A local look at the national billThe U.S. Senate is expected to take a final vote on its version of the National Health Care Reform Bill today, with the likelihood of it passing on a partisan vote.Rod Barton, chief executive officer of Powell Valley Healthcare, talked on Tuesday about what the bill might mean for health care providers and patients in Powell. Barton noted that the bill, in its current form, aims largely at health insurance reform.

“That's where they spent most of their time, reforming health insurance, not really the health care system,” he said. “There's a lot of things that have not been addressed yet ... But I recognize that, to try to reform a system as massive and complicated as the U.S. health care system, it cannot be done in one easy step.”

One of the most positive aspects of the Senate version of the bill, Barton said, is the fact that it would delay a 21-percent reduction in Medicare payments to providers that is slated to go into effect on Jan. 1. That would give Congress two months to come up with a more permanent solution that would prevent bigger problems.

“The obvious outcome (of the rate reduction) would be that more and more physicians would refuse to see Medicare patients,” he said.

Other positives for the local health care system stem from the fact that Powell Valley Hospital, with its 25 beds, is considered a critical-access hospital.

For instance, as a small, critical-access hospital, Powell Valley Healthcare would qualify for a key provision in the bill known as the 340B program, which would provide substantial discounts on prescription medications for critical access, children's and cancer hospitals.

“That's a good thing, with a cost savings potentially we could see from this,” he said.

Having a critical-access hospital also would exempt Powell Valley Healthcare from some provisions in the bill that would affect bigger hospitals.

“This was not about providers', this was about insurance coverage,” he said. “Usually, it's better for us.”

Another plus included in the Senate version of the bill is Wyoming's designation, along with four other states, as a “frontier state” with fewer than six people per square mile. Under that designation, health-care providers in Wyoming, Montana, North Dakota, South Dakota and Nevada would receive additional Medicare payments for services they provide, Barton said.

“I don't know how much it will be,” he added.

Barton said he thought that provision likely was included to help sell the bill in the Senate.

“I don't know why Alaska's not in there,” he added.

Taking a big-picture look, Barton said the bill is designed to extend health-care coverage to an additional 30 million people nationwide.

“That is good news,” he said, “but it still leaves about 25 million people out.”

Those left out include illegal aliens, who are excluded from the bill, “but I can't imagine that explains all of it,” he said. “I am encouraged that there will be more people who have health-care coverage, but, to be sure, this is not the final fix.”

Barton noted that lawmakers — and the public — are divided over proposals for a public option for health insurance. A public option is included in the version of the bill passed by the House; it was removed from the version the Senate planned to vote on today.

“Some wanted a single payer, which would be the government,” Barton said. “Then those on the other side think the government ought to stay out of it. I loved the quote, ‘Keep the government out of my Medicare,'” he added.

He said an advisory about the health care bill from the American Hospital Association is 29 pages long. And, despite the publication's relatively brief format, many of the bill's provisions it explains still are hard to understand.

“I want to be involved in the process, but at the same time, the process is much larger than we are,” he said.

Even if the bill passes the Senate, large differences between the House and Senate versions must be worked out before it can become law.

“It's not a certainty that they can work out their differences,” Barton added.

The American Medical Association and the American Hospital Association have come out in favor of the health care bill. But as it stands now, the bill doesn't address many of the problems that plague the nation's health care system, such as a lack of focus on prevention, Barton said.