Now we know…

The Republicans have just floored their health care reform bill. You can read the details all over the internet. But it’s a disaster for rural hospital districts like ours. We have the oldest population of any county in the State and  rely heavily on Medicare reimbursement. We also have a huge poor population, which relies on Medicaid. Let’s just set aside the number of people who come to the food bank weekly.

Our reliance on  Medicare and Medicaid patients being reimbursed from the federal government at rates that make it worthwhile to do the work of caring for them, make it important not to lose what ground has been gained. Before Obamacare we were running a deficit that the taxpayers of this county paid for. Since Obamacare we are running a surplus. Not much, but not in the red. Now this. Who’s going to pay?The general attitude that I hear all the time from acquaintances and on the Internet is that they don’t want more taxes. The poor will come into the emergency rooms regardless if they are covered or not. But if the Feds don’t pay for them, it will be on us. You and I. Or the hospital could eventually close. Just ponder the words of a Kaiser Family Foundation study published in 2016 (JHC is  a 25 bed hospital):

In 2012-2013, rural hospitals had an average of 50 beds and a median of 25 beds. They had an average daily census of 7 patients and 321 employees, and they were 10 years old on average. Compared to urban hospitals, rural hospitals are more likely to be in counties with an elderly and poor population.9 According to The North Carolina Rural Health Research Program (NC RHRP) at the Cecil G. Sheps Center for Health Services Research, which tracks rural hospital closures, there were 72 rural hospital closures between January 2010 and April 2016, compared to 42 closures between 2005 and 2009, and since the 2008-2009 recession, the annual number of closures has increased each year.10 More than half of all rural hospital closures since 2010 were in the South and few Southern states have expanded Medicaid under the ACA.

http://www.kff.org/report-section/a-look-at-rural-hospital-closures-and-implications-for-access-to-care-three-case-studies-issue-brief/

The expectations are that we are in for some very hard times in the years ahead. It will take a lot of effort to keep our hospital running efficiently and staffed appropriately. Even now, we are having a hard time retaining quality medical staff even though we offer competitive salaries to Seattle, according to the hospital administration. Unfortunately, we have not done a great job at looking at foreign trained medical professionals, which are in wide spread use at Harrison and other nearby medical facilities. We also are behind the curve in the use of less expensive mid-levels, ARNPs and PAs. To the hospital district’s credit, the number of those mid-levels is up recently, probably due more to federal requirements and an inability to retain physicians, more  than anything else.

Perhaps if the Democrats win back the House and Senate and eventually the Presidency we can hope for fixes to this awful proposal which was created by a cabal of men behind closed doors. No women, even of their own party, were asked to work with them. It was despicable back room politics of the worse kind. They have even screwed their own constituents in places like Spokane and Wenatchee, as rural hospitals there are even farther from urban centers.  You have to wonder just who they represent? Or maybe we already know and this next four years will finally drive that home to their supporters in places throughout the rural west and south. Or maybe those voters and non-voters are so tuned into Fox News that they can’t connect the dots anymore.

We can only hope that we will get through the next four years without seeing a collapse of our hospital and the services it is offering, even though prices are already causing people who are aware of the high charges to drive closer into Seattle to seek competitive rates for services.

Now more than ever we need engaged, knowledgeable people in the role of Hospital District Commissioner, which is an election that is happening now. We don’t need a rubber stamp for the hospital district administration, we need deeply knowledgeable people who can roll up their sleeves and help, challenge the administration when needed and go advocate for the hospital district in the State and Federal arenas.

We need leadership from skilled medical professionals who have spent time in the trenches, understanding  both the issues of health care administration and the needs of our neighbors because they have sat in the rooms with these patients as they poured out their hearts to them about their medical conditions and their ability to pay for treatment or drugs. People who held them as they cried. Who may have given them free treatment rather than walked away. Who might have sometimes given them hard news. People who know what we have to fight for and can help guide the hospital district administration and our elected officials forward through this coming dark night.

FTC & FDA Goes Against General Nutrition

TINA reports on GNC regulatory actions and consumer lawsuits

Truth in Advertising, Inc., has published a history of government actions against General Nutrition and its associated companies. The government actions have included three by the U.S. Justice Department actions, three major FTC actions, at least four FTC actions against companies whose products were sold at GNC, more than a dozen false representation actions by the U.S. Postal Service, at least six actions by State agencies, and at least ten actions initiated by the FDA. There also have been more than 100 consumer lawsuits. [GNC: No stranger to regulatory enforcement. TINA.org, May 22, 2017] The takeaway message is that government regulation is limited and consumers need to be very skeptical of claims made about dietary supplements

General Nutrition is one of the largest marketers of vitamins and supplements in the US.

pH Miracle author pleads guilty to practicing medicine without a license

Since Mr. Young was on “Coast to Coast” he likely has some audience here in Jefferson County. I know people tell me they listen to this show frequently.

Robert O. Young expected to do more jail time

Robert O. Young, author of The pH Miracle, has pleaded guilty to two more counts of practicing medicine without a license. In 2014, he was charged with multiple counts of grand theft and conspiring to practice medicine without a license. The San Diego District Attorney’s press release stated that Young accepted patients, including some who were terminally ill, and temporarily housed them at his pH Miracle Center. The charges alleged that Young and associates broke the law when they went beyond advocating dietary changes and administered intravenous treatments to patients, some of whom were terminally ill. In 2016, following a 2-month trial, he was convicted of two counts of practicing medicine without a license. During the trial, Deputy District Attorney Gina Darvas portrayed Young as a charlatan who preyed on the sick and vulnerable—including dying cancer patients—and duped them with bogus science. A few weeks after the trial ended, Darvas announced that Young would be re-tried on the charges for which the jury was unable to reach a verdict. In 2017, faced with this possibility, Young pleaded guilty to two more counts of practicing medicine without a license. The plea agreement calls for a 44-month sentence, some of which has already been served. [Diehl P. Sentencing delayed for pH Miracle author. San Diego Union-Tribune, May 1, 2017] Young, who for many years has represented himself as “Dr. Young,” has a “Ph.D.” from Clayton College of Natural Health, a non-accredited correspondence school that closed in 2010 after Alabama began requiring that all private, degree granting, schools be accredited by a recognized agency or be a candidate for accreditation. [Barrett S. Clayton College of Natural Health: Be wary of the school and its graduates. Quackwatch, Jan 8, 2015] The central premise of Young’s approach—which lacks scientific support—is that health depends primarily on proper balance between an alkaline and acid cellular environment that can be optimized by dietary modification and taking supplements. [Barrett S. A critical look at “Dr.” Robert Young’s theories and credentials. Quackwatch, May 5, 2017]

Washington State Passes Pregnant Workers Fairness Act

From NARAL: The Washington State Legislature has unanimously passed the Pregnant Workers Fairness Act and the bill is now on its way to the Governor’s desk.

The Pregnant Workers Fairness Act will protect pregnant workers by requiring employers to provide reasonable work accommodations during pregnancy, such as temporary reassignment to light duty, additional bathroom breaks, and flexible scheduling for prenatal appointments. It would also prohibit employers from requiring pregnant workers to take paid or unpaid leave instead of providing reasonable job modifications, as well as protect pregnant workers from unequal treatment or retaliation for asking for an accommodation.

Washington State joins fifteen states, D.C., and four cities that have passed laws requiring employers to provide reasonable accommodations to pregnant workers and protecting pregnant workers from retaliation when they request accommodations.

Congratulations to all the groups that spent huge amounts of time phone calling the legislators and going to meet them in Olympia.

 

Health leaders in Washington state seek improvements in existing health care law – Yakima Herald

Good original article by the Yakima Herald’s Molly Rosbach. Especially useful is it’s point on the use of Electronic Health Records, the bain of many physicians.

“Physicians don’t want to get rid of their EHRs; they understand the value, they just want to make sure it works in a way that’s natural to their work flow,” rather than a series of mindless boxes to check off, said Jennifer Hanscom, executive director of the state Medical Association. “It would be great if we could sit down with the folks at (Health and Human Services) in particular to kind of walk through that, and keeping the lens of a physician on all those regulations.”

A big area where documentation regulations appear at odds with the broader transition from fee-for-service to value-based purchasing is in prior authorization, Hanscom said: Why do insurers still require prior authorization, a extra step for patients and doctors, if doctors are already using the best evidence-based guidelines to make decisions about what services the patient needs?”

Read the whole story here:

http://www.yakimaherald.com/news/local/health-leaders-in-washington-state-seek-improvements-in-existing-health/article_70c50382-1767-11e7-ba24-87db1f07d72b.html

Washington State Providers and Delivery System Speak out Against Republican Plan


SEATTLE, March 22, 2017 /PRNewswire/ — Five organizations that represent Washington State’s largest health care delivery systems, physicians and providers are stating their opposition to the American Health Care Act. The Washington State Hospital Association (WSHA), Washington State Medical Association (WSMA), Washington Association of Community and Migrant Health Centers (WACMHC), and the Community Health Network of Washington (CHNW), along with its subsidiary non-profit managed care company, Community Health Plan of Washington (CHPW), are calling on Congress to reject the House proposal that puts their patients at risk. Collectively, these groups represent 107 hospitals, 267 clinics, 10,000 physicians and other providers, 315,000 members, and more than 17 million patient visits a year statewide.

 

Read the whole story here: http://www.prnewswire.com/news-releases/washington-state-providers-and-delivery-system-speak-out-against-the-american-health-care-act-300428243.html

Planned Parenthood: 88,000 people in Wash. state would lose health care under new proposal – KOMO NEWS

This is about a Christian dominated Republican Congress acting to reduce women’s health care rights and opportunities. It is at it’s core immoral and likely illegal. A number of courts, such as in Texas, have ruled that it is not legal to kill funding to Planned Parenthood over one specific health care need. To be clear, many women cannot have children or can’t afford to. The first reason, due to health concerns, can be from a variety of causes. The second, is an economic one, and I don’t see Republicans flocking to the adoption sites to take these adoptees in. The hypocrasy of a political organization like the Republican Party, claiming “Family Values” and that government should “get out of the way of people” while promoting such overreach into women’s (and men’s) lives, is so ugly, that it is hard not to get angry at them. Then there is the issue of the jobs at these clinics that would be lost. I thought Trump was trying for full employment?

SEATTLE – Inside a Planned Parenthood clinic in Seattle’s Central District Tuesday, Nicole Hurst juggled a full calendar of family planning and primary care patients.
Hurst, who has worked at the clinic for almost a year, said she and colleagues had prepared for the news they learned Monday night – that Congress was talking about cutting Planned Parenthood’s funding.

http://komonews.com/news/local/planned-parenthood-88000-people-in-wash-state-would-lose-health-care-under-new-proposal