South Florida Hospital News
Monday December 9, 2019
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December 2019 - Volume 16 - Issue 6

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Healthcare Professionals Share Perspectives on Policy Issues

South Florida Hospital News and Healthcare Report recently conducted a survey focused on healthcare policy options under debate in the United States. Respondents were recruited through the publication's weekly newsletter; and by 2CY, which sought participants from national email lists to expand the geographic representation.

Of the 242 respondents (148 in Florida, 94 outside the state), the largest group – 28 percent – worked in settings such as hospitals or outpatient facilities, or had jobs that provided direct patient care, such as physicians, nurses, dentists, etc. Those supporting the healthcare industry, e.g., consultants, attorneys, and accountants, comprised 26 percent; and those involved in industry associations, academic institutions, foundations, etc., made up 23 percent. Respondents' involvement in the healthcare industry was the largest factor (81 percent) in determining their replies to the survey questions, and 73 percent had 20 years or more experience. Nearly 45 percent reported they were senior executives: CEOs, CMOs, CFOs, presidents, board members, and the like.
 
One segment of the survey focused on attitudes toward politicians' understanding of the issues and their efforts to produce workable solutions. As background, generally speaking, Democrats want expanded health coverage for more Americans, although there is no consensus on their method to achieve this goal. Republicans want total repeal of the Affordable Care Act (ACA) and state control over insurance markets. Their best policy is to support consumer-based options, including purchasing coverage over state lines and forming health savings/health reimbursement accounts.
 
Respondents believe the Democratic party offers the best overall healthcare policies by a rate of 43 percent to 22 percent. However, neither party received many votes of confidence (4.43 percent/ Democrats, 3.5 percent/Republicans) that its policy will lead to a "great system of care" – one that offers quality outcomes, and affordable and accessible healthcare services – in the next five years.
 
Respondents were presented with seven statements that are frequently part of the national healthcare debate and chose the ones that most represented their own current beliefs. The top three responses of Republican policy advocates are: eliminating government interference in the healthcare system is better for patients; a work requirement should be part of Medicaid eligibility regulations; and healthcare is a privilege. Democratic advocates believe: healthcare is a right; gun control should be part of healthcare policy discussions; and taxes should support health insurance for all those who do not have coverage through their employers.
 
Along those lines, research indicates that two-thirds of Americans in general favor regulations that prohibit insurance companies from charging higher premiums to people with pre-existing conditions, although that support declines when the public realizes the costs associated with such a policy. Survey respondents, however, are not in favor of people with pre-existing conditions having to pay more for their health insurance coverage.
 
Some of the points under Medicare and Medicaid included:
• More than 40 percent of respondents strongly disagree that "Medicare for all" (a single-payor system) should replace the current system.
• A nearly equal percentage believe Medicare needs to be restructured to save the program for future generations.
• More than one-third strongly disagree with the idea of Medicare Advantage (Medicare Part C) replacing the Medicare fee-for-service option.
• The majority of respondents favor having Medicare pay providers the same amount for an identical healthcare service, regardless of the site of care; for example, a hospital versus a physician's office. Such a program could reduce hospital revenues by $760 million in aggregate.
• More than one-third of respondents believe a work requirement should be part of Medicaid eligibility requirements. (Federal courts however are blocking state mandates requiring residents work a minimum number of hours a month to qualify for the Medicaid.)
• Nearly 45 percent of those surveyed strongly favor Medicaid expansion, which would give health insurance coverage to nearly all individuals with an income at or below 138 percent of the federal poverty level (currently $25,750 for a family of four).
 
Pharmaceuticals in general and drug pricing in particular triggered intense responses, with 44 percent strongly agreeing that federal regulators should place price controls on the cost of pharmaceuticals. Likewise, more than 50 percent believe patients should be allowed to legally acquire prescription drugs from Canada. Pushback from industry however opines there is no way to guarantee the safety of drugs coming into the United States from outside the country; and the fact that Canada is concerned it may run into a shortage by diverting its medicine supply.
 
Medical marijuana continues to be a hot topic. Legalization received a 38 percent backing by respondents who strongly agree it is a good idea, whereas legalization of recreational marijuana was almost equally split by those who strongly disagree (24 percent) and those who strongly agree (21 percent). Regarding medical marijuana, approximately 36 percent believe long-term use could be dangerous to patients, whereas 55 percent don't consider it a problem. Overall, respondents did not see a need for medical marijuana – or CBD products taken internally (drops/pills) or externally (ointment/salve) – to be classified as Schedule 1 drugs; that is, those that have the potential for high abuse, no medical use, or the potential to produce severe safety concerns.
 
As a result of a measles outbreak in the first eight-plus months of 2019 (1,241 cases confirmed), respondents are highly in favor of the government passing tough regulations on immunization for childhood diseases such as measles, mumps, and chickenpox.
 
Aside from the issues themselves, the survey questioned respondents as to where they seek information on healthcare policy, excluding television. The internet is the leading source, as selected by 81 percent of participants, with local newspapers and Modern Healthcare tied with 33 percent. Among the television stations watched for news, CNN received the highest viewership with 28 percent.

For a more detailed report of the survey, visit adobe.ly/2ndTYRE.

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