Published April 2002

Health-care leaders say system is ‘in a crisis’

By John Wolcott
Herald Business Journal Editor

If Snohomish County’s health-care system was seen as a patient, it would be a candidate for blood transfusions, calling in specialists and connecting life support systems — ailing enough to put florists, clergy and embalmers on alert.

But how could the county’s high-tech, multi-service health-care industry appear so robust on the outside and be so anemic on the inside?

To warn that the health-care crisis in Snohomish County — and Washington state — can’t be ignored any longer, a gathering of health-care leaders told the Everett Area Chamber of Commerce in March how staff shortages, rising costs and shrinking revenues are threatening to bring down a once-vibrant network of medical care.

Just because the system is outwardly thriving — with new medical facilities opening and new health-care services multiplying throughout the county — doesn’t mean there are no cancerous-like financial ailments threatening its future.

That was the message the panel presented, through reports by Dr. Anthony Roon, President of the Snohomish County Medical Society; Richard Cooper, CEO of The Everett Clinic; Dr. Henry Veldman, CEO of Western Washington Medical Group; Patty Mitchell, Director of Strategic Planning for Providence Everett Medical Center; and Dr. Jess Jamieson, CEO of Compass Health.

Copies of “Washington’s Ailing Health Care System: Continued Decline, Guarded Prognosis,” a January 2002 report published by the Washington State Medical Education and Research Foundation, were also distributed, along with “Medicare: Is Rationing of Care in Our Future?,” a report by The Everett Clinic.

“We are in a crisis,” Dr. Roon said. “It’s hard for us to get the attention of people in terms of looking at social policies and understanding the long-term business (of health care). We have to make a fundamental shift in how we invest our limited resources. Until then, the problems will continue to get worse.”

Most of the county — and state — health-care ailments relate to low Medicare and Medicaid payments, the panel agreed, a national problem that is acutely worse in Snohomish County. While the county is in the top 20 percent nationally in cost-of-living rankings, it is in the lowest 10 percent in medical reimbursement.

Washington state ranks 42nd nationally in Medicare spending per patient ($3,400 compared to $6,900 in Florida and New York and $10,000 per patient in Washington, D.C.). The federal government pays physicians 20 to 30 percent less for Medicare patient care today than 10 years ago, a figure that will drop another 5.5 percent this year.

Panelists noted that rising costs for rents, supplies, salaries, benefits and utilities continue to impact the viability of health-care agencies as well. Two major health-care facilities — the Everett Family Clinic and Everett’s Obstetrics and Gynecology Consultants — have closed recently. Also, the Washington State Medical Association reports a 31 percent increase in physicians leaving the state and noted that the average age for physician retirement has dropped from 63 to 58.

Among the other problems contributing to the current health-care crisis in the county and state, the panel mentioned:

• Each time a physician leaves the area, about 2,000 patients need to find a new doctor. Remaining physicians are overloaded and many cannot accept new patients.
• In 2000, an average of 68 percent of the revenue generated in a Washington state medical practice was consumed by nonmedical expenses, including overhead and payrolls.
• A recent statewide poll found that 57 percent of physicians are either limiting or closing services to Medicare patients.
• Over the past 12 years, eligibility for the state’s Medicaid program has doubled to 850,000 people, while state Medicaid spending has remained relatively flat, growing only 4 percent annually since 1993.
• State budget changes are reducing funds for treating mental health and chemical dependency, shifting those problems to the more costly criminal justice system and hospital emergency rooms.

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