by Greg Ayers, Garth Eimers, John Gorton, Art Lange, John Mazzarella, Leslie Murdock, Tom Ritter
Everyone who lives on Orcas Island has a significant stake in having access to high-quality medical services provided in a financially sustainable manner. Unfortunately, the medical system we currently have is fragmented and unsustainable.
The four medical practices we now have provide an important variety of choices available to us as patients. However, the current provision of medical care on the island requires philanthropic funds totaling on the order of $750,000 per year. Most of this subsidy has been provided by a handful of very generous donors. We cannot count on this incredible generosity forever. A new model is required.
One model presently being explored by all the island practices would reduce the $750,000 shortfall by as much as $300,000. The concept is simple: all practices would provide services under one roof but would operate autonomously. The administrative services and facility would be managed by an operating foundation that would be independent of the practices. This model would eliminate the duplication of facilities, equipment and staffing that contribute heavily to the existing need for significant financial subsidy.
Even with this new cost-saving model, a need for subsidy will continue to exist. The realities of medicare and insurance reimbursement policies, which favor specialized care over family practices and urban care over rural practices, often result in our island doctors providing services that are under-compensated. One long-term solution, in addition to the philanthropic support that will continue to be needed, even if dramatically reduced, is the creation of a hospital taxing district. Other solutions might include partnerships with mainland health care organizations and endowment programs.
While these options represent an enormous shift in how medical care is currently being provided on Orcas Island, they are the foundation of a possible new system of collaboration. The resulting efficiencies would benefit Orcas residents as taxpayers and as patients. Such savings would allow our medical care providers to sustain their practices with less outside support. We would still have our full choice of providers. Combined resources would result in more and better equipment and technologies. Coordination of care – primary and urgent care – would inherently mean more comprehensive services for us all.
Discussions about such a new system have just begun. While the concept is simple, there are many details that will require careful consideration. We are hopeful that these discussions will lead to a positive, achievable and sustainable new model of health care delivery on Orcas.
The authors are all board members of the Orcas Medical Center Foundation.
