Dear Editor,

Health care reform is an urgent priority for President Obama and the 111th Congress, and rightfully so. The president has challenged Congress to work with him to pass legislation this year that will effectively reduce cost increases, provide universal coverage and give all Americans access to quality, affordable health care.

Having just returned from a visit to Capitol Hill, I can attest that the train has left the station and is on track and on schedule. My concern is that it is moving too fast. It needs to slow down long enough for policy makers to evaluate all the complexities and consequences that surround the various reform proposals. For example, they need to understand the unique and challenging issues of delivering health care services in rural communities, like ours.

Because a higher percentage of residents in rural areas are uninsured and elderly, rural hospitals face an increasing burden of uncompensated care every day. The most critical issue facing rural hospitals today is the growing number of uninsured patients, which puts pressure on everyone. Health care reform that leads to universal coverage is essential to the financial viability of community hospitals in the future.

However, to be successful in providing universal coverage and improving the health care delivery system, policy makers need to remember the old adage, “If it ain’t broke, don’t fix it.” In other words, we need to find ways to build off the aspects of our existing systems that are in place and working today, rather than dismantling and rebuilding everything from scratch.

That is why the “public plan option” presents real concerns. We don’t need a government-run health insurance plan that would compete with private insurance on an uneven playing field. Such a public plan could cause crowding out and likely result in payments to hospitals that are below costs, which is a challenge we currently face with Medicare and Medicaid reimbursement.

Most community hospitals, like Andalusia Regional, want to be part of the solution. We are committed to improving quality and helping to reduce costs. But it is essential for rural hospitals to be treated fairly and equitably with our urban counterparts when it comes to reimbursement by government health care programs, which is currently not the case.

Rural communities depend on their hospitals as major employers and as sole providers of necessary health care services. I ask you to reach out to our congressmen and remind them about the unique and challenging needs of community hospitals, before the train reaches its final destination.

Mark Dooley

CEO, Andalusia Regional Hospital