Gun violence has become a public health epidemic. Despite countless deaths in mass shootings over the last 2 decades, the Dickey Amendment—a provision inserted into the 1996 spending bill which blocked federal funding for research on gun violence—remains on the books. While every politician, media pundit, and policy expert “know” the solution, the answers are not that simple.
According to data from the Center for Medicare & Medicaid Services (CMS), hospital care in Kitsap County is 40% more expensive than in the surrounding communities. In documents filed as part of the lawsuit, a former physician president at TDC summed up the affiliation with CHI best: “You can now get your outpatient care in a complex, relatively unsafe, and vastly more expensive location.”
For the first time in a decade, the number of uninsured children in the United States increased in 2018. Apple Health seemed like the quintessential success story because it expanded Medicaid coverage for children — in Kitsap County alone, the number enrolled grew from 9,000 to over 21,000 in the last 10 years. However, Medicaid reimbursement also decreased by more than 35 percent, after a federal provision that kept Medicaid payments on par with Medicare expired in 2015. Some states set aside funding to maintain rates equal to those of Medicare, but Washington was not one of them.
Nonprofit hospitals, in general, are facing challenging times. And that challenge is going to reverberate through our county, whether that means a major facility on a new construction timeline or further corporate creativity to reduce health care costs.
To date, there have only been two female physicians elected to Congress. But in the coming midterm election there are six races with a chance at making history. It’s these battles which could make 2018 “The Year of the Female Physician.”
The patient was on the state Medicaid insurance and required a so-called prior authorization, or PA, for Ciprofloxacin. Consisting of additional paperwork that physicians are required to fill out before pharmacists can fill prescriptions for certain drugs, PAs boil down to yet another cost-cutting measure implemented by insurers to stand between patients and certain costly drugs.
In July, 2009, the family of Massachusetts teenager Yarushka Rivera went to their local Walgreens to pick up Topomax, an anti-seizure drug that had been keeping her epilepsy in check for years. Rivera had insurance coverage through MassHealth, the state’s Medicaid insurance program for low-income children, and never ran into obstacles obtaining this life-saving medication.
Only 6% of physicians practice in rural areas, yet they serve 16% of the population. Kitsap County has 443 physicians, equivalent to 2.4% of the state total and is one county experiencing a shortage of primary care physicians. Kitsap County falls below the state average in every primary care specialty across the board.
Just over a year ago, I met Dr. Shulkin in his office while working in Washington DC on behalf of independent physicians. A highly esteemed colleague of mine previously worked at the same hospital with Dr. Shulkin and scheduled a meeting to discuss healthcare reform. My colleague asked for a “wing woman” and I happily tagged along. Knowing their shared history, an exchange of pleasantries seemed far more likely than the haranguing with insults that ensued. In my opinion, Dr. Shulkin was one of the most pompous men I have ever encountered.
The DPC movement offers the first successful and innovative alternative health care approach to emerge in years. CMS is focusing on physician capture, control, and capitulation, yet should not underestimate the fortitude of independent physicians. We are steadfast, experienced in trench warfare, and refuse to succumb to their demands. We will continue to fight relentlessly against mounting administrative burdens which interfere with the provision of patient care.