As a doctor, I instinctively look to solve challenges by first searching for root causes, second working toward making an accurate diagnosis and lastly deciding on an appropriate treatment. On Vashon, I believe that the best remedy for long-term sustainable health care is the creation of a public hospital district. Only public funding will provide the consistent, stable revenue needed to maintain basic health services. Over 60 other communities in Washington have made this same choice and established hospital districts. Many of these districts do not have hospitals, but instead have public health districts to help fund and operate clinics, just as is being proposed for Vashon.
Over the last year, I have been invited into living rooms, sat at kitchen and conference room tables, slid into restaurant booths, and been given the coziest seat on the patio at homes, offices, and churches all over the island. By now, I have met with hundreds of islanders to talk about the current state of island health care as well as its future.
I have heard story after story of medical emergencies — some major, some less so. There was a wife who thought her husband was suffering from a heart attack. The child who fell from a tree and couldn’t catch her breath. The brother who had an allergic reaction to medication. All of these stories had something in common: They all had happy endings, often thanks to the quick-thinking of local medical professionals.
Whether your primary care provider is on the island or off, we all have an interest in having local medical care right here. It affects the quality of life of all islanders. With no healthcare option on the island, how will the mother of a toddler take her off the island to be treated for an ear infection and get back in time to pick up her kindergartner? What about a cooking burn which may need quick attention? Or the man who cuts himself doing yard work and needs stitches right away? While many of us can schedule a trip off the island to see a specialist, it’s neither convenient nor safe to do so in some medical situations.
Unfortunately, our current medical provider situation is quite fragile — it is neither robust nor sustainable. It’s not a problem our island alone suffers from. The cause is rooted in reimbursement rates by health insurance companies and government reimbursement programs. These payments are simply not enough to cover the actual cost of providing medical care. Because of the shortfall between what a visit or treatment costs and what a provider is reimbursed, many primary care clinics operate at a loss.
That was true for the last two clinics on the island as well as for Neighborcare Health, the current operator of our clinic. Large medical systems operate primary care systems at a loss and make up the expense by referring patients to their own doctors for specialty care.
The five commissioners we will elect in November will be stewards of the district, surveying our needs, balancing them with other interests, determining what is feasible and interviewing providers and medical systems for the right mix of providers and the best fit for our island. The commissioner candidates are our island friends and neighbors, accountable to us and responsible for funds raised from us.
The cost associated with a hospital district is about $225 per year for a home valued at $500,000 under current estimates. I use the term “current estimates” because the final numbers are established by the commissioners in public meetings. By law, there is also a cap on property tax assessment of $5.90 per $1,000 of assessed value for all local taxing districts. The total of property tax assessments by all local taxing districts cannot exceed this amount. We know there is currently about $0.45 left under the cap if every local district levy that has been proposed were to be approved. We expect that to be sufficient to start the process of providing enhanced primary care services on Vashon.
What will happen if Proposition 1 fails? In all probability, Neighborcare Health will withdraw from operating the clinic. They cannot continue to sustain ongoing unreimbursed costs on their own. The closure of the clinic will hurt these populations first and worst: older residents, families with young children and the working poor. In short order, the character of the island will change as these populations find the island cannot sustain a healthy life for them.
My colleagues and I on the campaign have been hard at work for over a year, researching other hospital districts, involving our elected leaders in plans and conversations and meeting with small groups of islanders to share facts and insight. There will be upcoming forums to hear more from commissioner candidates and learn about the hospital district itself. Please join us to learn more. We hope you’ll see the many benefits of passing Proposition 1, the measure that will create a public hospital district, fund a health clinic and sustain our quality of life. You can learn more at ProtectVashonHealthCare.com.
— Dr. Mary Bergman is a retired physician from Dallas, who has led conversations and discussions about Vashon’s health care with hundreds of islanders.