Congressman visits SWMC

Automation of medical records, Medicaid and Medicare reimbursement and immigration were top topics discussed during a visit Tuesday by Congressman Jerry Moran to Southwest Medical Center, where he met with hospital Administrator Tony Daigle and Vice President DeLany Fawkes.

Mr. Daigle expressed his appreciation of Congressman Moran's support and efforts in Congress on behalf of hospitals in Kansas.

Congressman Moran responded to Mr. Daigle saying he realized hospitals "face tremendous challenges."

"I worry about hospitals, but mostly I worry about your patients and their ability to access quality health care services in their home communities," he added.  "I appreciate the relationships I have with hospital administrators and with the Kansas Hospital Association. I have 75 hospitals in the First Congressional District of Kansas – more than any other congressional district - and I have been in all of them."

Automated Records
Mr. Daigle questioned Congressman Moran on what the catalyst was behind President George Bush's proposal of automated medical records.

"I think there is a theory that if we have automated records there will be cost savings," the Congressman said. "(I feel) they are looking at how to slow the ever escalating costs of health care to the patient by (asking if) savings can be had through information systems (technology).  It seems to me hospitals have advanced technology in the delivery of health care, but not in the way they keep records. Automated medical records could help minimize costs by reducing errors and making it easier for the medical records to follow the patient when they see a doctor. The problem is there is no financial incentive to invest in this technology and hospitals need additional resources to make the transition to automated records."

Mr. Daigle told Congressman Moran he believed if a financial solution could be found, it would be the "smart way to go." He also agreed that finances are a problem, but noted there are other areas which could also pose difficulties should records become automated.

"We have a problem with HIPPA on electronic records - something we already have difficulties with," he said.  "There is also no assurance it will be more safe for patient care using electronic medical records. The same mistakes can be made either electronically or hand written. However, my biggest issue is how do you allocate $2 or $3 million dollars from a hospital that is only making 1 or 2 percent of its bottom line? If they make this nationwide we are going to have hospitals that are not going to be in compliance because of the financial issue."

Improved Outlook
Congressman Moran noted that, through media reports, he had learned Southwest Medical Center was doing better financially.

"We dropped $2 million dollars on our bottom line last year," Mr. Daigle responded. "We took that very seriously and cut back on costs. Our costs this year are running about 1.5 million under where they were last year."

Immigration
Immigration issues were another topic during the Tuesday meeting.

Both DeLany Fawkes and Mr. Daigle noted that the language communication barrier is a problem.

"You hear Spanish more than English here now," Mr. Fawkes said. "Probably two-thirds of our staff in admissions here at the hospital are bilingual and we need that. It's difficult. Imagine being in a foreign country and having to see a doctor and you can't speak the language."

Mr. Daigle gave another example.

"Patient problems related to the abdomen for instance – there is no word in Spanish that means the same as abdomen," he said. "A physician will use what terms he or she knows and sometimes there is no word equal to it in Spanish - it becomes a guessing game."

Mr. Daigle also pointed out that even though a translator may know Spanish, often times the dialects are not the same.

Congressman Moran said many Kansans have expressed their concerns about illegal immigration.

"In my town meeting in Liberal in August, 80 percent of what we talked about was immigration." He said Congress is working to address the issue by improving border security, enforcement and promotion of a legal workforce. Though more needs to be done, he said there is not a simple quick fix to illegal immigration.

Congressman Moran asked if there had been any news about the proposed meat packing plant for Oklahoma or New Mexico.

Mr. Daigle stated that the consensus is the "plant would be coming" to Oklahoma; however, they also noted the presence of the plant would add to the already growing immigration issues.

"It is going to hurt us at the hospital and the whole community," Mr. Daigle said. "They will move to Liberal to work there. Some thought it would be a wonderful idea to have it located here, but there was a lot of opposition to it."

Lobbying
According to Congressman Moran the strongest lobbying effort in Washington involves pharmaceuticals.

"I keep pushing for greater use of generics - there is a tremendous pushback in the political world about that," he said. "We could save billions of dollars if 10 percent more generics were used than brand name medicine."

Both Mr. Daigle and Congressman Moran did agree there are some generics not as good as the brand name medicines.

"I have talked to patients who told me the generic did not work for what they needed," Congressman Moran said. "I think there ought to be an option for a patient. In other words, if it does work and they are equal – save the money and go with generic."

Medicare
The most common healthcare question Congressman Moran gets is from senior citizens.

"It is about the Medicare prescription drug benefit, and it is a complicated program," the Congressman said. "I did not vote for legislation creating this benefit, not because I believe seniors shouldn't have a prescription drug benefit, but before we do that, we should do something about why drugs cost so much. Otherwise, all you are doing is transferring drugs we can't afford from seniors to the tax payers who can't afford it either."

Veterans
Congressman Moran also mentioned veterans during his visit at Southwest Medical Center.

"I continue to push for outpatient clinics for my veterans," he said. "Many veterans are a long way from a VA hospital and they should be able to go to the doctor or hospital of their choice. I see hospitals to be a lot like schools. Schools need every student they can get and hospitals need every patient they can get. Rather than the VA paying for an outpatient clinic, if the veteran could go to this hospital or one of the local clinics, I think that is a good outcome for the veteran as well as the hospital."

Outlook
As for how the hospital is doing, both Mr. Fawkes and Mr. Daigle share positive outlooks.

"I think this hospital is doing a great job of delivering the care that is appropriate to the volumes we serve," Mr. Fawkes said, adding, "We can keep our skills and equipment up, but not try to be all things to all people - it doesn't work in this business."

Mr. Daigle echoed his sentiments.

"We aren't going to be everything to everybody," he said, "but we are going to do what we do best."

When asked how the relationship of Southwest Medical Center is with surrounding hospitals and communities, both Mr. Fawkes and Mr. Daigle again agreed, saying Southwest Medical Center does not try to "compete."

"We aren't out to take patients away from say, the Ulysses or Elkhart hospitals. if they come this way it is because of our reputation (for good service)," Mr. Daigle said.

Politics
At the end of their session, Mr. Daigle asked about the status of controversial issues of politics today.

Congressman Moran says Washington, D.C., has become even more partisan and political.

"Instead of working together to solve a problem, some would rather have a political fight," he said.

Congressman Moran said he often hears from Kansans about their concerns for the "day-to-day" casualties of Iraq, the high cost of gas, particularly for farmers, and the "poor response" by local Gulf state and federal officials in the aftermath of Hurricane Katrina.

"Unless the agriculture industry improves, we are going to lose farmers and the landscape of rural Kansas is going to change," he said. "(People are asking if) there is a plan for what victory looks like in Iraq.  (As for Hurricane Katrina), I think Americans saw what was happening in the region and thought 'this shouldn't happen in this country. This is the United States of America.' (As a result of all of these things), there is this continual 'what's going on' (attitude) and then when you add to the ethical issues out there, people are just shaking their heads."

Congressman Moran said he appreciated his time with the administrator and vice president and the opportunity to be at Southwest Medical Center again. "These meetings keep me informed of what challenges hospitals in the first district are facing," he said. "The feedback I receive guides my continuing efforts in Congress to improve rural health care."