GRANTS - As various versions of health care reform legislation wend their way through Congress, Senator Tom Udall (D-NM) visited Cibola General Hospital on Oct. 9 to listen to the problems and concerns of rural health care providers.

Senator Tom Udall discusses healthcare reform with, from left, CGH CEO Ken Cochran, hospital employee Pamela Akin and hospital board member Paul Milan during the senator’s visit on Oct. 9. BEACON / DONALD

    Hospital CEO Ken Cochran, along with Drs. Janice Shipley and Jane Pitts and department supervisors, welcomed the senator to the conference room.

    Dr. Pitts started the session by observing that health care is now “disease care” and that more primary care physicians are needed at the hospital.

    Hospital board member Lawrence Sanchez stated that more funding is needed for medical research. “Maybe money for research could be taken from the defense budget,” he suggested.

    Dr. Shipley talked about practical considerations that physicians face. “There are unintended consequences for certain regulations like the requirements that all local languages be available at the hospital. There are actually very few patients that we treat who speak the Keres language, but the regulation requires that we have someone to translate,” she said.

    Shipley pointed out that there was a requirement that all physicians return phone calls within 30 minutes. “Sometimes that just isn't practical,” she commented.

    She joined Cochran is calling for tort reform in medical malpractice cases in any health care legislative package.

    “If the public wants evidence based medicine, we need tort reform,” Cochran said. “Doctors feel compelled to practice defensive medicine as a hedge against lawsuits and that adds to the total cost for everyone.”

    Cochran went on to say that medical outcomes in Canada are as good as ours. “Their outcomes with infectious diseases are actually better than ours because Canadians don't take as many antibiotics as Americans do.”

    Sen. Udall had definite opinions on the practices of health insurance companies. “Insurance companies shouldn't be allowed to drop customers who are seriously ill or who have pre-existing conditions. There will be a prohibition on these practices in the legislation,” he said.

    Udall then asked the medical professionals what they thought of mandatory insurance like automobile insurance, which is required in most states to legally operate a car.

    Pitts replied that often an insurer will refuse to cover an illness and the patient just leaves.

Sanchez said that reimbursement of doctors and hospitals was a big issue at CGH. “How can we get fair reimbursement?” he asked.

    Pitts pointed out that the emergency room is required to treat patients even if they're not seriously ill.

Arlene Harvey-Ferrer, director of Patient Financial Services at the hospital, stated that, contrary to rumors, the hospital does not turn patients away if they don't have insurance. “We always care for emergency cases,” she said. “We provided $6  million in unreimbursed services last year.”

    Udall asked if the hospital was attempting to be certified as a critical access hospital and Cochran replied that there has been a holdup in the certification because of the proximity of Acoma-Canoncito-Laguna Hospital. “We're trying to solve this problem in the state legislature because we already do most of ACL's surgeries and a lot of their lab tests,” he said.

    He further explained that rural hospitals face special challenges because they're required  to comply with all the same regulations as large, urban hospitals. “All this requires too many auditors and it's very expensive,” he said.

    “We're now at stage three of electronic records development, but we want to be at stage seven. How can we get grants to comply with all the regulations?” he asked.

    In closing the listening session, Udall said, “I know how important small rural hospitals are to their communities and I want to be fair to the rural areas.”

    Shortly prior to his visit to Grants, Udall joined 29 other senators in signing a letter to Majority Leader Harry Reid stating that the inclusion of a public option is the only way to ensure competition and get health care costs under control. “We urge you to fight for a sustainable health care system that ensures Americans the option of a public plan in the  merged Senate bill,” the letter read.

    Following his meeting with the health care professionals at CGH, Udall was given a tour of the facility.