Health care is complicated

Health care, as President Trump reminds us, is complex.

And it’s just as complex on the financial side as it is on the medical side of the equation.

Just when you think you have a handle on things, another facet presents itself, another contradiction surfaces, another regulatory or legislative web entangles you.

That’s not only true on the national level. It’s just as true when you’re trying to sort out the fiscal future of Jay County Hospital.

So there’s a chance that any effort to explain the hospital’s current financial challenges will be flawed. Something might be oversimplified. Something else might be overlooked. Some assumptions might just be flat-out wrong.

But we’ll give it a try anyway.

To begin to understand the hospital’s financial difficulties, it’s important to understand where the hospital’s revenue comes from. Expenses, of course, are important. But what Jay County Hospital is dealing with at the moment is revenue-driven.

So, where does the money come from?

Essentially, it’s from four sources: health insurance companies like Anthem and its competitors, Medicare, Medicaid and what people reach into their pockets and pay privately.

But — and this is where the contradictions and complexities come in — not everybody pays the same price. The amount that Medicare and Medicaid pay is set by the federal government. Health insurance companies generally pay a higher rate, although they do their best to talk prices down and get every discount they can.

The result is something called “cost shifting,” and it’s an undeniable inequity in America’s current health care system. If you receive the same care, you ought to pay the same price. That’s pretty basic, but it’s not what happens.

For Jay County Hospital, however, it’s not so much cost shifting that’s the problem. It’s the mix of where those revenues are coming from. — J.R.

Friday: The revenue mix.