Local hospital administrators applauded President Barack Obama for putting health care front and center in his budget proposal. But they said they need to see more details and worry that, given the dire state of the economy, the changes could be hard to implement.
"He's addressing and raising the right kind of questions," said Michael Dowling, chief executive of the North Shore- Long Island Jewish Health System, on Friday. "My only worry is that he's bitten off more than he can chew."
The budget proposal released last week calls for setting aside more than $630 billion over 10 years as a reserve fund to help pay for and expand health insurance - a move toward universal coverage. Half of the money would come from reducing Medicare and Medicaid payments made to hospitals, drug companies and insurance companies, and half by capping tax deductions for families earning more than $250,000 a year.
The president's proposals include:
Eliminating subsidies to health insurers that sell Medicare Advantage plans, which are Medicare managed-care plans. Instead, the plans would be put under a competitive bidding process.
Requiring drug companies to give bigger discounts for drugs to Medicaid, which is health insurance for low-income people.
Cutting Medicare payments to hospitals that readmit a large number of patients within 30 days after they are discharged.
Linking a portion of Medicare payments to the quality of care delivered.
Reducing waste and fraud.
"Although there's not a lot of detail, we're delighted the president is pursuing health-care reform so early on," said Kevin Dahill, president of the Nassau Suffolk Hospital Council.
Dahill questioned some of the proposed cuts, but said hospitals are willing to talk about how to get closer to providing health insurance for everyone.
"We've said for a long time we would work really hard for universal coverage," he said. He added that he isn't opposed on principle to cuts that might affect hospitals: "We have said all along that everyone has got to give a little."
But Tom Ockers, chief executive of Brookhaven Memorial Hospital Medical Center in Patchogue, while praising Obama's focus on health care, said, "None of this should be accomplished by weakening hospitals or doctors through further reimbursement cuts."
Ockers also called for "reducing the burden of malpractice insurance premiums for doctors and hospitals, and funding practical programs for preventive care and wellness."