Imus Kisses Up to Bob Garrett, CEO of Hackensack Univ. Med. Center, Until He Learns Garrett Can't Write Scripts

Imus didn’t have a doctor on the phone this morning, but that didn’t stop him from bitching about his ailments to Hackensack University Medical Center’s President and CEO Bob Garrett.

“I have cancer, and emphysema, and a paper cut,” he told Garrett “So maybe I should come out there and check in.”

He wouldn’t be alone; HUMC is the fourth largest hospital in the United States, based on admissions, and it’s doing very well considering the present economic condition of the country, Garrett said. They’ll open a brand new cancer center soon, and early next year a new heart and vascular hospital will debut. On top of those developments, HUMC is also one of the “greenest” hospitals in the country, thanks largely to Deirdre Imus and her team and the Deirdre Imus Environmental Center for Pediatric Oncology.

But’s it’s not all flowers and rainbows. “We’ve seen more people that don’t have insurance, or who are underinsured due to the economy,” Garrett said. “Also, we’re seeing people putting off elective procedures.” The number of Medicaid patients in New Jersey has also increased, he told Imus, and he suspects the same was true around the country.

Garrett admitted there was truth to Bernard’s observation that with President Obama’s health care plan, “Taxes are going up, Grandma’s going down.”  Of the three major goals Garrett said health care reform set out to accomplish, he believes Congress achieved only one: providing coverage for the uninsured.

The bill, he said, “will probably provide some insurance to about 30 million Americans who don’t have insurance now.” As for the other objectives—bending the cost curve and finding a way to pay for the newly insured—Garrett said, “They didn’t really roll up their sleeves and find a good way to pay for it.”

But this progress is a double-edged sword: Garrett suspects health insurance companies will ultimately pay for these additional insured people by significantly cutting reimbursement rates to hospitals and physicians. “That’s going to put a real strain on the health care system,” he said.

Some hospitals will likely close, he predicted, while others will simply curtail services. One glaring omission from the bill, in his view, was not including malpractice reform. Garret sees firsthand doctors bankrupted by malpractice suits, and others who practice “defensive medicine” by ordering tests and procedures that are probably unnecessary, just to protect themselves.

“It’s almost impossible, I think, for a physician coming out of medical school today to go into private practice with some of the malpractice rates,” said Garrett, touching on two other dilemmas in the medical field: a shift in the way service will be provided going forward, and an overall shortage of doctors.

With 30 million additional Americans added to the insurance rolls, Garrett believes it will be more difficult than ever to see a doctor. “People are predicting it could take 12-15 months just to get an appointment with a primary care doctor,” he said, and likened this to the way things are in Europe, where many more physicians are employed by hospitals because they can’t afford to be in private practice.

Congress’s failure to recognize an impending physician shortage—200,000 by the end of the decade, by some estimates—also frustrates Garrett. Though some new medical schools are being established, the problem remains that since 1991, there has been no increase in the rate paid by the federal government to hospitals and clinics for taking on medical residents.

“There’s no incentive for hospitals and clinics to take on more residents,” Garrett said. “That was another deficit of the health care bill. There really should have been recognition that we have a physician shortage.”

Imus, who definitely does not have a personal physician shortage, wondered if Garrett can write prescriptions, particularly for Vicodin, a personal favorite. Though he could not comply, what’s even more alarming is that Garrett replied, “I can give you some names.”

-Julie Kanfer