Many of you have asked where I stand on the public hospital district vote issue. Contrary to popular opinion, the primary issue is not the PHD and related choice of commissioners. The primary issue is UW physicians medical agreement with Orcas Medical Foundation. This agreement dictates and controls all aspects of management with Orcas Medical clinic, PHD and commissioners. Please consider these facts, problems and conclusions and then vote.

Facts:

• Kaiser is the only insurance company offering Affordable Care Act individual and family health insurance plans and Med Advantage plans in San Juan County.

• Kaiser only offers the CORE network on these products.

• The UW and affiliated hospitals in Seattle have a small number of specialists in the CORE network. The primary care physician should only refer specialists in the CORE network.

• Kaiser’s CORE network providers are available in almost all medical clinics and hospitals in NW Washington. Kaiser is in direct competition with UW medical in Seattle for medical care. If Kaiser experiences losses in SJC, they will have to either raise premiums, which they have done, or terminate policies and presence in SJC.

UW and Kaiser have had numerous meetings to try and resolve this issue. The agreement specifically mandates access to complex tertiary and quaternary care. This agreement also mandates a PHD on Orcas will be formed and will assume the role of the OMF. In the event the 2018 ballot measure fails to take place or fails to pass, this agreement may be terminated. The agreement also states that the PHD board must accept unconditionally the assignment, or the UW may terminate the agreement.

Problems: UW has a small number of specialists in the CORE network; yet they ensure care if one is needed. The pro forma annual operating amounts are highly questionable. You can view this exhibit on the OMF website under UW Agreement. The coalition is proposing using a short and long-term financing arrangement to jump start the revenue to OMF.

Conclusions: Why go into debt? Did we not raise $17 million for Turtleback Mountain and what about the almost $1 million raised for the startup fees of the UW Orcas Medical Center? The UW shortfall should not be funded when the agreement is not fulfilled. Let’s explore all our options.

David Ecklund

Orcas Island