Yes, it is a goal to have available and accessible health care for islanders — in fact, for everyone. But establishing a Vashon public hospital district is a critically flawed approach being promoted in what I believe is a less-than-transparent manner. The core flaw in the public hospital district is that we are being asked to hand control of our tax dollars to five individuals with the power to define the “problems” and “solutions” and to raise taxes without a vote of the people. Once a public hospital district is established, we will have little recourse except to vote for new commission members.
I’ll go into this in a bit more detail, but first let’s review another concern — the definition of the problem and the proposed solution behind the vote for the hospital district. The purpose of the district would be to subsidize a health clinic, like Neighborcare, on the island. But this may not be the best or most cost-effective solution for near urban primary care in the 21st century.
We live in a large metropolitan area. Many of us get our primary care in the urban core — Seattle, Tacoma, Burien — through Kaiser, UW Medicine, Swedish or physicians in our insurance’s network. Community clinics, operated by Neighborcare and others, are also available in Seattle and Tacoma to ensure care is accessible to those covered by Medicaid/Apple Care and the uninsured. Funds are already available to offset commuting costs when they pose a hardship for islanders.
The good news is that we also have emergency medical technicians and paramedics for pre-hospital urgent and emergency care, and transport to world-class hospitals. And there is a range of naturopathic options on the island. And Vashon Island School District has its own clinic. The campaign signs for the hospital district say “Protect Vashon Health Care” — from what? From going to the city for primary care and drop-in care?
Yes, it can seem overwhelming when we have a child with an ear infection at 7 p.m. or we have an unexpected attack from a chronic condition like asthma, or we are old and find the trek into the city difficult. But trying to maintain a primary care clinic on Vashon has proven too costly to operate. The last clinic operator found losses so great that it left the island, and Neighborcare officials said that last year they were losing $350,000 annually and would require community support simply to maintain what they are currently doing.
So, let’s be creative. We should be considering options such as telemedicine, which would be less costly to provide and could benefit everyone on the island. Telemedicine allows you to text or video-chat with a doctor on your smartphone or a computer. This service can provide constant, reliable access (many operate 24/7) and is incredibly flexible for patients. You can access primary, urgent or chronic care any time, anywhere. A variety of companies — Doctor on Demand, Teladoc, Amwell or Seattle-based 98point6 — provide such services starting at about $20/per person/per year. There might be opportunities for Vashon to purchase these services in a bundle, much like employers are doing, at an even lower cost so that every islander has access to care.
There’s no argument that a public hospital district is a great way to raise funds, but how do we fix its inherent flaw that takes us out of the decision-making role? Let’s get the state Legislature to authorize creation of a local health district with more limited powers, one that requires approval of taxing levies by a vote of the residents. That is the way our school and park districts function. This structure would give us the checks and balances we’ve come to expect. It would allow us to say “no” if the tax is too high for our middle class families, or if it is going to eliminate our park district — as the proposed hospital district could — or if we just don’t agree with the approach the elected commissioners select.
In summary, we are being asked to approve a very blunt instrument — the public hospital district. What we need is a more appropriately limited health district that enables voter approval of future taxes and health care solutions.
Over the 39 years I’ve lived on Vashon, I’ve voted for almost every levy — for libraries, schools, parks. On this one I say let’s slow down and fix the flaws first.
— Sheri Reder raised her family on Vashon Island. She holds a master of public health degree and a doctorate in health communication from the University of Washington.