Senate Health Chair Says Its Time For Local Doctors To Pay Fair Share To Hospitals
CHRISTIANSTED — The Senate chair of the Health Committee for the Legislature says her office will be vetting a bill that would require local doctors who work in Virgin Islands hospitals to share some of their fees with the health facilities they work in.
Senator Nereida “Nellie” Rivera-O’Reilly said in a Facebook post that the bill would require “physicians who are on the hospitals payroll receiving GERS and health insurance benefits to share a portion of their professional fees with the hospitals.”
“This is a fair request as these physicians who draw a salary as well as fringe benefits also bill a patient’s health insurance when they see that patient in the hospital and use hospital resources,” Rivera-O’Reilly said. “We look forward to continuing this dialogue.”
Troy de Chabert-Schuster, the former vice chairman of Juan F. Luis Hospital’s governing board of directors, first raised the issue when speaking extemporaneously during a meeting of the Rules and Judiciary Committee on February 22. At the time, de Chabert-Schuster said local hospitals were being “held hostage” by local doctors and overall health care in the territory suffered as a result.
Rivera-O’Reilly said some physicians have a monopoly on some health care specialties and it must be ended if overall health care is to improve in the territory.
“I received a text today from a doctor essentially threatening to sue the Legislature if we change the current physician compensation model because it is this doctor’s opinion that allowing the hospitals to hire doctors who do not want to have their private practice and prefer to be full-time employees of the hospitals (allowing the hospitals to bill for all services) is interfering with their union,” she wrote. “I forgot to mention that our physicians are unionized. Essentially controlling what doctors can be hired by the hospitals and how much they can be paid.”
As an example, the chair of the Health, Human Services and Hospitals committee of the Legislature, said there “one and only one” gastroenterologist on St. Croix.
“Many doctors see uninsured patients at the hospitals and take the insured patients to their offices,” Rivera-O’Reilly said. “Some have set up surgical suites taking away out-patient procedures from the hospitals. It is a system that was created decades ago to protect local doctors.”
Rivera-O’Reilly charged that taxpayer dollars are used to pay for medical malpractice insurance to protect the very doctors who are enriching themselves through the current system.
“The medical malpractice insurance which our government (your tax dollars) pay was established to entice doctors to come and provide services at the hospitals,” she said. “Today your tax dollars pay for settlements when doctors are sued for medical malpractice. That model doesn’t work anymore.”
“Nonetheless, physicians including our own sons and daughters are trying to protect the status quo. Today the Governor did just as the doctor predicted, he vetoed our measure to expand the hospitals’ ability to hire physicians. I guess physicians have more lobbying power than patients. This should get you riled up. This should make you angry. This should make you demand change.”
The five-term St. Croix senator said the high pay doctors are making through the hospitals is keeping local health facilities from being able to hire more needed doctors and specialists.
“Physicians compensation package with our local hospitals impedes hospital’s ability to hire doctors and meet the critical needs of care,” Rivera-O’Reilly said. “Delayed licensing of physicians and other medical professionals delays entry to specialists.
Rivera-O’Reilly said “under-insured and uninsured population overburden” our local hospitals.
“Low participation rate of private physicians in Medicare and Medicaid in direct violation of the law,” she wrote. “High cost for services (fees negotiated by V.I. physicians with insurance carriers are secret). Private provider organization is the sole PPO in the V.I. Abuse of emergency room due to uninsured and high rates charged by physicians to the indigent. Monopoly of services by some medical professionals.”