Thurston County Democrats

Washington State ranks 43rd in the country in per student funding for elementary and high school education. It ranks last in reimbursement for immunizations. Our ability to cope with the H1N1 pandemic is being severely hampered by these two factors. Logically, schools and primary care providers would be the providers of mass immunizations. In Washington, schools are too underfunded to afford the nurses necessary to carry out this endeavor. Primary care physicians actually lose money giving immunizations to state funded patients. The cost for this will be exorbitant as sick patients end up clogging the health care system, particularly the intensive care units. With another round of budget cuts in the offing, one wonders what it will take to make Washington State Democrats see the foolishness of sacrificing the health and welfare of our children to the expediency of balancing the budget without any new taxes. What use is power if our elected officials are afraid to exercise it?

Obama recently signed into law the new CHIP program, providing funding for children's health care nationally. This legislation was the result of bipartisan effort. Of note is the new acronym: CHIP instead of SCHIP. This hardly noticeable change in acronyms may seem unimportant, but the "S" in SCHIP stood for State. The new law directly funds health care for children and provides a mechanism for monitoring whether states are providing adequate reimbursement to providers and ensuring access to health care for all children. I hope our Democratic leadership is taking note of this. Among other things, this change is meant to encourage increased reimbursement for primary care providers. Right now, only 10% of medical students are interested in pursuing a career in primary care, mainly because of inadequate reimbursement. Washington State's recent decrease in reimbursement to primary care providers of 33% is hardly likely to increase the percentage of young doctors interested in primary care. One has to wonder who is running the show in Olympia. Certainly whoever they are, they are out of step with the national movement for health care reform.

For the last few decades, Washington State has been penalized for providing efficient medical care. Medicare rates have been set in such a way that states which are less efficient are reimbursed at a higher level. Since most health care reimbursement is calculated from this index, Washington State is being severely penalized for being efficient. Our representatives at the national level have been trying to get this changed. Yet, for all the rhetoric about rewarding efficiency, there has been no guarantee that this will change in the proposed health care reform package. The issue will be "studied." That is bureaucratic double speak for "don't hold your breath." We need to be careful about issuing a carte blanche to the administration without guarantees that fundamental inequities will be addressed.