Bankruptcy

Medical debt has become the No. 1 contributor to personal bankruptcy. Over 100 million of us have significant medical debt. The Consumer Financial Protection Board issued a letter to the IRS outlining its recommendations to give indebted consumers relief.

1. Debt resulting from necessary medical care kept off credit reports.

2. Ban hospitals from selling patient debt to collection agencies. 3. Require hospitals to increase their financial assistance and charity care as they are tax exempt. 4. Establish standards for charity care. (NYS has a “bad debt and charity pool” that can compensate hospitals for charity care, but it is basically underfunded and pays only a fraction of charity care.) More than two-thirds of hospitals sue their patients or take other legal actions. The collection industry has pushed back saying these consumer protections will only hurt their provider clients. infections further reducing the strain on overtaxed and understaffed hospitals. I understand while they are at it, they can help set up your TV.

Trinity Health Losses

In what is probably a sign of the times for the hospital industry, the Michigan-based 100 bed hospital system lost nearly $300 million in the second half of last year. St. Joseph’s in Syracuse and St. Peter’s in Albany are affiliates. The pandemic has created a “new normal” for hospitals, meaning inpatient revenues will continue to be a declining percentage of overall revenues. The innovative hospital-at-home program discussed above, born out of necessity, exemplifies the rapid transition to cheaper non-inpatient settings such as home care, ambulatory care, digital/virtual care, urgent care, remote monitoring and pharmacy care.

Insulin Costs Capped

Depression in Physicians

The pandemic has been debilitating impact on care givers. A recent survey of more than 9,000 physicians by Medscape revealed 25% of the respondents indicated they suffered from clinical depression and 9% indicated they had suicidal ideations (versus 5% of the general population). 40% of the docs surveyed admitted they have not shared their thoughts with anyone, let alone sought professional help. A legitimate fear of disclosure is the possibility of an untoward or punitive action by a medical board. Clearly, the pandemic has increased depression and anxiety in all of us. But when it severely impacts those who battle on the front lines, we are all in deeper trouble. Many of the respondents felt our fractured healthcare “system” continues to contribute to the depression and anxiety felt by patients and physicians alike.

Medicare Trust Fund

Safety Net Hospitals Threatened

They are typically located in isolated rural communities and underserved urban neighborhoods. Consequently, they serve a relatively higher percentage of patients with Medicaid insurance or no insurance at all. Consequently, these hospitals, so critical in providing care to underserved populations, receive “disproportionate share payments” to help them maintain fiscal viability. Congress is now threatening to cut $8 billion in DSP to these safety net hospitals. At least nine hospital and medical associations have petitioned congress to maintain the funding needed to keep these hospitals open. Still reeling from the negative impact of the pandemic, the $8 billion cut could not come at a worse time.

Industry analysts predict dozens of these hospitals, already on the brink of financial crisis, could close.

Healthcare From the Geek Squad?

In what is certainly innovative, Atrium Health has partnered with Best Buy, (yes, Best Buy) to provide what they call “hospital-at-home” care. It was born out of the pandemic which undoubtedly strained inpatient care. According to Rasu Shrestha, the chief “innovation and commercialization” officer (yes, commercialization) the program has served more than 6,000 patients at home saving the insurer 25,000 inpatient days. Initially serving mostly patients suffering from COVID-19, they now treat chronic heart problems, COPD, pneumonia, asthma and

Thanks to the Inflation Reduction Act, effective Jan. 1, Medicare members with Part D (drug) coverage will pay no more than $35 a month for insulin. The rest of Medicare recipients, all of whom have Part B (physician) coverage, will pay not more than $35 a month effective July 1. 34 million of us, or one in 10, suffer from diabetes. Drug manufacturer Eli Lilly will voluntarily slash its price for insulin. Mark Cuban’s company will follow suit as well as nonprofit Utah based Civica. Diabetes is one of the fastest growing chronic conditions in younger Americans. The Inflation Reduction Act also permits Congress to negotiate the price of 10 selected drugs starting in 2026. That’s right. JUST 10 drugs. THREE years from now. But that “leaps” to 20 drugs SIX years from now. Cynics worry, and with good cause, drug manufactures will simply raise prices on the myriad other drugs where prices aren’t negotiated. Optimists hope the insulin price competition will infiltrate the industry and finally result in more price competition outside negotiations. It is estimated that 44% of us don’t fill prescriptions, or reduce dosages and cut pills, due to cost.

It is expected to be near depletion in just five years. This is a concern for all of us, both younger than and older than 65. Medicare taxes have been subtracted from our paychecks since we started collecting one. President Biden is proposing to raise the Medicare tax rate from 3.8% to 5% on those making more than $400,000 a year. Analysts believe that certainly will help, but not make Medicare totally solvent. Negotiating ALL drug prices immediately, not just 10 prices in 2026, will make Medicare solvent. It should be noted, Medicare (basically congress) SETS fees/reimbursement for physician and hospital services. While provider lobbyists can plead, there are NO formal negotiations.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Practical advice those who live Need Help? No Need to Go it Alone

It hasn’t been easy. Like many people, I’ve been reluctant to ask for help, not wanting to be a burden or inconvenience my family and friends. But things have changed. Thankfully, for the better.

As I write this column, spring cleaning is tugging at my proverbial apron strings.

I need, I must, make sense of the boxes and bags of family photos, documents and items I inherited after losing my mother and father. I’ve procrastinated far too long. It’s time.

So ... I called my dear friend Carol and asked if she would help me begin the emotion-laden process of deciding what to keep, donate or throw away.

A self-described decluttering guru, Carol happily agreed to get me started. Among many helpful tips, she encouraged me to ask myself, “Does it have value? Does it bring me joy?”

I’m delighted to report that we made great progress. Her help was invaluable!

And we had a good time together, often laughing at the silly things I’ve held onto all these years. My grade school report cards come to mind. No need to be reminded that I “whispered too much.”

Below is an essay titled “Asking for Help” that I included in my book, “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.”

I hope it inspires you to reach out and ask for assistance if you need it.

Asking For Help

A ride to the doctor’s office. Extra hands to move heavy furniture. An emergency dog-sitting request.

Giving and receiving help from my friends and family has proved to be a wonderful way for me to strengthen bonds. I have learned time and again that asking for help brings blessings, not burdens.

Many people — and often those of us who need it most — find it hard to reach out and ask for help in times of need.

The reasons are numerous, but my experience tells me that lots of women and men who live alone avoid asking for help because they fear being seen as weak or vulnerable.

I know that after my divorce I was reluctant to ask for help. I wanted to show the world that I was perfectly fine, thank you very much. I avoided asking anybody for anything, determined to muscle through on my own. It led to isolation and pointless hardships.

But the biggest shame? Not asking for support kept me distant from friends and family. I denied myself (and them) the chance to connect on a genuine and meaningful level. Looking back, it’s clear to me that my healing and personal growth came more slowly as a result.

I encourage you to let go of any excuses not to ask for help, in favor of being true to yourself and to those who love and want to support you. How can you help yourself?

• Be honest. Take a moment to reflect on what keeps you from asking for assistance. Could it be pride? Do you think you’ll be seen as incapable or inadequate? Are you concerned about being a bother? Or, would asking for help force you to acknowledge that, indeed, you need it?

• Redefine what it means to be strong. Everyone needs outside support from time to time, and seeking help on your terms is not a weakness. In fact, the strongest people are often those who have the courage to admit they need reinforcements. I’ve always admired this quality in others. Real strength is knowing your personal limitations and having the confidence to recruit assistance when necessary.

• Have some faith. Believe that people truly want to help. Just think about how you’d respond if a friend, family member or co-worker asked for a helping hand. You likely wouldn’t hesitate; you might even feel slighted if not asked, especially if someone you cared about was having real difficulty. Know that others, too, want to be there for their friends and family in need.

• Take a chance. When you choose to open yourself up and expose your authentic self, you are taking a risk. That’s a good thing! When you are real like this, you have an amazing opportunity to cultivate deeper, more meaningful bonds with others.

• Make the request. First put some thought into where you could really use some support; then ask for help with one specific item. It could be something as simple as asking a neighbor for help raking out a garden bed to something as important as identifying a financial adviser.

If you think you’ll feel awkward making the request, you might start out by saying, “You know, I’m not very comfortable asking for favors, but I wonder if you might be able to help me with something?”

• Express your gratitude. You know this, of course. A heartfelt thank you in person or in writing will be warmly received by the person whose help you have accepted. No need to go overboard. Remember, people want to help others and don’t expect to be compensated for doing a good deed.

• Offer help in return. Because giving can be as gratifying as receiving, make it known that you are available to return the favor. Better yet, find opportunities to offer help. We all have gifts and can be of great assistance to one another.

So, take it from me ... life can be better, just for the asking.