concerning healthcare. GRMC provides a refuge for people in need of medical care. Our goal is always to heal people to their best possible health after an illness or injury. I am proud of the quality of care our team works hard to offer the communities we serve.

GRMC is in the “quality-of-life” business, in that our own personal health and wellbeing dramatically impacts our everyday lives. As the quote from Galen puts it, preserving health in the first place should be the number one priority.

Unfortunately, the healthcare system in this country has really been more of a “sick care” system. Too much emphasis has been on mending bodies after health has left them. We have shielded folks from the true cost of healthcare through the proliferation and misuse of health insurance. The personal responsibility for maintaining optimal health has not been incented in the system. Although a growing number of Americans are health conscious, it is hard to deny the obvious epidemic of poor health. Really troubling is the rise of childhood obesity, for example.

So what can be done to be more proactive in preserving health? I believe community hospitals can be a catalyst for health improvement and the quality of life for our citizens. In March 1997 with the help of Claude Ahrens, GRMC built the Paul W. Ahrens Fitness and Rehabilitation Center in the heart of our campus. It was our first really visible commitment to preventive health. Over the years we have built on this initiative with integrative health services at the Postels Community Health Park and Fly High Fitness Studio in downtown Grinnell for all our group exercise activities such as yoga, aerobics, Spinning®, and now Zumba®.

I truly cannot predict what the future of acute care medicine is going to look like for rural hospitals in America, but I do know our survival depends upon staying relevant to the community. People understand the importance of an easily accessible emergency department in their community for urgent healthcare after a car accident or with the onset of a heart attack. But hospitals are often considered only a place to go to be “fixed” when something is broken.

As hospitals, we can become more skilled in helping people stay healthy in the first place. If we can do this well, community hospitals will continue to be vital to the wellbeing of the community.

Stay tuned to future blog entries on health improvement topics, such as how we are working to strengthen our health coverage for our employees and our vision to create the healthiest community in America, a project we call “The Heart of Grinnell.”

A Mighty Band Travels to DC

On April 25, a mighty band of GRMC advocates made our way to our nation's capitol to fight for fair and equitable Medicare and Medicaid payment as part of the American Hospital Association's Annual Meeting. Susan Witt (board chair), Ed Hatcher (board chair-elect), Michelle Rebelsky, MD, (physician board member), Rachel Cain (UI graduate student and our summer intern), and I all left Iowa on a gloomy day hoping to get our voices heard.

We arrived to 90 degree weather in Washington, D.C. The temperature was the perfect metaphor for the red hot debates on healthcare reform and sizzling presentations from some Beltway insiders we witnessed. By now, anyone who reads my blog knows GRMC is a so called "tweener" - too big to be a critical access hospital and receive cost based reimbursement and too small to be a rural referral center, which also has better payment levels. As for GRMC, we got paid some $7 million below our costs last year for providing care to Medicare and Medicaid patients. Our simple goal is to push for legislation that would level the playing field and improve payment so we can continue to provide the care our patients have come to expect and deserve.

The highlights of our trip included a meeting of tweeners from around the country pledging to work together to coordinate our efforts and build a stronger voice to get our message heard. We also got educated on the latest efforts by our law makers and the Obama administration to reform healthcare. There seems to be a great deal of optimism that we will see legislation yet this year that will fundamentally change the way healthcare is delivered and paid for in our country. As we heard over and over again, "the devil will be in the details." We wait to see just exactly what Congress will develop.

When talking to many Congressional leaders specifically about GRMC's payment issues, we were heartened to hear not only a thorough understanding of the unfair payment we receive, but a strong commitment to get the issue addressed this year. We had the great fortune to have dinner with Congressman Boswell on Monday evening and lunch with Congressman Braley on Tuesday. We also meet with both Senators Grassley and Harkin later that afternoon. There is no question that our congressional delegation is leading the effort to both reform healthcare and also address this specific issue that plagues GRMC. I am grateful for their efforts. I took along stories from more than 40 GRMC patients. You can read them here.

I also want to assure everyone that GRMC leaders are watching our pennies as we push for payment improvements. I am willing to bet that members of our delegation were the only ones attending the AHA annual meeting who shared hotel rooms - the ladies in one room, the gentlemen in another. Best of all, there was a power outage in our hotel Sunday night for eight hours. After we asked, the hotel agreed to not to charge us for that day. We took turns covering meals and taxis, and several of the board members covered their own costs. I believe this is going above and beyond, given these individuals are donating their time to go and advocate for the patients served by GRMC. Finally, I personally paid the cost for our intern to attend the meeting and will also cover her summer stipend. The legislation we are pushing for would increase GRMC's Medicare payment from between $800,000 and $1.6 million per year - so obviously the investment in travel to Washington is worth it if we can make it happen!

We managed to do some sightseeing between meetings and visits on Capitol Hill. Here are a couple photos of interest:


Standing in the "Soup Line" at the FDR Memorial hoping for a little relief from our lawmakers on our Tweener issue.


Ed and Michelle contemplating the day standing at the foot of Abraham Lincoln looking at the Washington Monument in the distance.


Taking our message to Capitol Hill.


We even stopped by the "Senate ATM" to try to get our share of the Federal stimulus funds, to no avail.


Finally, Ed thought maybe he could just jump over the fence at the White House to talk directly to President Obama. We talked him out of that idea!

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.