— from Steve Smith for Madrona Voices —
Madrona Voices is operated by Steve and Jennifer Smith of Orcas Island. It is where research and surveys of interest to the community are posted.
We considered creating a pro/con report. However, what some people consider a pro, others might
consider a con. We don’t want to tell you how to vote. We know intelligent and well-informed people on both sides of this issue. We have worked hard to research all of the information you find here and on our website.
We have talked to our fellow islanders, to the providers, and to the candidates. The perspectives below are some we have heard and read. They may seem like valid ideas to some and unreasonable to others.
We list them here simply as points to ponder as you decide what the correct vote is for you and our
community. We write them in the form of questions, as it is up to you to consider whether or not each is a reason to vote either FOR or AGAINST the PHD.
- Do you think that, without the PHD, our current health care providers (or new ones) and staff
will provide care on-island, even though they can make more money elsewhere? Do you think
the current health care providers and staff are paid too much, too little, or about right? - Do you think that there will be primary care providers on-island, if the PHD isn’t established?
- Do you think that someone will operate a cash-only, no-insurance-accepted clinic, if the PHD
does not pass? Would that cash-only clinic meet your needs? Do you think it would meet the
needs of the community? - Do you think that your health care needs will be adequately met, if the PHD does not pass?
- Both Dr. Shinstrom and Dr. Russell subsidized their clinics in the form of time. Those who
supported the OMF-funded clinic often did so with cash. Do you think donors will continue to
subsidize, in either time or cash, like they have in the past? - Do you like or dislike the policies of the probable PHD-funded providers?
- Do you feel that the benefits you receive from having a PHD are worth the higher taxes?
- Do you think the commissioners that are likely to be elected, if the PHD passes, will support the
people or things you want supported? - Do you trust that the elected commissioners will set the levy responsibly and spend the money
wisely? - If you like or dislike the sales pitch of either the “pro-PHD” or “anti-PHD” camps, is that reason
enough to vote “yes” or “no” on having a PHD?
Madrona Voices is operated by Steve and Jennifer Smith of Orcas Island. It is where research and surveys of interest to the community are posted.
No matter how we vote on starting PHD, voting for Commissioner is important. Commissioners have the difficult task of achieving the best cost of health care while also maximizing access to care and quality.
People deserve and expect high quality public services in exchange for their investment. I doubt they expect the cheapest service no matter how much it costs in terms of access, quality and poor health outcomes. Commissioners are under pressure to provide good return on investment.
As a public health administrator, I was once advised to strive for the “minimum acceptable” level of service. That goal was inadequate to those of us who went into government work specifically to serve our communities, improve health and solve problems. In this case, I wouldn’t favor candidates inclined to accept poorer health care quality and access than what we have right now.
As a public official, I learned that a big part of the job is cleaning up messes that you didn’t make (and of course, cleaning up the ones you did). It is critical that we elect responsible Commissioners with the patience and dedication to take on that task. We also need Commissioners capable of collaborative approaches to reconciling divergent interests. They need to understand medical systems well enough to undertake innovative solutions to bureaucratic challenges.
The good news is they don’t have to do it alone. Wise Commissioners can succeed in this mission through open and responsive dialogue with their constituents and our island medical practices. The solution won’t come overnight. If the PHD passes, Commissioners will need ongoing support and counsel to succeed on our behalf.