— 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.
Steve & Jennifer:
As is your custom – you carefully report the FACTS.
The lack of a ‘perceived BIAS’ is genuinely appreciated!
Thanks Steve for you letter, here. Just a couple of highlights from a nurse at Orcas Family Health Center:
You said, “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.” Just want to make things clear here, Dr. Shinstrom is with Orcas Family Health Center, not Orcas Island Clinic. So, some of your readers may not fully understand your statement.
And, as Orcas Family Health Center’s Registered Nurse, I’d like to reach out to all that have supported us, encouraged us, and who are our very valued patients: the hospital district levy could be a very good thing for all of us at Orcas Family Health Center. If this passes, it could provide us at the clinic with more valuable resources and financial support to ensure we can continue to provide quality care to all of our current and new patients. UW and OFHC cannot fully support and provide care to every person on Orcas alone.
Shila – Thank you for the clarification.
Also, a thank you to Dr. Shinstrom and Aaimee Johnson for the interview today that we will share on our web site in the next couple of days.
I take exception to the rumor that Dr. Shinstrom *may* retire. I talked with him directly on this and he assured me that he has no plans to retire any time soon. We all retire eventually and I can believe that he is planning to retire someday, just not any time soon. I also asked him about the future of the Family Health Center when he does eventually retire and he assured me that he will plan for that well in advance and assure that the transition to new medical personnel will be done professionally and responsibly. I’ve known Dr. Shinstrom for nearly 20 years and trust his word. Personally, I like having a choice of primary care provider and worry that any effort to consolidate practices in the name of efficiency will put us at risk.
Regarding taxes, I continue to remind islanders that we live in a state and county with desirable tax policy. With no state income tax, low sales tax, and a property tax that is below the state median, we have little to complain about.
I plan on checking out your website, and thank you for your research.
One thing that seems unclear: although, according to your interview, UW does refer to “out of network” hospitals and doctors for those who need off-island care or further testing, apparently, it does not offer local services such as blood tests for patients and clients of off-island specialists and oncologists who may need regular blood tests and results – and locals may not be aware of this. Was this covered in the interview, and how was it addressed? Thank you.
Paul, thank you for your comments. We are currently communicating with Dr. Shinstrom and will respond here soon.
Sadie, we asked UW Medicine in our questions and they responded to the question about courtesy labs. We will post that on our site shortly. The candidates also asked about that in their meeting with UW. The UW Medicine response to the candidates was the same as it was to us. To paraphrase, UW Medicine said they had heard the public request for courtesy labs, and they are changing their policy. They plan to begin doing courtesy labs in early April.
You can read their exact response by clicking on the big box on the Madrona Voices website that says “Clinic Responses,” then click on the link saying, “Notes from the conversation…” That will open a PDF of the meeting. To quickly find the information about courtesy labs, just do a search of the document. Or, go to this link: https://www.madronavoices.com/wp-content/uploads/2018/03/Orcas-Mar-14-Candidates-and-UW.pdf
I encourage you to click on all the links on the website, for there is much more information there. Especially visit the PHD Fact Sheet for information about some of the most common questions about the PHD.