The Public Hospital District won’t build a hospital on Orcas. Rather, it will support and stabilize local practices to provide ongoing access to primary, urgent and after-hours medical care.
Sustaining local health care access begs the question: Why is it harder for a medical practice (doctor’s office) to survive financially in rural communities than in cities? Many factors contribute, but three stand out: rural jobs, rural populations and practice requirements that disadvantage rural medical business. See http://files.cfra.org/pdf/Ten-Rural-Issues-for-Health-Care-Reform.pdf.
Rural populations are poorer, older and sicker than urban ones. Rural employees are more likely to be self-employed or working for small businesses that don’t provide insurance. They are 70 percent more likely to be uninsured or underinsured than urban workers. This is especially true for a seasonal, tourism and service-related economy like ours.
Young workers (including doctors) leave rural communities for higher-paying urban jobs with benefits. Remaining rural residents have a higher prevalence of chronic diseases (arthritis, asthma, heart disease, diabetes) and injuries. They have less access to health promotion (diet and exercise). There is a greater reliance on Medicaid and Medicare, which do not reimburse private practices the full cost billed. Uninsured patients can seldom pay the full cost of medical care out of pocket.
The reality is that rural health care providers serve a less-healthy, higher risk population, with less financial security and less employer-sponsored medical insurance than their urban and suburban counterparts. Lacking a well-insured population, Orcas medical practices have depended upon local charity, which is declining.
Like all businesses, doctors’ offices must recover the cost of providing services to break even. Medical practice today requires expensive information technology (electronic health records), increased medical technology and diagnostics for reimbursement plus increased administrative staffing for quality assurance, documentation and collection. Urban practices with greater numbers of patients can better afford to hire the necessary support staff and spread employee costs across many providers.
For these reasons, to create financially sustainable and predictable health care here on Orcas for generations to come, please vote “yes” for the public hospital district.
Tom Eversole
Orcas Island
