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Health care ‘fix’ will impact southern Ohio

The next several issues of this column will look at national health care reform and how it portends to impact southern Ohio, a region I hold dear.

I was born in Lawrence County, lived in Coal Grove, went to elementary school in Jackson, attended my first prom in Pike and graduated from high school in Scioto.

The other counties I include in Southern Ohio are Brown, Adams, and Clermont, communities I traversed en route to college in Cincinnati.

Proposals in Washington are promising to provide health insurance to an additional 31 million citizens, liberalizing access to care for all, and offering a more generous benefits package.

At the same time, these proposals are projecting net cost savings (after 10 years) by increasing the pool of payees into the system, cutting profits to health care providers and the insurance industry, and taxing the rich.

Health care services are like any other business service, where there is a supply (physicians, hospitals, pharmaceuticals, etc.), a demand (those seeking treatment) and costs.

Economics 101 teaches us that if demand rises considerably, and there is not an increase in supply, then costs go up and access to services is restricted in the form of longer wait lines and drive-by appointments. There is no getting around this economics maxim.

Just the same, reform will do little to increase beneficiary access to health care in southern Ohio unless there is an offsetting increase in the supply of health care providers to service the certain spike in demand that will occur as a result of the compulsory individual insurance mandate and subsidized care.

The U.S. Census Bureau estimates in 2006 (latest data) the counties of Lawrence, Jackson, Pike, Scioto, Adams, Brown, and Clermont had a combined uninsured population of 45,627.

According to the American Association of Family Physicians, the optimal primary care physician caseload is 1,806 patients per year.

Based on this benchmark, southern Ohio would need up to 25 additional primary care physicians to meet the surge in demand caused by reform, with supporting hospital beds, equipment, specialty care physicians, etc.

Massachusetts is a case in point. In 2006, the Bay State enacted health care reform similar to proposals gestating in Congress, including an individual mandate for all to carry insurance and extending coverage to two-thirds of the uninsured.

A health policy study at Boston University calculated that in 2009 Massachusetts spent 33 percent more on health care per person than the national average, up from 23 percent in 1980.

Moreover, 1-in-5 adults in Massachusetts surveyed in 2008 reported being denied care because a physician was not receiving more patients or would not accept their type of insurance.

In 2010, Massachusetts elected a Republican Senator for the first time in over 40 years who campaigned solely on halting national health care reform.

But make no mistake, Massachusetts is still one of the most socially minded states in the union and supports health care reform — but without the downsides of higher costs and restricted access to care.

Much good can come from health care reform and it is commonly known that skyrocketing costs are threatening to sink the U.S. fiscal ship.

But without balancing cost-cutting measures with incentives for growing the supply of health care providers, the objective of reform to increase access to care may prove elusive.

Joe Green is from southern Ohio, is President & CEO of NPRC, a management consulting firm, and may be reached at joe@ohiogo.us.