— from Steve and Jennifer Smith, Madrona Voices —

We interviewed UW as well as took notes at a meeting between UW and the commissioner candidates. We will be sharing more information from our research, from those meetings, and from UW’s written responses to our questions via our site: MadronaVoices.com.

While UW operates its own hospitals and clinics, UW told us that the local clinic makes referrals to the specialists of the patient’s choice, including non-UW specialists.

About 50% of the island residents are eligible for Medicare. Those who work for companies or groups, such as the County or schools, may be able to access health insurance not available to individuals. For those who pay for their own insurance, there is one health insurance option — Kaiser Permanente. Carriers such as United, Premera, and Aetna do not offer options for individuals.

According to Wikipedia, Kaiser insures 11.7 million people, operates 39 medical centers and 720 medical facilities, and employs over 21,000 physicians. Why this matters is that if you are insured by Kaiser, Kaiser prefers that you go to one of their facilities or specialists. This allows them to better control their costs and to keep the insurance dollars within their own organization. If you use one of the island clinics, need a referral, and Kaiser is your insurer, then Kaiser will require that you get prior authorization, if you want to see a non-Kaiser specialist. This will be true no matter what health provider you’re seeing. It doesn’t matter if it is a private practice, UW, Peace Health, or Island Hospital that runs a clinic. Kaiser will preferentially direct those they insure to their own network.

The 2018 tax levy for most of Orcas Island is $7.89/$1,000 valuation. If the public hospital district is approved by the voters in April, and if the new hospital district commissioners choose to levy the maximum they are allowed ($0.75/$1000), then the new 2019 levy would be $8.64/$1000. This does not take into consideration any changes made by other taxing entities for 2019. If the new commissioners levy the maximum allowed, it would cause a 9.5% increase in taxes in 2019 from the current 2018 amount. Some of the commissioner candidates have stated that they want to levy less than the amount they are allowed.

The island clinics have been operating at a loss and on subsidies for years. Dr. Shinstrom has been donating his time and may retire. Several individuals, who have consistently provided large donations on an annual basis in order to cover operational losses at the Orcas Island Clinic, are no longer here.

How the election is structured, where we vote on the district and the commissioners at the same time, is determined by State law. The concept that we must have districts and that candidates must choose a district is also set by State law. The idea that the tax is on property owners and not a sales tax is also controlled by State law. In order to do things differently, one has to persuade the legislature and governor to change the law.

There are many well-informed and intelligent people on both sides of the issue. This letter is not to persuade anyone how to vote but rather to share some highlights

from our research and information from our discussions with the providers and candidates. We hope that this letter and the information we post on our website will provide facts that help as we each decide how to vote.

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