National health care and its affects on hospitals, care providers and consumers alike was one of the topics of the Neosho Area Chamber of Commerce’s quarterly luncheon, held Thursday at the Neosho Civic.

Scott Watson, vice president of operations for Mercy, and Renee Denton, administrative services director for Freeman Neosho, spoke before a large group of local business leaders.

“If you want everything I know about how ‘Obamacare,’ or the affordable care act, is going to affect you,” Watson said before pausing a moment, “you’ve just heard it. Anybody who knows exactly how it is going to affect all of us is either far more advanced in reading the document than I have had the ability to do or, unlike most of us. Trying to be real honest, it’s going to be a learning adventure. It’s going to change the way we do business, it’s going to change the way you do business, and we will not know the affects … for quite some time.”

Watson further explained that the lengthy national health care act is in a constant state of change, therefore, the ways it could affect the average person or business owner are still being determined.

One part of the measure is changing how hospitals are reimbursed for care by Medicare to include customer satisfaction. Measuring this is done through customer surveys, Denton said. One question, she said, is “Did your nurse address you respectfully,” and the survey offered four potential answers: Always, usually, sometimes, and never.

“The ‘always’ response is our ‘A’ on the report card,” Denton said. “Meanwhile, ‘usually’ is our ‘C.’”

She said most people will not give the highest mark because they are accustomed to thinking there is always room for improvement.

The federal government would hold on to a quarter of one percent of reimbursement pending the results of satisfaction surveys by patients newly released from the hospital.

“The good side of that is, it makes great common sense,” Watson said. “The difficult side of that is this: meet my mother. She is 4-feet, 11-inches, 85 pounds of pure hurricane. There is nothing that you are going to do, whether you are at Freeman or Mercy, if a score of 5 is tremendous, you are not going to get a 5. You are very lucky to get a 3, and most of the time, you will probably struggle to get a 2.”

While the amount the government withholds pending survey results doesn’t sound like much, Watson said, it can add up to millions of dollars and have an impact on hospitals and the services they provide.

Watson said another change looming for the healthcare industry is how insurance companies reimburse hospitals for services provided to their clients. Watson said under current Medicare / Medicaid reimbursement, hospitals may see less than $150 for a $1,000 procedure. In the future, he said, insurance company reimbursements will mirror the federal government’s for physicians and hospitals.

“The most challenging thing about medicine today is how much money it takes to open the doors every day,” he said. “To build a hospital — to build it, not to furnish it — we’re talking about $450 a square foot. To build a clinic … is about $125 a square foot. So, one of the real challenges that we have every year, is finding enough capital to do business. The sequestration, for example. When it occurred, $20 million went off the books that day. That’s a pretty good chunk of change.”

The Medicaid expansion is another issue facing healthcare. Watson said as an attorney, he could make an argument for either side of the issue, and both would be right. But whatever the argument, he said something needed to be done to help the uninsured pay their medical bills.

The session ended with a brief question and answer period. Gib Garrow, the chamber’s director of economic development, asked Denton and Watson what could be done to get more young people interested in healthcare as a career.

“I’d celebrate my nurses like crazy,” said Watson, whose youngest child will begin her nursing studies this fall at the University of Missouri-Columbia.

Meanwhile, Denton told of a medical internship program Freeman began which would allow qualifying high school students ages 16 and up to job shadow doctors, nurses and certified nurse assistants, spend time on different units of the hospital, and learn if health care was a good career fit for them.