Healthcare Bills in WA State legislature

Dear Persons Who Care About Healthcare —
Three bills are making their way through Olympia and have a chance at passage this session. WA has a one-stop website where you can look up the information, read the bill, and comment on it.

Go to:  https://app.leg.wa.gov/billinfo/

Type in the number of the bill.  (HB stands for House Bill, SB is for the Senate. If you type in 1523 the website also shows the link to the corresponding bill, which in this case would be 5526.)

Just below the name and summary of the bill is a green box labeled “Comment on this bill.”

You type in your address to validate your district, then it pulls up your elected officials. Click on all of them to send the same comments. And if you don’t want to comment, you can click the box for “support” and send it on its way.

Please read the bills and send your support, and get everyone you know to comment. 

HB 1523/SB 5526—Relating to increasing availability of quality affordable health coverage in the individual market. 1523 Passed House, 3/8.  Public hearing in Senate Health and Long Term Care 3/20, 1:30. 4/5 Public hearing in Senate Committee Ways & Means. 4/6 Public Hearing House Committee on Appropriations

(This one props up the WA ACA plans.) 

HB 1612/SB 5602—Provide maximum access to reproductive health care and reproductive health care coverage for all in WA.  5602  Passed Senate 3/7.  Public Hearing in House Committee on Health Care and Wellness 3/20, 1:30 pm. 4/6 Public hearing House Committee on Appropriations.

(With the threats to Title X funding, this is important for women’s health.)

HB 1877/SB 5822—Providing a pathway to establish a universal health care system for the residents of Washington State. 5822 Passed Senate 3/13; 1streading in House Health Care and Wellness Committee 3/15. 4/6 Scheduled for public hearing in House Committee on Appropriations.

(This is a longer term approach to set up the trust that would fund a WA-only universal health care program.)

Washington state becomes the latest to embrace a Netflix model for buying hep C drugs -Stat Magazine

Good news on the Hep C front. Progress.

The so-called Netflix payment model for obtaining hepatitis C treatments appears to be catching on among state officials as a Washington state health agency is the latest one hoping to convince drug makers to participate in such a scheme.

https://www.statnews.com/pharmalot/2019/02/06/washington-netflix-hepatitis-drug-prices/

Pro -Vaccine Physician still attacked by critics even as measles outbreaks spread – Guardian

While this is world news, given that Port Townsend has played such a larger than life role in the anti-vaccine skeptic crowd, with such validation of the inaccurate claims coming from the local Townsend Newsletter over the years, and the low vaccination rate in the county, I thought I would include this.

In today’s Guardian they include a story about “Trapped in a hoax: survivors of conspiracy theories speak out”, including an update on Dr. Paul Offit, who has been one of the leaders on speaking out against anti-vaccine skeptics. He took on the now discredited British gastroenterologist Andrew Wakefield and setup the Vaccine Education Center. Read the whole sordid tale of those that attacked him, at

https://www.theguardian.com/technology/2019/jan/23/conspiracy-theories-internet-survivors-truth

Closer to home, a measles outbreak in southwest Washington Clark County, another hotbed of anti-vaccine skeptics and the county with the lowest rate of vaccinations in the state,  has now been confirmed to have moved to South Seattle.

https://www.usatoday.com/story/news/health/2019/01/17/washington-state-measles-outbreak-grows-most-patients-unvaccinated/2611087002/

and

https://www.seattletimes.com/seattle-news/health/king-county-man-may-have-contracted-measles-from-southwest-washington-outbreak/

A King County resident contracted measles after traveling to Clark County, where an outbreak has spread to at least 23 people, public-health officials said Wednesday.

Portland is also at high risk, due to low vaccination rates.

As the Times article points out, “you can get it just by being in a room where a person with measles has been.”

Many, including this blog, have been warning that we are likely to pay the price for this hoax having been spread around the world. No other vaccine-preventable disease causes as many deaths. (according to the Cochrane database of Systematic Reviews August 2013)

If you want to educate yourself to measles, start here.

https://en.wikipedia.org/wiki/Measles

In states, Democrats start delivering on health care pledges – Chicago Sun Times

The outcome of the Blue Wave of November is starting to be felt. The article, while from Chicago, opens with Washington State and California as examples. In case you haven’t been following, newly elected Governor Gavin Newsome is off to an incredible start. He ran on healthcare as a major issue, and is already starting to deliver.

https://chicago.suntimes.com/news/democrats-midterm-election-campaign-promise-health-care-affordable-healthcare/

Trump Administration Slashes Medicare/Medicaid Payments. Local Hospital Is Targeted

The Peninsula Daily News (PDN) is reporting that the Trump Administration, against the wishes of hundreds of letters and testimony against it, is slashing Medicare and Medicaid reimbursal rates to clinics more than 250ft away from a central hospital. The new rule is called the “CY (for Calendar Year) 2019 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System”

The rule announcement from July is found at

https://www.cms.gov/newsroom/press-releases/cms-empowers-patients-and-ensures-site-neutral-payment-proposed-rule

and the October 30th update is found here:

https://www.cms.gov/newsroom/fact-sheets/cms-finalizes-hospital-outpatient-and-ambulatory-surgical-center-policy-and-payment-changes

The goal of the proposed rule was to eliminate patient clinic visits to hospital clinics that charge more than non hospital clinics. The Center for Medicare and Medicaid Services (CMS) claims in it’s press release that, “Currently, CMS often pays more for the same type of clinic visit in the hospital outpatient setting than in the physician office setting.” They offer no proof to that claim.

The most affected facility for this on the Olympic Peninsula is Olympic Medical Center’s (OMC) offsite clinics in Sequim. Ironically the clinics serve a population that voted for President Trump in the last election and they will, if this rule is not overturned via legislation, be the most effected by it. The chart at the link below shows how various precincts voted in 2016.

https://www.nytimes.com/interactive/2018/upshot/election-2016-voting-precinct-maps.html#8.27/47.920/-122.715

The PDN is reporting that payments may be slashed up to 60%, which would apparently make these clinics financially nonviable. Medicare and Medicaid payments today are so lean that many physicians do not take new Medicaid/Medicare patients because they cannot survive on the reimbursal rates.

The outcome of this will be that seniors and the poor will have to travel further for medical care, and that some hospitals, like OMC may be forced to close their remote facilities and possibly even put their main hospitals in financial jeopardy. Hospital closings in the last decade in rural areas have reached new highs, leading to rural areas often being the most under-served areas for healthcare in the country. Forbes magazine, in 2017, had an article that researched the issue and found that “Approximately 2300 rural hospitals are in the United States. Of those, 81 have closed since 2010.” Forbes went on to show how President Trump’s proposed healthcare cuts were putting “673…at risk of closing”. The full story from Forbes is available at https://www.forbes.com/sites/bisnow/2017/07/26/obamacare-repeal-could-cripple-rural-hospitals-and-lead-to-more-closures/#6dbd6b4f42b8

It is not known how this will affect Jefferson Healthcare (JHC) as they have kept their clinics within the required 250 yard rule. They have worked around the issue by setting up their clinics in Quilcene and Port Ludlow in a different legal framework. They claim that they will be less affected.

There have been rumors from healthcare providers that other standalone clinics may be affected, those not attached to a hospital. We will track those as we hear from the community. Your comments and insights are welcome to be sent to albergstein@gmail.com

What is happening is an ongoing push to centralize healthcare in urban centers and reduce the costs. While healthcare costs are rising, much of these costs are centered in the last years of life. Our insistence on providing all out high cost medical support to terminally ill patients, for example, rather than focusing on expanded hospice care has led to a heavy weighing of costs to end of life medical intervention. From personal experience, I can say that in some locales there seems to not be honest dialogue between patient and provider about the likelihood of a successful outcome, leading to the patient not knowing that they are essentially terminally ill and wanting to continue, under the providers suggestions, with expensive treatment that will only likely extend life a few months.

Medical providers are also, due to litigation costs, often insisting on far more tests than necessary, driving up costs. There is no easy route out of that issue, as patient expectations are not often aligned with actual healthcare scenarios and outcomes. The inability to also properly judge physician history and ratings also make it hard for patients to know when some providers have a history of malpractice.

But the slashing of medicaid and medicare costs to OMC and other hospitals like it, is a cynical ploy by the Trump Administration and Congress to do a stealth attack on these services, one which was highlighted in an article last month.

Larry Kudlow, the director of the Trump White House’s National Economic Council, recently said he wants to take aim at “entitlements” as early as “next year.” A few months earlier, House Speaker Paul Ryan (R-Wis.) said he wants to see policymakers bring the budget closer to balance by cutting “entitlements.” Rep. Steve Stivers (R-Ohio), who currently chairs the National Republican Congressional Committee, made the same argument in August.

And now Senate Majority Leader Mitch McConnell is making the identical pitch.

http://www.msnbc.com/rachel-maddow-show/mcconnell-eyes-cuts-medicare-social-security-address-deficit

This all comes after slashing taxes to the wealthiest Americans and corporations earlier in the year.

It is worth remembering that this administration and previous ones have spent approx. $170M a day for 16 years funding the war in Afghanistan. We have the money to fund Medicare and Medicaid at appropriate levels. It’s all about priorities.

Just last month, our legislators from both Clallam and Jefferson counties, including some of our county and hospital commissioners and executives, traveled to Washington D.C. and met with numerous staffers, both at the White House and Congress. Some of them, such as Republican Congresswoman Jamie Herrera Butler, was not in Washington and sent out a staffer who knew nothing of the issues.

It remains to be seen if our legislators can fix this problem in Congress next year. If you want to help ensure it gets done, vote Democratic on Tuesday November 6th. Putting Democrats at least in charge of the House will allow a real debate and bipartisan approach on how this all proceeds. Representative Kilmer, who is up for re-election, along with other Democratic Representatives have been fighting hard to protect rural hospitals. These politicians are not perfect. None of them will agree with all of us all the time. That’s just not how this representative democracy works. But these Democratic politicians in our district have a track record and to elect more Republicans and expect a different outcome seems unrealistic.

Otherwise these kind of cuts are going to continue to come at us, with the outcome being far worse healthcare options for all of us, no matter who you voted for in this election. This is not “making America great again.”

The final rule will appear in the November 13, 2015 Federal Register and can be downloaded from the Federal Register at: http://www.ofr.gov/inspection.aspx?AspxAutoDetectCookieSupport=1.

 

Open Enrollment: Seven insurers offering plans for 2018

Open enrollment for 2019 coverage will run from November 1, 2018 to December 15, 2018.

Source: https://www.healthinsurance.org/washington-state-health-insurance-exchange/

All counties will have 2019 exchange coverage, but 14 (up from 9 this year) will have only one insurer; average proposed rate increase is more than 19 percent

Washington marketplace highlights and updates

Source: https://www.healthinsurance.org/washington-state-health-insurance-exchange/
Follow us: @EyeOnInsurance on Twitter | healthinsurance.org on Facebook

 

Rare polio like disease cases growing in WA – Seattle Times

What is causing AFM? This is bizarre disease is increasing in the number of cases, and apparently is happening in Washington State.

Hayden Werdal was born “perfectly healthy.” He caught a nasty cold at age 14, and now, four years later, he’s considered a paraplegic and needs a ventilator. Werdal, of Bremerton, has a rare and mysterious illness that’s left Washington families reeling. AFM is spiking, with 127 confirmed or reported cases nationwide this year, including eight in Washington. – Seattle Times

Just today, another case in Yakima:

http://newstalkkit.com/possible-acute-flaccid-myelitis-case-in-yakima-county/

While this is emerging, Trump has cut the budget at the Center for Disease Control. According to Politifact:

Among other changes, Trump’s budget would cut $138 million from the program dedicated to chronic disease prevention and health promotion, cut $59.9 million from programs studying “emerging and zoonotic infectious diseases,” and $46 million from a program called “Racial and Ethnic Approaches to Community Health.” A zoonotic disease is a disease that can be transmitted from animals to people.

Remember this as you decide who to vote for. A vote for Republicans is a vote to continue cutting the one agency that might help find a cause for this emerging illness.