First to lose Obamacare? The sickest county in the state – Seattle Times

The Seattle Times has a good article about the outcome of the Republican led move to sow uncertainty and doubt about Obamacare’s future. Gray’s Harbor joins the growing ranks of county’s without healthcare insurance for over 2200 of it’s residents. And if the Republicans in Washington get their way, there will be over 7000 more joining them soon. Oddly, out of all this, we may end up getting single payer, due to the Republicans apparently hell bent on committing political suicide by alienating their base of white rural lower to middle class voters. 47 counties nationwide now don’t have health insurance companies serving them, most of the counties voted Republican. Read it and weep. Because counties like ours, which are largely using Medicare and Medicaid to supply us with health coverage are next up on the Republicans chopping block.

Obamacare is starting to crack, starting in our state’s sickest spot, Grays Harbor County. But the plan isn’t to fix it. It’s to make it dramatically worse.

How U.S. Health Care Became Big Business – Fresh Air

Terry Gross interview with Dr. Elisabeth Rosenthal.

Health care is a trillion-dollar industry in America, but are we getting what we pay for? Dr. Elisabeth Rosenthal, a medical journalist who formerly worked as a medical doctor, warns that the existing system too often focuses on financial incentives over health or science.

How U.S. Health Care Became Big Business

The Vitamin D Craze- Truth and Fiction

The New York Times has an excellent article outlining the current Vitamin D craze, it’s roots and it’s myths. I have discussed this with a medical professional, who mentions that for people with certain diseases, like osteoporosis or kidney disease, a real deficit in Vitamin D is possible. But for most people, it’s just not an issue. And because the craze has insurance companies declining to cover the testing in many cases, these patients with real need are getting their tests turned down by the companies. As the NY Times article points out, the wide scale studies are not backing up the medical professionals who set this whole fad in motion.


Mayo Clinic’s Sad Statement on Healthcare in America – Minnesota Nurses Association

Folks, I’ve talked to a lot of providers in our area in the last few years. This article by the nurses association of Minnesota, is the clearest picture I’ve seen lately. This is exactly where every hospital in this area is at, despite whatever they may publicly state. It’s not to damn them, they do what they need to do to survive. But places like the Mayo Clinic have significant surpluses, JHC doesn’t.  This whole mess is the system that we have in place. Single payer would certainly be a much better alternative. Not perfect, but how much percentage of our federal budget (using our tax dollars) do we want to put into the military/industrial complex instead of helping give health care to all citizens?  Trump’s election has made this not a theoretical question. You have to stand up now. It’s time.
Read it and weep.

By Mathew Keller, RN JD
Regulatory and Policy Nursing Specialist

Mathew Keller, RN JD
Regulatory and Policy Nursing Specialist

A recent statement by the Mayo Clinic’s CEO John Noseworthy, as reported in the Star Tribune, speaks volumes as to the true status of healthcare in America: those with the money get the care they need, those without, get something else. As Noseworthy put it, “if [a] patient has commercial insurance, or they’re Medicaid or Medicare patients and they’re equal…we prioritize the commercial insured patients enough so … we can be financially strong at the end of the year.”


Read the rest of the story at:

Creating a Culture of Caring – NEJoM

The New England Journal of Medicine had this eye opening article from a doctor turned patient.

As a patient, I was privy to failures that I’d been blind to as a clinician. There were disturbing deficits in communication, uncoordinated care, and occasionally an apparently complete absence of empathy. I recognized myself in every failure.


Reassessing the Jefferson Healthcare & Providence relationship

Now that the Seattle Times has brought out a truly shocking series of articles (see other posts on this site)  on the neurosurgery unit of Providence/Swedish, the question is “What should Jefferson County’s hospital do about this?” We have a working relationship with these hospitals. From what I understand they send us doctors for certain shortages we face from time to time and we also are tied to their electronic records systems, called EPIC.

I have discussed with a number of medical professionals who have read the articles and they were in  agreement that this is more than a simple story that can be easily brushed over. To them it’s a deeply concerning one. Some of them said, “Yes, it’s been understood for years that the implementation of a numbers based goal for surgical units is going to drive more surgeries.” Jefferson Healthcare themselves uses the system, and evaluates their doctors on these units.

That the neurosurgery unit of Swedish Cherry Hill has been run like a machine on overdrive, churning through questionable surgeries for the sake of racking up maximum reimbursable value for the hospital and doctors themselves, should force us to discuss the future of the relationship with the Seattle hospital system with which we have allied ourselves. Would you want to see yourself or any loved one of yours sent there after reading this damning expose that took over a year to uncover?

I have a personal dog in this hunt. My best friend was in the neurosurgical unit at Cherry Hill during the last half of 2016, fighting multiple brain cancer sites and a chest tumor. He and his partner went through a great deal of stress over the pressures that the staff were putting on him to undergo more brain surgeries after he was deemed terminal. I told them to push back and discuss with the staff the quality of life issues that he would face one way or the other.They  finally found a doctor at the hospital  who sided with them against the surgical teams. Apparently there were heated words in meetings with the patient present about the choices being made. My friend died at home in January without undergoing further surgeries.

The Jefferson County Healthcare CEO Mike Glenn and the Hospital Board of Commissioners needs to take some time, but come forward and help us understand that they are concerned about this state of affairs and questions need to be asked as to whether our hospital should continue sending patients to Providence and Swedish Cherry Hill.

More thoughts on this issue will be forthcoming.


Transforming Washington’s health care landscape – Seattle Times

This is a problem in Jefferson County, along with physicians who we hire, and pay top dollar to, only to have them leave within a few years. Expanding use of Physician Assistants and Nurse Practitioners would be a way to help this supply, since most of the PA’s I’ve met have been at their jobs for years, if not decades. These highly trained staff are often working at half or less of the pay of the physicians they serve under. Getting two for the price of one, and having those people stay for a lot longer time in the community is a win-win situation. The Federal Government seems to have no interest in expanding the supply of physicians, nor opening up the immigration roles to more from foreign countries, many of them, as highly trained if not more so than our own US physicians.  We have always had a very chauvinistic attitude towards physicians from other countries. It has not served us well.

Growth projections suggest that Washington will need an additional 1,695 primary-care physicians between 2010 and 2030.

Physician shortages plague vast areas of Washington state. Sixteen of 39 Washington counties are severely underserved, with 10.4 or fewer doctors per 10,000 residents. Rural hospitals and clinics in particular often struggle to attract doctors to their communities.