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Compromising on healthcare policies

Novant Health will remain committed to finding common ground



The following column is by Pete Brunstetter, chief legal officer for Novant Health.

As a former member of the North Carolina Senate, I learned that governing requires compromise. Compromise includes listening to those who disagree and the willingness to work through difficult issues to find common ground. In the absence of compromise, short-term political wins may be found, but policies are often developed that leave behind the very people they were meant to help. 

The most recent debates in Congress regarding healthcare reform highlight this point.  

After months of debate on several different bills, the U.S. Senate declared an impasse in late September on efforts to repeal and replace the Affordable Care Act (ACA). 

The process to bring these bills forward was filled with political gamesmanship that often overshadowed the far-reaching impact these proposals would have on the American people, including patients at Novant Health.

For example, most of the proposals considered would have changed the Medicaid system in a way that would have left states with significantly fewer dollars to fund their already cash-strapped Medicaid programs. While there is undoubtedly a need to reform our country’s Medicaid program to make it more cost effective, these proposals, according to the American Hospital Association, would have left millions of people without health insurance coverage over the next decade. 

While a handful of senators balked at such widespread coverage losses and ultimately did not support the bills, the fact remains that a lack of willingness to compromise on both sides of the aisle continues to prevent needed changes. The marketplaces created under the ACA remain unstable as insurers face uncertainty on, for instance, whether they will again receive the cost-sharing reductions (CSR) from the federal government that help make plans on the health insurance exchange affordable to many.  

While there are currently some bipartisan efforts in Congress to address stabilization of the exchange marketplaces, it remains unclear if these efforts have the support needed to pass and, therefore, to bring certainty to a very uncertain healthcare landscape.

Inaction and uncertainty themselves have already had an effect on healthcare. Individuals who are uncertain about coverage, or faced with rising premiums and deductibles, appear to have delayed elective procedures. Declining hospital volumes across the country reflect this uncertainty. 

While those of us in the healthcare community continue to push those in Congress to work together to find a sustainable path forward, our day-to-day reality remains. Every day, our hospitals care for the people who need – and expect – us to care for them. In fact, Congress itself expects us to care for them, as evidenced by the myriad of laws and regulations that healthcare providers must comply with. We are open 24 hours a day, seven days a week, and we treat any and all who walk through our doors, regardless of the severity of their illness or their ability to pay for treatment. 

In the meantime, while the debate continues, Novant Health will remain committed to finding common ground, partnering with organizations across our footprint, because we know that these partnerships will lead to the best outcomes for our patients. It is my hope that recent and ongoing efforts to reform healthcare lead lawmakers to where we as health systems have been: keeping patients at the center of decisions.




Published: 12/1/2017