by Bill Bangs, Orcas PHD Commissioner Candidate

A number of people have, quite properly, raised the question of what an Orcas Public Hospital District (PHD) would do to ensure care for all islanders, including the uninsured and underinsured. My position is that any practice or provider would need to satisfy certain conditions before they were eligible to receive public funds. Here are two such conditions that I would like to see imposed.

  1. A provider must accept, as payment for primary and urgent care, all government-sponsored insurance plans (including Medicare and Medicaid) and all private insurance plans approved by the State Department of Insurance.
  2. A provider must have a financial assistance policy that is at least as generous as the Washington State charity care law (RCW 70.170.060) where “hospital” is extended to apply to primary and urgent care clinics receiving support from this district. I believe that this says, among other things, that access to medically necessary care shall not be based on ability to pay (although the final cost to the patient, if any, will be based on that ability).

I cannot speak for the two existing practices, OFHC and UW Medicine. However, it appears that both assert that they currently satisfy these conditions. See https://www.orcasfamilyhealthcenter.org/pages/care-for-all/   for OFHC and https://www.uwmedicine.org/patient-care/billing/financial-assistance/policy for UW Medicine which explicitly states that you are eligible for financial assistance if you are at or below 300% of the federal poverty standards. For a family of four, this means you are eligible if your annual income is $75,300 or less (see: https://www.payingforseniorcare.com/longtermcare/federal-poverty-level.html).

Of course, policies are one thing and actual practices are another. The PHD should monitor the providers to verify that they are living up to the spirit as well as the letter of these conditions. Should the PHD operate a “complaint management system” (as I’ve previously recommended – https://www.madronavoices.com/wp-content/uploads/2018/02/Bill_Bangs.pdf ) then issues arising from real or perceived policy deviations can be addressed.

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