What do Hospital Commissioners do?

The short answer:  There are five Hospital Commissioners for Jefferson Healthcare.  They meet a minimum of twice a month and have final authority over all hospital district operations and policy.  Each commissioner serves a 6 year term and can earn no more than $8,640 in compensation from the hospital district per year.  Commissioners may not work as employees of the hospital district.  Hospital Commissioners also have access to State and Federal representatives in order to lobby on behalf of the healthcare interests of their district populations.

Why am I running for Hospital Commissioner?

I am running for Hospital Commissioner because the US healthcare system has big problems and I want them fixed.  I believe all public hospital commissioners can play a vital role in helping make this happen.  The most pressing crisis in healthcare is access.  I personally know people who cannot access health care services due to costs.  You probably do too, just start asking them.  We have pretty clear data that 1 in 7 Jefferson County residents do not receive needed medical attention due to costs.  This lack of access is unacceptable and unnecessary and Jefferson Healthcare can take the lead in our local community in working to resolve this crisis.

We don’t have to have such a messed up healthcare system- there are solutions out there.  The best solutions ultimately will require Federal or State level action- but we don’t have to sit around waiting for our Federal and State politicians to overcome the current partisan gridlock (which has persisted on healthcare for about 75 years).  Jefferson Healthcare and Jefferson County Washington can join the ranks of a handful of other local municipalities (San Francisco and Howard County Maryland) and take powerful effective action to immediately improve healthcare access.  If you elect me, I will do everything I can to make this happen.  Moreover, I will use my access to state and federal legislators to actively lobby for the big solution the US healthcare system needs: single payer healthcare reform (or Medicare for all).

How do you know people cannot access healthcare due to costs?

First, I know because I talk to people.  If you happen to be on of the lucky people with comprehensive health coverage, I bet you know many people who don’t.  Start talking to people about this and you will hear about how difficult and painful the financial barriers to healthcare are for your neighbors.

The data available clearly reveals this problem.  Much of my job over the last 15 years at Jefferson Healthcare has involved working as a data analyst.  To better understand what was going on with health care access in our country and in our county, I have spent a ton of hours over the last year pouring over data and researching the history (and annoying politics) of healthcare.  One of the best resources for data on healthcare access in all counties in the USA is called the Behavioral Risk Factor Surveiliance System (BRFSS).  This is a national random digit telephone survey conducted each year by the Centers for Disease Control.  You can browse the data yourself here, here, and here.  What you will find is through a random survey of 1790 Jefferson County residents, 14% report they did not go to a doctor in the last 12 months for needed medical attention due to costs.  In a county of 30,000 people, this means every year about 4,200 of your neighbors are staying home with unmet medical needs because they cannot afford to see a doctor.  Studies also indicate that 1 in 3 people nationwide are delaying seeking needed healthcare due to cost barriers.  This is a serious problem effecting many people in our community.

Won’t the Affordable Care Act make sure all people have health insurance?  And won’t that fix a lot of this problem?

No.  Unfortunately, the healthcare debate over the last decade has been focused on a slightly misguided question:  Do people have health insurance?  This question is misguided, because health insurance has evolved into a product that does not guarantee financial access to health care.  Millions of people have some type of health insurance, yet the insurance doesn’t cover what they need, only pays a percentage of costs, and or has high deductibles you must pay before you even get insurance benefit.  This problem is called “underinsurance” and unfortunately, the Affordable Care Act- although it does a few good things – it is absolutely not going to solve the underinsurance problem.  In fact, it will make the underinsurance problem far bigger.  (For more details see this article.)

Why should our hospital district take the lead in the healthcare access problem?  Shouldn’t this be lead by the County or State?  After all, San Francisco is a city and Howard County is a county, neither were hospital districts.

San Francisco and Howard County Maryland are much bigger populations than Jefferson County Wa.  San Francisco has over 800,000 residents and Howard County has over 250,000 residents.  Both these regions also contain a large number of distinct healthcare institutions and hospital districts.  Considering the size and complexity of those situations, they needed a city or county government to take the lead in order to unite all the healthcare providers under one common cause.  In our rural county, Jefferson Healthcare is the single dominant entity in health services to our residents and as such, it is in a unique position to single handedly create programs and policies that improve access.  Nonetheless, I don’t believe it can or should do this alone and I believe a coalition of agencies including county, city, and others should be assembled to coordinate our efforts.  Then, for whatever healthcare challenges we cannot address with our local resources, it is the job of our hospital commissioners to go to Olympia and DC lawmakers and lobby for the additional help we need in terms of funding and better healthcare laws.

What types actions am I suggesting to resolve the healthcare access problem in Jefferson County?

The first step to solving a problem is to admit you have a problem and commit yourself to trying to fix it.  If you read the Jefferson Healthcare 2013 Strategic Plan you will see many great and good goals- but you will not see improving access among these goals.  The Jefferson Healthcare 2013 Strategic Plan names 38 strategic initiatives and health care access is not one of them.  This plan was presented to and approved by the current Hospital Board earlier this year without any discussion of adding access as a priority.  We need commissioners who will not easily forget that the first step to high quality healthcare is being able to afford to walk through the front door to seek care.  We also need to recognize that high deductibles and copays create a financial barrier to healthcare for many insured residents.  Health care access is a problem and we need to continuously explore what we can do to improve it.  So my first request of the Jefferson Healthcare Board of Commissioners is this:

Currently, 14% of all residents of Eastern Jefferson County do not have financial access to healthcare.  I ask that you make financial access to healthcare for all county residents a strategic priority and set a goal to reduce the number without access (as measured by BRFSS) from 14% to 0% within 3 years.  I ask that you modify your current strategic plan an integrate this goal into your list of top organizational priorities.

If Jefferson Healthcare embraces this challenge, what would happen next?

The exact steps to happen next would depend upon the collaborative thinking of the Jefferson Healthcare strategic leadership group and the board of commissioners.  I certainly have many ideas of how to approach the goal of solving the financial access problem in Jefferson County, but I don’t have all the answers.  We won’t really know what all our options are until we understand the problem more deeply.  Jefferson Healthcare employs an impressive group of administrators, directors, and staff, and amazing things happen when this entire team unites around a common goal.  I’ve seen it many times.  The vital action they need to truly tackle this issue, is a clear and firm shift of priorities from the Board of Commissioners saying, “Healthcare access is a top priority for our organization.  We will work as hard to ensure all residents have access to our services as we do to make our services the industry best.”

What did San Francisco and Howard County Maryland do to solve this problem?

San Francisco and Howard County Maryland have taken the most exciting and effective action to resolve the financial access to healthcare problem.  They didn’t solve it, but they made a big dent.  In both cases, coalitions of government, business, healthcare, non profit, and citizen organizations were formed and tasked with collaborating on creating an aggressive solution to a problem.  Jefferson Healthcare could call for a similar such coalition.  Both San Francisco and Howard County ended up creating innovative programs that made healthcare affordable and accessible to thousands of people who needed it.  San Francisco funded the program largely through a tax on local businesses.  Howard County funded it from their county funds.

What is Single Payer/ Universal Healthcare?

The best and most cost effective solution the the healthcare mess in which we currently find ourselves is single payer/ universal healthcare- which is probably only feasible at the State or Federal level.  You can watch a great animation explaining single payer here.  Some of my favorite healthcare organizations advocating for single payer are the Physicians for a National Health Program, Mad as Hell Doctors, and National Nurses United.  For more, please read my post “Why I advocate for Single Payer/Universal Healthcare.”

What will you do as Hospital Commissioner to promote single payer healthcare?

Jefferson Healthcare could officially join one of these great organizations advocating for single payer healthcare.  It could also lobby the Washington State Hospital Association to endorse single payer.  As Hospital Commissioner I will urge the board to officially and aggressively advocate for single payer healthcare at every opportunity and I will encourage all our healthcare professionals to do the same.  If I am on the board, the next time our State representatives make a visit, local citizens won’t have to solely rely upon begging for a few seconds to urge our representatives to take action in support of single payer, because you will have at least one commissioner clearly advocating for the exact same thing!

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