Jefferson Healthcare Commission Meeting – 06/29/2016

In Chelan, Wa the Jefferson Healthcare Board of commissioner met in regular session following the annual WSHA conference.  Since our normal audio recording equipment does not travel with us, I recorded the meeting with my own handheld digital recorder.

To my surprise, the majority of my fellow commissioners took exception to me recording the meeting.  When I refused to stop recording the meeting, they decided to conclude the meeting rather than continue.  You can hear commissioner De Leo leave the meeting in protest of my recording.  He later rejoins the meeting at about the 5:50 mark.

As I say during this brief meeting, I make sure a recording of all meetings is made because I feel it is essential for me to do my job.  Everyone in that room needs to be held accountable for what we say- because what we say and do matters.  Without a complete record of the meetings, too much time can be spent arguing about what we agreed to or said in the past, rather than discussing actually important and difficult subjects.

I truly thought this board was done debating the issue of recording our public meetings.  A year earlier, I recorded our regular meeting in Chelan, WA in the exact same manner, but last year none of the objections raised during this year’s meeting were raised.  The recording a year ago is here.

If you listen to the recording the following are the two objections raised as best I can discern.

  1. A hospital lawyer has advised that if a commissioner records the meeting, then the recording may be argued to be an official record and therefore needs to be archived with other recordings.  The resolution to this point, as I say in the meeting and have said since this point was first raised two years ago:  I will give the recording to the hospital to store with the other recordings.
  2. The second objection seems to be referring to the board policy on recording meetings which was intentionally drafted in a way to give the board the freedom to not record a meeting if it so chooses.  The reason for this flexibility was to allow the board to meet with people off campus who might be disinclined to meet with us if we insisted on recording the meeting.  If we insisted on recording such meetings, we might hamper our ability to serve our district if our access to elected officials became more limited.  The policy in place at the time of this meeting reads as follows:

In addition to the written minutes of regular and special meetings, official audio recordings of all open public meetings may be made by board designated staff and said recordings will be processed, retained and made available in accordance with the Open Public Records Act.

Since this meeting was not with any outside entities and was merely a meeting of our board off campus, there was no reason for it not to be recorded.  So I recorded it as I did the meeting in Chelan the year prior.  Moreover, though this policy gives the board the choice to record a meeting or not, it does not take away every individual commissioners right to record the meeting if they so choose.  I continue to be unsure exactly why my fellow commissioners decided to suddenly raise these objections and refused to continue the meeting while it was recorded.  Below is the recording I made.

Mental Health in Jefferson County

Anyone who would like to hear more detailed discussion of the work exploring the possibility of building an inpatient psychiatric facility here in Jefferson County is encouraged to listen to the April 20, 2016 Jefferson Healthcare Board meeting.  The discussion of the mental health facility begins at 44:20

Access to care will remain a challenge without a Single Payer system

I came across this article in the Summer newsletter from Physicians for a National Health Plan.  In it, a practicing physician in Iowa writes:

Potential 2016 presidential candidate Sen. Bernie Sanders has stated: “There is one major country on Earth that does not guarantee health care as a right for all. There is one major country on Earth that spends twice as much per capita on health care as almost any other. There is one major country on Earth where private insurance companies and drug companies earn huge profits. Guess which country.”

As a physician in private practice I abhor each coming new year. This is the time when health care practices have to deal with patients with new insurance policies and former policies with stringent regulations. This year, more than any previous time, I’m noticing more and more folks who have high deductibles — allowed up to $6,600 with the Affordable Care Act (Obamacare). And for some folks that means they can’t see me or they have to greatly limit the number of times they can receive services from me.

In some cases I have to refer middle class folks with these high deductibles to places with sliding scales, places I used to refer indigent folks with no insurance. Not seeking or delaying care can lead to delayed diagnoses and possible tragic consequences. And as Michael Moore has pointed out, now it’s the middle class who are hit with being under or poorly-insured while more indigent folks now have an expansion of Medicaid. The confusing mix of deductibles, co-pays, co-insurance and limitations on what services can be provided are now daily frustrations with our lack of guaranteed health care for all.

A single-payer system of reimbursement for health care services has never seemed more in need, with 38 percent of Americans citing health care costs they pay out of pocket as a somewhat or significant level of stress, according to the physician website Doximity. Health care bills could go to one payer — an expansion and enhancement of Medicare — with a great reduction in administrative costs for paying the bills and for providers of health care and their offices. Single payer does not imply a system like the Veterans Administration, where all the providers are employees, but one that allows for private as well as employed practices.

The article quoted above gives you a glimpse into the reality of access to healthcare.  It is not all about having insurance.  Under the affordable care act, more and more people are becoming under insured with deductibles too high for adequate access to care.

Why is single payer the answer?  I found the answer put very eloquently in another article by James G. Kahn, M.D., and Paul HOfmann, Dr.P.H.  They write:

Research from dozens of developed countries demonstrates convincingly that single-payer financing reduces costs, assures access, and improves outcomes.

To ignore this compelling evidence risks lives in the United States as we experiment with partial fixes to the multi-payer system. This experimentation would be rejected by any responsible university institutional review board as violating the principle of equipoise and causing unacceptable patient harm.

And so, we continue to fight the good fight, push for single payer, and deal with the partial fixes to the multi-payer system as best we can.

This website is my primary means of letting people know about my work as hospital commissioner, the issues I am working on and the specific actions I am proposing.

My goal is to make high quality healthcare affordable and accessible to every person in our community.

I love meeting with groups to discuss healthcare issues big and small. Please contact me if you would like me to join you for a talk.

Please contact me using the contact form on this website, email me at, or you can leave me a message at (657) 777-2182