Study projects $32 million needed for health care

By Roger Morris Western News Publisher

Medical care for Libby¹s asbestos victims could cost about $32 million over the next five years, according to the latest figures from an actuarial study funded by the state.

And as many as 60 new people suffering from asbestos-related disease can be expected annually during that same time period, the study indicated. That could be balanced by as many deaths per year, said Jim Buck, of Insurance Service Organization of New Jersey.

The firm was hired by Gov. Judy Martz to help identify the health care cost problem in Libby related to asbestos-related disease.

Buck released the latest information during a teleconference Friday organized by Jean Branscom, Martz¹s health policy advisor. The teleconference included officials from St. John¹s Lutheran Hospital, the Center for Asbestos Related Disease and Dr. William Spence, state medical officer — who is also directing the Montana Asbestos Screening and Surveillance Activity in Libby, and representatives from U.S. Senators Conrad Burns and Max Baucus.

Buck said the best-case projection of cost is about $32.2 million but that number might be a little high. The worse case scenario for cost would be $90.1 million but that is unlikely to happen. It involves having everyone who was screened in 2000 and 2001 becoming ill.

Presently W.R. Grace provides a health plan for 855 Libby asbestos victims administered by Health Network of America. Although Buck could not identify 2004 costs by HNA, the study is projecting the company¹s costs at $10.5 million over the next five years.

The remainder of expenses covered by Medicare, Medicaid, paid by the patient or written off by the hospital, said Jeanie Gentry of St. John¹s.

Gentry said the hospital doesn¹t have a breakdown of how much money the hospital specifically writes off annually on care for asbestos victims. She said 10 percent of the hospital¹s overall patients do not have insurance and 18 percent pay for their own healthcare.

³We will continue to provide heath service and no we can¹t afford it,² Gentry said of the write-offs.

³You and I — the taxpayers — are going to pay for it and the hospital is going to eat some of it,² Spence admitted.

Representatives from the two senators asked for a breakdown of what is not covered by HNA. Both Baucus and Burns have been working to establish special criteria in ongoing discussions of a bill seeking to relieve corporations of asbestos liability and establish a national victim¹s fund. As of yet, victims of Grace¹s former Libby operations would not meet the criteria to qualify for coverage by that fund. There has been congressional discussion of a special Libby exemption.

The two senators have also discussed creation of a national ³white lung² program similar to the black lung program for coal miners. There has also been talk of creating a special Libby trust but the amount of money needed has been a question mark with estimates ranging from $50 million to $500 million.

³It think it¹s good news for the people of Libby although there is no good news with asbestos,² Spence said. ³But this is better than people of Libby expected.²

Buck¹s study results showing that the community may expect 60 more diagnoses a year compares favorably to what Spence is discovering through MASSA, that more of the 7,307 people screened in 2000 and 2001 by the Agency of Toxic Substances and Disease Registry have been diagnosed with asbestos-related disease. The ATSDR screening identified about 18 percent of the people screened were showing lung abnormalities consistent with asbestos-related disease. Buck said the overall probability of positive status is about 21.7 percent.

Spence said that is consistent with what he is seeing by providing periodic screening for the people who had a negative reading in the ATSDR screenings.

Buck¹s study also shows that 49 percent of HNA¹s total costs come from 77 people with serious illness. He said HNA was paying for about 92 percent of what was charged compared to Medicare, which pays about 62 cents on the dollar.

CARD manager Pat Cohan said Grace expenses are tempered by constant adjustments and cuts to the HNA program.

³Each year HNA has cut what they pay for,² she said. ³In 2001 they were paying for some medications that they have since cut. At the end of 2003 they changed criteria on who was eligible for oxygen. Now the program is saying that the pulmonary function tests are only needed once every three years and not every year.²

³Keep in mind that HNA exists, no jest intended, by the grace of W.R Grace and could go away,² Gentry said.

Speculation in the community has Grace ending the health program once they have resolved their bankruptcy case. Grace is also supporting the congressional bill, which would absolve them of legal responsibility to Libby asbestos victims.

In a recent development, the company is facing criminal charges in federal district court related to their Libby operations. Those charges are expected to be released by a federal grand jury in January.

Hospital and CARD officials agreed to provide additional health care costs for the next governor¹s study group teleconference meeting on Feb. 4.

When the total amount of money spent on health care, besides the amount paid by HNA, is available, Buck said he can project a better estimate of the total amount of cost for the next five years.