Poor still top priority in hospital system

WASHINGTON, Dec. 29 (UPI) -- Getting adequate healthcare services to the disadvantaged was identified this week as the top concern of a top non-profit hospital chain.

"It keeps me up at night," Vincent Caponi, CEO of St. Vincent Hospitals and Health Services in Indiana, told United Press International.

Caponi's institution is part of Ascension Health, the nation's largest, non-profit Catholic health organization, and supports 1,700 beds in 16 hospitals in the central part of the state.

He said that adequate care for the poor remains his number one concern.

"Whether they have insurance or not, making sure the poor and underserved get the care they need is a real problem. Our system's bottom line is not affected -- we're too big -- but federal and state budget cuts are gutting Medicare and Medicaid and we must figure out how to keep these people healthy."

"If you ask me what's on my wish list for 2006, Caponi continued, the first thing would be recognition that healthcare is a right, not a privilege," Caponi said. "People without insurance or with bad insurance don't get treatment or they delay treatment until they must seek emergency care. If nothing else, that's not cost-effective. Emergency room treatment is the most expensive form of healthcare that exists."

Caponi said he thought the cure lay in changing healthcare policy for both Indiana and the nation.

"We need a national health system," he told UPI, "but many people who would like to preserve the status quo object to even exploring that option. It's useless to cast blame at this point, we must simply get everyone who matters to the table and start figuring out what's best for everyone."

The national health system Caponi envisions would include what he called "the art of medicine." It would make a clear distinction between treatment that was recommended from habit and treatment that produced benefit, and would not be so restrictive that progress could not take place.

Caponi added that he saw no financial obstacles to the plan.

"I think there's plenty of money in the healthcare system to make sure everyone gets what they need. A lot of it gets spent on the business instead of patients. I think we could reduce administrative expenses and free a lot of money for care.

"We have the economic wherewithal to do whatever we want, we just need bold statements and strong leadership. If someone challenged this country to solve our healthcare crisis by 2020, it would get done, the way we put a man on the moon during President Kennedy's time in office." Caponi said his second wish is to fully explore the way information technology can help patients and integrate it into his system, although he recognized that the costs involved put that option out of reach of some providers.

"I wish it were less expensive," he commented, "because it's pretty shameful that there's more technology in your local grocery store than there is in your local hospital. We're all behind on this one."

The CEO said a third wish was for healthcare providers to start cooperating instead of competing and really push safety issues, especially in local areas that could produce significant safety improvements for all their patients if people worked together.

"Prescription errors are a good example," he explained. "Doctors have sloppy writing and pharmacists make mistakes when they try to decipher it. If we could create a list of standard notations every institution in a city adopted or got everyone to use an electronic physician order entry system, we could solve this problem for a whole metropolitan area at one time."

The healthcare chief said he felt passionate about these three issues and thought if they were solved, many other problems would take care of themselves.

Caponi noted that the St. Vincent Health Services system consists of large, tertiary care institutions with 700 beds in Indianapolis alone, six critical access hospitals of 25 beds or less in areas where reaching healthcare providers is a problem, and three long-term acute care hospitals that accommodate patients on respirators or other forms of equipment who need up to 30 more days of treatment but don't require all the services of a regular hospital. There is also a heart hospital, a children's hospital, a women's hospital and several suburban hospitals. The system employs 11,000 people and delivers around 8,000 babies a year.

Caponi added that he loved his job.

"At the end of the day, what everyone wants from their employment is recognition for a job well done, to be in on the issues that affect us, and to make a difference. Everyone in healthcare must feel this way - that they are in a field that makes a huge difference. There's so much good work that can be done and so many people we can help in the process. It's a wonderful way to serve."