How does the Washington legislature affect healthcare?
The legislature passes laws that direct government agencies to develop policies intended to improve our broken healthcare (HC) system, hopefully.
This bill extends the reach and authority of the Health Care Cost Transparency Board, which operates under the auspices of the Department of Health. Their task is to gather information on HC expenditures, cost, and growth, as well as analyze the impact of ‘cost drivers’ on HC spending (labor, technology, prescription drugs, supplies, uncompensated care, administrative costs, etc.). The board is now authorized to share data with the Prescription Drug Affordability Board, study underinsurance of WA residents, set yearly growth benchmarks, and more.
Gathering data about where we are is the starting point for improvement, which then informs where we want to go. Think of their work as a part of developing a ‘healthcare change map.’
The bill’s sponsor, Rep Nicole Marci (Democratic, 43rd district, Seattle) said, “When health care is one-fifth of the state budget and my constituents have to choose between going to the doctor or paying rent, it’s time for a fresh approach.”
This bill was notably co-sponsored by our local representatives, Jessica Bateman and Beth Doglio – thank you!
This law bans surprise billing by ambulance companies when out of the patient’s insurance network. This brings ambulance billing up to par with other non-surprise billing acts for HC services.
Many other healthcare bills failed at different levels of the legislative process, some of which will be revisited in next year’s full-length session. They were directed towards solutions to a whole array of healthcare issues, including the availability of insurance, fair pricing at many levels, mental healthcare equity, long-term care issues, fair contracting of healthcare providers with corporate entities, telemedicine availability and payment, and much more.
Our Attorney General (AG) makes sure the laws are followed.
Attorney General Bob Ferguson recently acted to hold Providence and PeaceHealth systems accountable for providing the charity care they are legally obligated to offer to those eligible. Considering that our state has the 4th highest average charge per day for a hospital stay in the country, at $3,843/day, it is no wonder that nearly half a million Washingtonians are being chased by debt collectors for medical treatment costs. As a result of his actions, our citizens will see millions in refunds. Thank you, AG Ferguson!
Until a few months ago, I knew little to nothing about any of these statewide and national organizations. They are staffed by brilliant, dedicated individuals (who are not getting rich doing this) with professional credentials ranging from attorneys to those with master’s degrees in public health, administration, social work, and more. They are working to study, support, and create legislation to regulate the out-of-control problems in our healthcare system.
I was privileged to attend NoHLA’s (Northwest Health Law Advocates, one of Washington’s non-profit research organizations) 2024 Legislative Session Review with Emily Brice, Deputy Director, and their lobbyist, Erin Dziedzic.
This was a one-hour rapid-fire review of the few bills passed and many unpassed in every area imaginable that impacts HC. Most of this was over my ‘medical head’ with ‘legalese’ but I got the gist. That meeting helped inform this column. The conclusion? There is a lot more work to do with many bills awaiting another year for passage!
They pointed out that there are several unknowns looking ahead at HC legislation in WA. Our state will soon have new leadership: Governor, Attorney General, and Insurance commissioner. There will be many legislative shakeups with all House and half the Senate members up for re-election, plus a VERY uncertain federal landscape. Stay tuned!
The Lown Institute is one of those national non-profits. It was founded by Bernard Lown, M.D. (1921-2021), a pioneering cardiologist and inventor of the modern direct current defibrillator that is responsible for saving countless lives from cardiac arrest.
His vision for the institute, a non-partisan, nonprofit think tank, is that a radically better American healthcare system is possible.
Their Lown Index Rating for Social Responsibility ranks hospitals and healthcare systems nationwide according to their ability to provide the best outcomes, value, and equity.
In their newly released Fair Share Spending study, they compared non-profit hospitals’ spending on patient financial assistance and community health investment to the estimated value of its tax exemption based on their fiscal year 2021 IRS Form 990. Hospitals and healthcare systems were determined to have fair share deficits (meaning they received more in tax benefits than was shared with their patients and communities) or surpluses (they gave more than received).
It turns out that Washington is home to the top 3 healthcare (HC) systems with the largest deficits: 1 Kaiser Permanente with a $1.2 billion deficit, 2 Providence at $1.0 billion, and 3 Commonspirit Health (which operates as Virginia Mason Health) at $834 million.
We have the additional “honor” of being one of the five states in which 97% of our hospitals have a fair share deficit. We also claim two of the five U.S. Catholic healthcare systems that are among the nation’s 10 HC systems with the greatest Fair Share deficits: Providence and CommonSpirit.
These grim statistics and data, along with our own HC experiences, leave many of us feeling powerless and depressed about the state of all things healthcare.
1 - Don’t delay your medical care. In the end, this poor choice turns out to be more expensive financially and, more importantly, detrimental to your health and quality of life in the long run. Take care of yourself first. Stuff happens, but many things can be prevented.
2 - Get health insurance if you don’t have it. You may qualify for public options – Home | Washington Healthplanfinder (wahealthplanfinder.org).
3 - If you have been hit with large balances on your healthcare bills, you may be eligible for charity care and substantial discounts. Eligibility is more generous than you imagine, set to 300-400% of the poverty level. Use the resource link below to see if you are close to qualifying. If so, apply through the HC system that is billing you. If you are eligible, they must comply with federal and state guidelines to provide these discounts and write-offs.
Charity Care Legislation - https://www.atg.wa.gov/charitycare
4 - Participate in the Legislative Process: Washington State Legislature Participating in the Process. This easy-to-navigate webpage has many ideas of how to participate with links to just about anything you can do.
5 - Stay informed about your health AND the democratic process.
6 - VOTE.
7 - Read reliable journalism: The JOLT for local news (it’s FREE and non-profit) – oh, you are reading it – thank you! and The Seattle Times for state news (subscriptions are reasonable).
8 - Look up your hospitals’ ratings on the Lown Institute Website: Rankings - Lown Institute Hospital Index (lownhospitalsindex.org). You may be surprised.
9 - For some specialty care, it might be necessary to travel northward. Do not hesitate if so. Olympia is a small city, medical specialty-wise.
I am grateful to lawyers, policy writers, and legislators for what they are doing to regulate and save the sinking ship of healthcare. Lack of regulation for decades is what we have now.
Sam Hatzenbeler, Senior Policy Associate at the Economic Opportunity Institute (a WA non-profit), aptly states about the legislative success, “While we are encouraged by these gains, we know that these are just the first steps and we need to continue the fight for incentives that put patients over profits.”
Debra L. Glasser, M.D., is a retired internal medicine physician in Olympia. Got a question for her? Write drdebra@theJOLTnews.com
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Bannerwoman4
Thank you for all your excellent work on healthcare in Thurston County and WA State. As I followed the legislation, one issue jumped out: there is no regulation of private assisted living facilities when it comes to diet requirements for residents. That means a diabetic or a person on salt restriction or any prescribed diet often does not get it. In addition, there is a lack of fresh fruits or vegetables. Residents often supply their own food but still must pay the facility for food they do not eat.
Unfortunately, a bill to change this did not pass.
There is much work to do as you noted.
Tuesday, April 9 Report this
Snevets
Thank you sharing this information.
Wednesday, April 10 Report this