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A local exception to the ongoing Obamacare narrative

Wednesday, November 20th, 2013

Amid the persistent drumbeat of stumbles and fumbles with the roll-out of a new healthcare system, there is one local example being held up as how the new program can work well.

Brad Camp of Kingston has seen his name in an editorial penned by three governors and distributed across the country starting with The Washington Post.

Camp, who co-owns the Olympic Photography Group business and does freelance assignments for the Kitsap Sun, received notice that the private plan he had enrolled in for this year would be canceled at the end of the year. He had that coverage for himself and his children. His wife has insurance through her work, he said, but covering the entire family through her work policy would have been “prohibitively expensive.”

So Camp went through Washington’s Health Insurance Exchange and (eventually) found a plan to cover himself and his children for about $550 a month. That’s about $70 more than he was paying this year, but he is getting far more coverage. And he is getting no subsidy, so there is little (I say “little” because I hesitate to be absolute about anything.) chance that the state could come back to him and say there was a miscalculation.

For another $45 a month Camp added dental coverage.

Subsidy miscalculation is justifiably all the rage among Obamacare opponents. On Tuesday they trumpeted the story from Washington State Wire about the Federal Way woman who was held up by Obama as a success story, but thanks to the news she’s not getting the subsidy she originally thought she decided she won’t get health insurance. The story is quite comprehensive and highlights the problems here in Washington, even though Washington’s online program has been held up as an example of health care enrollment going well.

Camp, who is a success story now, had big problems with the site initially. “If I judged it by the website I would have given it an ‘F,’” Camp said. “The first three weeks it was tough to even get the website to acknowledge I was there.”

Once he got insurance though, Camp revealed his good fortune via Facebook.

So, just got a monthly raise starting in January–FINALLY, got thru on the WAHeath site and was able to sign up for insurance.
*As a small business owner that had no corporate plan available, benefits for me and the kids was VERY expensive.
For $600 LESS a month (no subsidy) , we have for the first time in 5 years:
-full office visit coverage (before is was max 4x a year)
-Prescription coverage (had to pay full freight before)
-Vision AND dental. (had NO benefit before)
-we get to KEEP our current provider and all doctors.
—-Politics and other BS aside, Our coverage is deeper, more comprehensive and much, much less costly.–
Brad Camp and Family. Now fully insured.

The post had more than 60 “likes,” and found its way to Gov. Jay Inslee’s office. Inslee included Camp’s story in an editorial he co wrote with the governors of Kentucky and Connecticut. Camp was also interviewed for a Seattle Times story.

The governor’s office asked Camp if he would be available to go the other Washington, in case someone there wanted to highlight his health care exchange success. Camp is willing to tell his story in Washington, but has no interest in entering the political debate, he said. He just knows that the coverage he has now is superior to what he had this last year and it is far superior. “I’m not taking a political side on this issue,” he said. “There is so much passion on the health care act. All I can talk about is my situation. This health care plan for my family worked out pretty well.”


Little impact locally from AG opinion on maternity and abortion

Thursday, August 22nd, 2013

On Wednesday state Attorney General Bob Ferguson issued his opinion about whether hospitals in public hospital districts are obligated to provide reproductive services (contraception and abortion) if they are offering maternity care, even if they are operated by faith-based organizations.

The short version of his answer is “Yes.” This appears to have no impact in Kitsap County, because there are no public hospital districts here. It will have an impact in Mason County.

There are two public hospital districts in Mason County, in fact, and Harrison Medical Center is contracted by Mason County PHD #2 to provide a clinic and primary care services in Belfair, but not maternity care.

So there was a question of whether a hospital that is in a PHD anywhere is obligated to provide abortion services everywhere it offers maternity care, even if it is outside the PHD.

“Our reading of his opinion is that it’s just for public hospital districts that offer maternity care benefits,” said Mary Kay Clunies-Ross, Washington State Hospital Association spokeswoman. An ACLU spokesman agreed. So Harrison, which is in the midst of merging with Franciscan Health System, doesn’t even need to consider how to comply with the AG’s opinion.

Mason County PHD #1, which covers essentially everything in Mason County except Belfair, is another story.

Scott Hilburn, Mason County PHD #1 board president, said Mason General Hospital, which does offer maternity care, has never performed a scheduled abortion. The hospital has done them in emergencies, such as when the life of the mother was at risk.

Ferguson cited state law, RCW 9.02.160, which reads:

“If the state (defined elsewhere in the law as “municipal corporations.” A PHD is one of those.) provides, directly or by contract, maternity care benefits, services, or information to women through any program administered or funded in whole or in part by the state, the state shall also provide women otherwise eligible for any such program with substantially equivalent benefits, services, or information to permit them to voluntarily terminate their pregnancies.”

Hilburn said hospital officials will be meeting with its attorney and WSHA officials. “We’re going to go ahead and comply with the law to the best of our abilities,” he said.

You can read the AG’s opinion here.


‘Washington health care costs lower for some, but not like New York’ and other stories.

Wednesday, July 17th, 2013

I may bust your New York Times paywall limit with a couple of stories I’m going to recommend you read. I’m also recommending one from the Washington Post.

The first story deals with health care reform. If you are skeptical that any government involvement in an industry could be beneficial, I would not try to dissuade from your skepticism. The news that follows was announced by supporters of the legislation, after all. Still, could this be good news? The Times reports Health Plan Cost for New Yorkers Set to Fall 50%.

State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower.

Stephanie Marquis, spokeswoman in the office of Mike Kreidler, state insurance commissioner, said state officials here are encouraged by what they’re seeing from insurers, but rates would be unlikely to drop as much here as they appear to have in New York. Different states have different rules for what gets covered under health insurance programs, and Washington has about 15 times the number of people buying insurance on their own. That might be one reason. Still, state officials are encouraged. Here’s Kreidler’s statement on the subject:

“When the rate filings started coming in, we were pleasantly surprised,” said Insurance Commissioner Mike Kreidler. “We’re not seeing the double-digit rate increases some of the insurers predicted. In some cases, people will pay the same or slightly lower for much better benefits. How much you pay will largely depend on the plan you select, your age, whether or not you smoke and where you live. People should have plenty of plans to choose from both inside the new WashingtonHealthplanfinder, Washington’s exchange, and in the regular insurance market. Premium subsidies also may be available for people buying coverage inside the exchange, depending on their income.”

Washington insurance officials will be able to comment more specifically after July 31, Marquis said.

________________________________

The second NYT story is an inside-baseball story about D.C. politics, but the players’ own admissions are stunning, if not refreshing. The U.S. Senate reached a deal that would stop Senate Majority Leader Harry Reid from blowing up the chamber’s filibuster rules. The entire story is worth reading, but these three paragraphs floored me, in a good way.

The agreement came after a meeting on Monday night where 98 Senators vented for over three hours. Members of both parties admitted some culpability in the political fighting, with Democrats conceding that their headlong drive to alter the rules may have been overly aggressive.

“We’re not without sin,” said Senator Claire McCaskill, Democrat of Missouri.

Many Republicans admitted their efforts to hobble executive agencies by denying confirmation of their leadership was wrongheaded. “Cordray was being filibustered because we don’t like the law” that created the consumer agency, said Senator Lindsey Graham, Republican of South Carolina. “That’s not a reason to deny someone their appointment. We were wrong.”

__________________________

The final story comes Al Kamen’s “In the Loop” column at the Washington Post. In case you hadn’t heard, someone pulled a prank worthy of a Porky’s (I’m dating myself here. I never saw the movie, but heard of the name gag.) movie and convinced a Bay Area TV channel of the names of the Asiana Airlines pilots involved in the crash were Asian names that when spoken should have been obvious to anyone were a joke. (I won’t put the names here. It shouldn’t be too hard to find out if you’re that curious.)

The one saving factor for the TV station was they went to the trouble of confirming the names with the National Transportation Safety Board, and someone from the NTSB did confirm it. The agency said it was an intern, one who no longer has an internship with the NTSB. Kamen writes:

Good strategy! Blaming the intern for cringe-inducing faux pas is a time-honored tradition. Interns, after all, make the perfect fall guys, with their not-always-fair reputation for cluelessness and laziness, and their status somewhere underneath the lowest rung on the Washington ladder. It’s not easy to earn respect when the most infamous alum is Monica Lewinsky.

But is it fair to turn eager young public servants into the equivalent of the dog who ate Washington’s homework? Joe Starrs, director of U.S. Summer Programs at the Fund for American Studies, which places Washington interns, said it’s an employer’s job to provide those young, inexperienced (and often unpaid) workers with guidance and a supervisor. “To throw the intern under the bus is the ultimate in abdicating responsibility,” he says.


County employees’ premiums to rise despite new health care initiative

Tuesday, July 17th, 2012

See today’s story in the Kitsap Sun (paper version) for an explanation of Kitsap County’s move to a self-insured health care program. A number of counties and cities around the regional have already made the switch in an effort to curb rising health care costs.

The new program, combined with other cost-saving measures, is expected to reduce the amount the county spends on health care by $12.5. But the “savings” will not mean a decrease in employees’ share of insurance premiums.

Employers nearly everywhere have responded to escalating health care costs by asking employees to shoulder a greater share of the burden through higher premiums and deductibles. So Kitsap County employees were not alone when they saw their premiums jump from two percent of the total cost in 2009 to eight percent in 2010. In 2012, the county pays 86 percent of the tab for premiums; employees pay 14 percent. In 2013, that’s expected to go up to 17 percent, according to Bert Furuta, director of personnel and human services.

Bear in mind that the county isn’t simply shifting the burden, said John Wallen of DiMartino Associates, the county’s health care consultant. The county’s own costs continue to increase, even as it leans harder on employees to foot their portion of the bill.

Nationwide, the proportion of employees’ share of premiums varies widely depending on the industry and region of the county. A recent Mercer survey that divides the county into four regions, showed that, among combined private and public sectors for the “West,” the percentage was 21 percent for single employees, 30 percent for families. At that rate, Kitsap County employees are still ahead of the game.

You may wonder — and I asked — why the county needs a health care consultant, at a current cost of just more than $40,000 per year. According to Furuta, the field of health care is so complex that it requires specialized expertise to navigate. The county tried to go without some years back and found it was not cost-effective, Furuta said.


Health care reform study aids

Monday, March 26th, 2012

All the nation that pays attention is paying especial attention to the U.S. Supreme Court this week as it considers health care reform. Chris Henry is working on a story about a local woman who says she has insurance and has received benefits because of the new law. She will be taking a letter to Rob McKenna, Washington attorney general, asking him to drop the lawsuit he is in along with 25 other states. I wouldn’t look for McKenna to reconsider at this point.

When I had a chance to sidle up to the McKenna the governor candidate when he visited the area in January, he joked that the odds were 5-4, a reference to the idea that the decision could be a 5-4 split among the justices.

Calling it “The” decision is actually incorrect. Today the court hears arguments on whether it should be considering the law now, or wait until the mandate actually kicks in, which is 2014.

The mandate decision, whether Congress can write a law forcing you to buy something, is the key question, and those arguments are on Tuesday. On Wednesday is an argument over whether the entire law should be scrapped if the mandate is killed.

Should you like to be informed as the debate goes on, allow me to provide you several links that will prepare for conversations around the watercooler on Facebook.

PolitiFact.com provides the primer Everything you want to know about the health care law* and also gives you a chance to check out the truth or falsehood of several claims about the law. I’m not sure why there is an asterisk in the headline. Maybe it’s an unexplained admission that “everything” probably isn’t accurate.

On NPR’s All Things Considered is a piece about this week’s activities. The package begins with a story about a guy who sells places in line to get into the hearing for $36 an hour. The first customer placed someone in line on Friday, for Tuesday’s arguments. Further on Nina Totenberg responds that she doesn’t know which side will win, but Clarence Thomas is the only one predicted to be solidly against the act. Four justices — Ruth Bader Ginsberg, Elena Kagan, Stephen Breyer and Sonia Sotomayor — are predicted to be locks in favor of the law and the constitutionality of Congress mandating what people have to buy. Antonin Scalia and Samuel Alito are considered in play and Anthony Kennedy is seen as a swing vote. An interesting tidbit: Chief Justice John Roberts could end up voting to uphold the law if there is already a 5-3 vote among the associate justices, because a 5-4 decision “wouldn’t be good for the court as an institution of the country.”

The New York Times and ABC News both have stories on a 1942 Supreme Court decision that serves as the basis for arguments on both sides.

Finally, on Salon, an academic explains some of the motivation behind how judges may rule. Andrew M. Koppelman, John Paul Stevens Professor of Law and Professor of Political Science at Northwestern University, goes into some detail explaining some of the difficulty for the justices in overturning the law. That doesn’t mean they wouldn’t do it, but there are consequences that go beyond the new things the law introduces.

When you read the follow-up news stories on each day’s arguments, you could very well get an inkling of where this will end up in June. Both sides have reason to be optimistic, and to worry.


Hearing set for Tuesday on Port Orchard’s medical marijuana moratorium

Monday, March 21st, 2011

The city of Port Orchard on Tuesday will hold a public hearing on a moratorium on medical marijuana dispensaries approved by the city council Feb. 22.

The city was allowed to impose the “emergency” moratorium without formal public input, but it is required to follow up with a hearing on the matter.

The owner of Greenthumb Medical referral service and Tacoma Greenthumb, a medical marijuana dispensary, was thwarted by the moratorium in his efforts to establish a medical marijuana facility at 944 Bay Street in Port Orchard. His attorney will be at the hearing tomorrow.

“My position is that I think it’s kind of ridiculous,” said the man, who does not want to be publicly identified due what he describes as recent changes in the industry.

He somewhat understands the moratorium on dispensaries where marijuana is sold, but believes it should not apply to referral centers, where patients obtain medical certification to receive marijuana for treatment of a wide range of ailments. He is not a doctor, but contracts with a doctor to provide referrals.

“A doctor should be able to write a recommendation anywhere in Washington,” he said.

Greenthumb Medical Inc. is registered with Washington State’s Department of Licensing. The owner, who operates in Tacoma, has been denied business licenses in Port Orchard, Bremerton and Gig Harbor.

Meanwhile, he and others with dispensaries in Tacoma are doing so in a state of limbo. Tacoma has temporarily allowed medical marijuana dispensaries, pending the outcome of proposed legislation. A bill to clarify the rules on medical marijuana has passed the state Senate and is under consideration in the House.

Greenthumb was among 19 new dispensaries to receive letters from the city of Tacoma ordering them to stop selling to patients by March 28 or face losing their licenses and possible criminal charges. The Tacoma News Tribune reported Saturday on the latest development in that city’s approach to the budding industry.

Tacoma in October sent similar cease-and-desist letters to eight dispensaries, which caused an immediate uproar. City officials decided to allow the dispensaries to operate, at least until the outcome of the bill became clear, but they were required to file appeals.

The purpose of the latest round of letters, according to the article, was to put all dispensaries on the same legal footing in anticipation of whatever action the city will take when the bill either passes or dies.

According to this business owner, however, the cumulative effect has been chilling, hence his desire to remain anonymous.

The city of Poulsbo also has instituted a moratorium on medical marijuana, although no inquires had been made about such a business when it went into effect.

A poll on the Kitsap Caucus homepage asking, “Do you favor or oppose passage of SB 5073, ‘concerning the medical use of cannabis?’” shows 31 votes for and 12 against the bill, or 72 percent to 28 percent.


Marijuana dispensary hoping to set up shop in Port Orchard

Friday, February 18th, 2011

The day after an article in the Kitsap Sun reporting that Port Orchard is considering a moratorium on medical marijuana dispensaries, Dave Norton was in a quandary.

Norton, former owner of medical marijuana dispensaries in Key Center and Tacoma, was getting ready to set up shop at the Bayside Plaza in downtown Port Orchard. He’ll take the keys to the leased storefront on Saturday.

Norton asked me what the moratorium could mean to his budding business. Should he move forward with his plans? What are his options? What’s the chance dispensaries will ever be allowed in the city?

Norton said he just wants to help people who have health problems and can find no relief elsewhere. The organization NORML, which seeks to legalize marijuana, lists 19 clinical indications for medical marijuana, from Alzheimer’s, ALS, chronic pain and diabetes, to Rheumatoid arthritis, sleep apnea and Tourette’s syndrome.

The drug is not without side effects and risks, including the possibility of addiction and negative effects on the heart, lungs (if smoked) and impairment of activities of daily living, according to the National Institute on Drug Abuse.

There are implications for mental health as well. According to NIDA, “A number of studies have shown an association between chronic marijuana use and increased rates of anxiety, depression, and schizophrenia.”

No doubt marijuana is powerful medicine, say proponents. But testimony from some who commented on the Kitsap Sun’s story indicate that, at least in some cases, it provides significant relief, where traditional prescription drugs have not, and with fewer side effects.

“Marijuana has replaced the psychotropics, and most of the pain meds and the muscle relaxers. … No more zombies,” wrote robodrill, whose wife has cancer and whose two sons are “wounded warriors.” “I have my wife back, and my sons are no longer the victims they once were, they have some pride back.”

Norton’s intention is to provide a “clean, neat, organized” facility where authorized patients can safely obtain the drug.

“We want people to realize this is going to be very, very professional,” he said.

And discreet. No tacky signs looking like something out of the 1960s. Even the name will be discreet: Bella Oha, meaning “beautiful leaf.”

Norton’s former business was “Green Health.” He shut it down after employees left in change while he recovered from a heart attack engaged in less than professional activities. Norton, with about 1,000 clients and a new partner, wants a fresh start in a new town. But since announcement of the pending moratorium, he’s wondering about the odds he’ll be able to do so.

City officials on Tuesday had plenty of questions of their own. What does the current city code say about dispensaries? Can they deny someone planning one a business license if they apply before the moratorium is formally enacted? Would this open the city up to a lawsuit? And how would the passage of a bill on medical marijuana currently before the state Legislature change the rules?

City code as it stands would allow dispensaries, and other jurisdictions, including Port Angeles, have allowed them. A business license was issued to one dispensary there, and the Port Angeles police won’t intervene unless a violation of the law is called to their attention.

But Port Orchard Police Chief Al Townsend is clear that, in his book, dispensaries are illegal — at least for now — and in his town they’ll be shut down. Townsend on Thursday issued a statement (complete text below), saying, “While the laws clearly need clarification for both those using it and those enforcing it, in my opinion it still is clear that dispensaries are not legal,” he said. “If one of the dispensaries opens in the city, I’m 100% sure we will take enforcement action, unless the law changes in the mean time.”

That could change with the passage of SB 5073, which calls for clarification of the rights of medical marijuana patients, as well as ways to track and regulate legal use of the drug. Hence the discussion of the moratorium. Townsend advised the city council to take a stance that will clearly spell out the city’s policy on dispensaries, at least until they know the fate of the bill.

Until the moratorium formally passes the council, anyone seeking to operate a dispensary could apply for a business license. But City Attorney Greg Jacoby said that the city would be within its rights to deny a license to such a business — even though current code allows it — based on the chief’s interpretation that it is illegal.

In doing so, however, Port Orchard could be opening itself up to the kind of controversy that occurred in Tacoma, when the city tried to revoke the licenses of eight dispensaries. The Tacoma City Council agreed to wait on enforcement until the fate of the bill is clear, after protesters descended on city hall.

The moratorium is not on the council’s agenda for Feb. 22. Norton will be there to state his case.

Take the poll on the Kitsap Caucus homepage: Do you favor or oppose passage of SB 5073, “concerning the medical use of cannabis?”
***********************************************************
Chief Al Townsend’s statement on medical marijuana dispensaries, Feb. 17, 2011:

While the laws clearly need clarification for both those using it and those enforcing it, in my opinion it still is clear that dispensaries are not legal. One patient, one caretaker or grower. That’s how I see it. I believe that’s how the prosecutor feels about it.

If one of the dispensaries opens in the city, I’m 100% sure we will take enforcement action, unless the law changes in the mean time.

If the law does change to legalize dispensaries, my biggest concern was how the city was going to regulate where they would be located. It appears now that the city will create a moratorium on the facilities until such time as they can sufficiently study that issue. I think that’s a really good idea.

What I find most interesting about this is……..if people really want to have options for medical marijuana, why not regulate it and dispense it through the facilities that already exist……..pharmacies. It would seem natural to do so in this way to help ensure compliance with the laws that they already have to follow. The facilities are professional and clean and already located around the community. Seems like the best way to do business. Let Pfizer and the other drug companies market it!

Alan L. Townsend
Chief of Police
City of Port Orchard
546 Bay Street
Port Orchard, WA 98366
(360) 876-1700 FAX: (360) 876-5546
www.cityofportorchard.us


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