The Gristle

Monopoly

Wednesday, March 15, 2017

MONOPOLY: For seven years, the Republican Party vowed they would repeal Obamacare, the Patient Protection and Affordable Care Act of 2010. Some in the national party were content with just that and only that, and the massive tax cut that would deliver to an economically advantaged class of billionaires for whom rising healthcare costs are but a trivial personal concern. Other Republicans believed the ACA should be replaced with something, and in February they unveiled a proposed American Health Care Act (AHCA) amid a great deal of chaos and secrecy.

The scoring of the impacts of AHCA was released this week by the Congressional Budget Office, creating shock at how bad the proposal was for the Republican congressional leaders to whom CBO reports. The estimated healthcare coverage losses of 14 million in the first year alone and 24 million within ten years were astonishing, and worse than many believed possible. Still, the promised tax cuts continue to charm a lobbying donor class that can practically buy their own private hospitals, and a plan that would ordinarily be slaughtered by its poor CBO score may continue to thrum in national discussion.

Much of the healthcare debate in the United States revolves around questions of demand—the numbers of people in the risk pool; and the incentives and subsidies necessary to keep healthy people in the risk pool to lower delivery costs and insurance premiums. But we’ll suggest issues of supply also yield clues to the solution of the healthcare debate. There’s something about the delivery of medical care in the United States that pressures for monopoly—a standardization of methods and practice, a consolidation of facilities in the form of medical campuses, and the regulation of the whole in the manner of a utility—and that means the standard capitalist model of many providers and many insurers, all financed through investment profits, is likely inadequate to provide permanent, stable, affordable health care for millions of Americans. In other words, we probably should give up on the taxonomy of health care as some free-market, many-limbed creature and begin to consider the beast more in the sense of a regulated, monolithic utility.

Most communities have only one hospital, one centralized campus for the delivery of medical care; and Bellingham is no exception.

For years PeaceHealth has grown, and in its growth acquired other medical service providers and laboratories. The nonprofit organization’s remarkable growth and consolidation caused the City of Bellingham in 2014 to revise its tax code as PeaceHealth acquired for-profit ventures and brought them under its tax- exempt umbrella, successively starving the city of considerable business revenues with each acquisition.

Having effectively eliminated competition in local laboratory services, in February PeaceHealth announced the sale of its laboratory services to Quest Diagnostics. Under the agreement, Quest Diagnostics will manage 11 laboratories PeaceHealth operates in hospitals in Washington, Alaska, and Oregon. PeaceHealth will maintain ownership of those labs, including the one at St. Joseph hospital in Bellingham. Quest Diagnostics also will purchase eight patient centers throughout Whatcom County. The patient centers are typically places where people can go to get blood tests and other services.

In a news release, PeaceHealth President and CEO Elizabeth Dunne said the agreement was made to keep its commitment to care that is both accessible and sustainable in an environment of increasing cost and complexity in the delivery of health services.

“In our current healthcare landscape, that sometimes means collaborating with organizations that offer the data, tools and resources necessary to stay ahead of the curve in specialized services,” Dunne said. “After thorough and thoughtful consideration, it became clear that Quest Diagnostics offers the expertise to enhance our services and increase convenient access to care in our communities.”

PeaceHealth has yielded to the pressures of a capital-driven healthcare market.

The agreement has unsettled a community of patients and health service providers concerned the outsourcing of laboratory services will weaken local control in the delivery of medical services and eliminate good-paying jobs for a professional class of technicians, analysts and practitioners.

According to numbers from SEIU Healthcare 1199NW union that represents these professionals, PeaceHealth employs about 100 lab assistants and 45 technologists in Whatcom County, with about 50 of those combined positions being eliminated. Last month, PeaceHealth sent a notification to the state, announcing 142 employees will be let go in various locations in Washington beginning in April.

Organized emergency medical service providers weighed in on the agreement this week, announcing “the more than 205 firefighters that serve Whatcom County are calling on PeaceHealth to walk away from its misguided plan to sell its currently locally run, not-for-profit labs to an out-of-state, for-profit operator.  As firefighters, the safety of our community is our top priority and we fear public health and patient needs will suffer after the sale.”

“These labs serve our community with quick, reliable data provided by community-based lab staff,” said Robert Glorioso, president of the Bellingham Whatcom County Firefighters Local 106.  “After the sale, the new owner will be shipping specimens out of state for testing, slowing results and possibly sacrificing the integrity of the testing.  This can’t be good for public health.”

Firefighters also pointed to the loss of living-wage jobs in the community.  PeaceHealth Labs staff are currently union members with a contract guaranteeing wage increases and affordable health benefits. The replacement workers, who may not even be from our community, are unlikely to have the kind of stability the union lab jobs offer.

“Bellingham thrives when workers thrive,” said Dave Pethick, Firefighters L106 vice president. “The loss of 100 good jobs in our community will hurt us all.”

The quality of medical care in the United States outshines the world. Its costs and delivery, baked into a broken capitalist model that demands outsourcing and wage suppression, is misaligned to that quality. The game of Monopoly always ends with a bankruptcy. That’s no way to deliver medical care.

Smoking Crow
Past Columns
Symptoms of Pain

April 25, 2018

A Last Ditch Effort

April 18, 2018

Much ADUs About Nothing

April 11, 2018

The Sin of Sinclair

April 4, 2018

All Thumbs on the Scale

March 28, 2018

The Boundaries Between Us

March 21, 2018

Dirty Deeds

March 7, 2018

Sunshine Storm

February 28, 2018

A Public Education

February 21, 2018

Power Play

February 14, 2018

Neutral Ground

February 7, 2018

The Nature of the Emergency

January 31, 2018

‘Fix’ fumbled, punted

January 24, 2018

New Energy

January 17, 2018

Save Our Salish Sea

January 10, 2018

Predictions of Protractions

January 3, 2018

Parsing the Puzzle

December 27, 2017

Camp Kelli

December 20, 2017

Gifts of the Three Magi

December 13, 2017

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English Country Dancing

1:30pm|Bellingham Senior Activity Center

Mt. Baker Plant Sale

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Jazz Jam

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Pub Run

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Canadian Exploration

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Mexican Kitchen

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Balkan Folk Dancers

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Get Gritty

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9 to 5, the Musical

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Misty Flowers

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Skagit Valley Tulip Festival

10:00am|Skagit Valley

Free Appliance Pick-up

10:00am|Whatcom County

Bellingham Beer Week

10:00am|Throughout Bellingham

Mt. Baker Plant Sale

3:00pm|Mt. Baker High School

9 to 5, the Musical

7:30pm|Anacortes Community Theatre

Wild Things

9:30am|Stimpson Family Nature Reserve

Book and Bake Sale

10:00am|Deming Library

Valley Writers

1:00pm|South Whatcom Library

Coffee Tasting

3:00pm|Camber Cafe

Food Not Bombs

4:00pm|Downtown Bellingham

Fourth Friday Art Walk

5:00pm|Historic Fairhaven

Ship of Fools Closing Reception

5:00pm|Cooper Lanza Gallery

Inspire Higher Dreams Gala

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Always...Patsy Cline

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Wilderness and Wellness

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Cantabile Chamber Choir

7:30pm

Skagit Community Band

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The Kid

7:30pm|Lincoln Theatre

Friday Night Flicks

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Legends and Brawls

8:00pm|Upfront Theatre

Trove Web Village Books
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Skagit Valley Tulip Festival

10:00am|Skagit Valley

Free Appliance Pick-up

10:00am|Whatcom County

Bellingham Beer Week

10:00am|Throughout Bellingham

Mt. Baker Plant Sale

3:00pm|Mt. Baker High School

9 to 5, the Musical

7:30pm|Anacortes Community Theatre

Book and Bake Sale

10:00am|Deming Library

Always...Patsy Cline

7:00pm|Conway Muse

Skagit Community Band

7:30pm|Maple Hall

Cantabile Chamber Choir

7:30pm

Legends and Brawls

8:00pm|Upfront Theatre

Ferndale Breakfast

8:00am|American Legion Hall Post #154

Have a Heart Run

9:00am|Edgewater Park

Senior Center Plant Sale

9:00am|Bellingham Senior Activity Center

Hydrangeas 101

9:00am|Garden Spot Nursery

Linuxfest Northwest

9:00am|Bellingham Technical College

Everson Garden Club Plant Sale

9:00am|Everson-Goshen Rd.

Independent Bookstore Day

9:00am|Village Books

Backyard Habitat and Native Flora Fair

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Bellingham Farmers Market

10:00am|Depot Market Square

Vaisaikhi Day Celebration

10:00am|Guru Nanak Gursikh Gurdwara

Sudden Valley Garden Club Sale

10:00am|Sudden Valley Dance Barn

Correspondence Club

10:30am|Mindport Exhibits

Sculpture Tours

10:30am|Big Rock Garden Park

Growing Dry Beans and Grains

1:00pm|Chuckanut Center

Panel discusses oil sands pipeline

3:00pm

Klee Wyck Journal

4:00pm|Village Books

Visions of the Soul Opening

5:00pm|Forum Arts

Spring Has Sprung Opening Party

5:00pm|Matzke Fine Art Gallery and Sculpture Park

Naomi Shihab Nye

7:00pm|Performing Arts Center

Moon Walk

7:00pm|Whatcom County

Contra Dance with Incognito

7:00pm|Fairhaven Library

Dylan Foley and Eamon O'Leary

7:00pm|Littlefield Celtic Center

Skagit Symphony Classics Concert

7:30pm|McIntyre Hall

Paula Poundstone

8:00pm|Lincoln Theatre

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