The issue of health care on Orcas Island is not going to solve itself.
Rural medical services are difficult to sustain financially, as evidenced by the 58 public hospital districts in Washington (that’s nearly half of all hospitals in the state). All but a few are in rural areas. Our county already has two public hospital districts – one on Lopez and one on San Juan – and this April, voters will be casting their ballots in a special election for both an Orcas hospital district and a board of commissioners.
We need a reliable funding source for health care on Orcas Island or we will be left with few options. However, the editorial staff at the Sounder has thought long and hard about endorsing the public hospital district because of some community dissatisfaction with UW Medicine Orcas Island Clinic.
Within the pages of the Sounder there has been a great deal of discussion regarding the policies of UW Medicine. There are three primary concerns: UW will not conduct blood draws and run lab work for patients under the care of physicians outside the UW system; Kaiser is the only insurance company offering ACA health insurance plans in San Juan County, but some patients have reported receiving referrals for non-ACA-covered specialists within the UW system; and patients are often unable to get same-day or next-day appointments for urgent or semi-urgent care.
Candidates for the public hospital board of commissioners sat down with Executive Director of UW Neighborhood Clinics Debra Gussin in mid-March to discuss some of those concerns. Art Lange, a PHD candidate and member of the Coalition for Orcas Health Care, said the session was “encouraging” and that UW Medicine “really does want to fix things and understands we are a rural community unlike any other.”
As a result, UW has released the following statement: “We’re listening to your feedback which indicates that you’d like to be able to have non-UW lab work done at the UW Medicine Orcas Island Clinic. We are working with our partners at UW Lab Services to identify a workable solution for this issue, and we hope to make it available by April 1.”
They also released this statement about Kaiser. “We appreciate that Kaiser continues to maintain the same contract for Orcas Island residents that existed before UW Medicine came to the island. This contract allows residents to maintain primary care at the UW Medicine Orcas Island Clinic. Kaiser also retains the same access for specialty care as before. We request authorization from Kaiser to be able to send our patients to UW Medicine specialists if that is their preference. Kaiser then reviews these requests on a case-by-case basis. We’re continuing to work with Kaiser to find ways to streamline this process. No matter which specialists our patients see, our providers will still coordinate with them.”
This is what UW had to say about same-day care: “We reserve about 25 percent of our appointments every day for same-day needs, so we can see acutely sick patients as well as those who schedule in advance. For non-acute needs, we can usually offer appointments within 3-5 business days.”
We aren’t fully satisfied with that answer. What is UW’s definition of acute? Three to five days is a long time to wait for something like an ear infection or seeing a physician to simply renew a prescription. We’ve also heard from countless patients about a lack of post-appointment communication with physicians, leaving patients feeling undervalued and with little direction on next steps.
On a positive note, these announcements speak to the willingness of UW to make changes that fit our community. How they are implemented long-term remains to be seen, but we are hopeful. In addition, before the hospital district provides any funding to a clinic, an entirely new contract must be agreed upon. We have faith that the hospital commissioners will address the public’s concerns and measure patient satisfaction. Plus, funding can be used as leverage to enact policy change, and if Orcas has a hospital district in place, other providers may be enticed to provide services here.
We also believe that the elected hospital commissioners will select a fair levy rate, and not approve the maximum rate of 75 cents per thousand of assessed value. At recent town hall meetings, 55 to 60 cents has been discussed as a viable levy amount. Although things could change between now and when the budget is due in November, commissioner candidates think it is unlikely that it will alter drastically.
San Juan County residents have seen a huge increase in property taxes this year after state Legislature passed a budget in June that includes ways to fund education more equitably in Washington. The rate is around 90 cents per $1,000 of assessed property value, which is $498 a year for the owner of a median-priced resale home in the county of $553,600. Additionally, Orcas voters approved a levy and a bond for Orcas School District, which increased the overall cost from 34 to 54 cents per thousand, which is nominal compared to the state increase.
While the thought of more taxes is unsettling, without a PHD the cost of health care will assuredly increase. For years, a handful of generous island donors have been subsidizing the financial shortfall of our local medical practices, but that is not sustainable. If UW Medicine leaves (as it will without sufficient funding to cover its deficit) and Orcas Family Health Center closes, we will have to travel to Anacortes for all health care, which could be more of an expense than a hospital district levy rate.
One way or another, we will have to pay more for our health services. We urge you to vote yes for the public hospital district in the April 24 election.