Join the informed writers of The Times' editorial board in lively discussions at our blog, Opinion Northwest.
Topic: health care
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November 26, 2013 at 6:00 AM
Many in philanthropy and social services were caught off guard by federal Medicaid officials recent decision to cut off funding to Childhaven, which provides child care and therapy for abused and neglected children. Childhaven would lose $4 million a year, the combined total of the 50-50 match between state and federal Medicaid dollars — nearly half its revenue. Federal officials should reconsider. (more…)
November 18, 2013 at 12:36 PM
Anti-poverty efforts must move away from a singular focus on inner-cities and go where poverty is growing fastest: the suburbs. People with limited economic means are stereotyped as living in inner-cities, but America’s poor more often than not live and struggle in suburban communities far from the things they need most, including public transportation, health care and jobs.
These points rest atop rigorous research and public policy advocacy by Alan Berube, a senior fellow and deputy director at the Brookings Institution Metropolitan Policy Program. He is co-author of Confronting Suburban Poverty in America (Brookings Press, 2013). Berube was in Seattle early Monday to talk about the poverty’s shift beyond urban centers. There are now four times as many people living in poverty in the suburbs compared to a decade ago. Indeed, there are more poor people in suburbs now than in cities. Part of the story is the migration of low-wage jobs, chiefly in hospitality and fast-food restaurants, as well as limited affordable housing in cities like Seattle.
Berube’s talk was sponsored by the Equity kNOW project, a smart partnership between King County and Futurewise to promote more understanding of poverty and general agreement on solutions. I’m encouraged by all of this. King County has the capacity to offer forward-looking mapping and analysis of changing demographics countywide. Anti-poverty efforts need this type of regional leadership, Berube notes. He also credits smart regional cooperatives around the country, giving a nod here to the Road Map Project, a nonprofit organizing South King County communities around improving public education.
Poverty will always exist, just as there will always be unemployment. Efforts to raise incomes should be joined by efforts to ensure everyone, regardless of income, lives in communities helping them not simply survive, but thrive. That means close residential proximity to healthy and fresh foods, public parks, quality schools and reliable bus service. There is a large correlation between people who do not have access to these things and their race, ethnicity and income.
Consider the following in King County:
- The number of people of color has quadrupled over the last 30 years.
- People of color account for more than half of young people under the age of 18.
- Tukwila, Renton and SeaTac are majority minority cities.
- Three ZIP codes – Skyway, SeaTac-Tukwila and Seattle’s Rainier Valley – are the most racially and ethnically diverse in the nation.
The YouTube video by the Brookings Institution below offers a vivid snapshot of poverty’s changing face nationwide.
October 18, 2013 at 6:00 AM
In the vast arena of public education, the part least understood or addressed well is mental health. Think about it. Schools remain vigilant about ensuring students perform well academically. Immunizations are legally required and periodic check-ups for hearing and vision remain even as school systems have cut back in many areas. These things are appropriate because they directly impact students in the classroom.
Mental health also directly impacts students, as I note in my latest column. But a combination of stigma and inattention has left mental health issues on the periphery of education policy discussions. I write in my column about the many ways that is changing.
An example: In the Seattle Public Schools, all the comprehensive high schools and middle schools, plus the Interagency Academy and the World School, have mental health professionals on staff. This is possible because of the Seattle Families and Education levy, a seven-year measure approved by voters four times, most recently in 2011 for $231 million.
A focus on student health that includes the range from emotional/social issues to diagnosed disorders is a key piece of prevention efforts. It is obviously needed. About one in five adolescents has a mental health disorder and 60 percent to 90 percent of them don’t ask for or receive treatment, according to Child Trends. Most mental health needs of adolescents are first identified in schools, although the point I make in my column is that intervention often does not come soon enough.
This conversation ought to continue next Tuesday when Insurance Commissioner Mike Kreidler holds a public hearing about insurance plans and coverage of mental health services. Participation is vital because testimony from the public hearing will be used to craft rules guiding mental health parity requirements in this state. Families looking for more information about mental health services can find plenty at the Early Assessment Support Alliance website.
October 10, 2013 at 6:00 AM
Civil Disagreement is an occasional feature of the Seattle Times editorial board. Here Bruce Ramsey and Lynne K. Varner offer dramatically different takes on the federal budget battle and the government shutdown. This interactive includes a poll about American sentiment toward the political standoff.
Republicans are just taking on a partisan-passed law.
Lynne, all the sewage poured on the Republicans for “shutting down the government” is partisan and unreasonable. Yes, the Republicans are stubborn. But stubbornness takes two. And which side is asking to negotiate? The Republicans. Who is refusing to give a centimeter? Obama and the Senate Democrats. And the voices in the press (around here, anyway) are saying, “oh, you pig-headed Republicans.”
Let’s be fair here. What has happened? The Democrats in the Senate have passed a continuing resolution that funds everything in the government. The Republicans in the House have passed one that funds everything in the government except Obamacare.
Imagine two families were going to have a barbecue and the plan made months before was to have beef, pork, chicken and fish. Imagine one family changed its mind about the fish: They hated the whole idea of fish, but they were OK with the beef, pork and chicken. And if the first family insisted on the original plan and the second family insisted on no fish, and they were at loggerheads and guests were starting to go hungry, what would be the reasonable course of action?
Have the beef, pork and chicken, and save the fish until later. And if they couldn’t agree and the result was no food at all, would it be reasonable to put the entire blame on the family who didn’t want the fish?
It’s true that Obamacare is the law. But so was paid family leave, and the Legislature in Olympia refused to fund it, and it wasn’t funded. Legislatures can do that. They make the law. And Obamacare was a partisan law, passed entirely by Democrats, including members of the House of Representatives who are no longer in office. It squeaked through the U.S. Supreme Court by one vote. It is the law, yes, but this fight means it is still in play.
Basically, the people making ugly faces at Republicans are supporters of Obamacare. They are saying, “We won! Fight’s over.” And it’s not over. It angers them that it isn’t over, and they are having a tantrum about it.
Republicans shut down government, they can open it back up.
Interesting analogy Bruce. To misquote any restaurant chef, “You don’t want the fish, don’t eat the fish!” House Republicans must stop trying to prevent others from choosing the fish, or in the real-life example, medical coverage under the Affordable Care Act. Americans are not pleased. A new Gallup poll shows the GOP’s brand is at a new low. A CNN/ORC International poll spreads the blame among Republicans, Democrats and Obama. Nobody is winning in this ugly battle.
The federal government is closed and the nation’s ability to make good on its debt is imperiled due to a law that passed both houses of Congress and was signed into law by President Barack Obama. Sure, laws are not sacrosanct. They are altered or thrown out regularly by Congress and state Legislatures. But Americans enduring a second week without employment or a paycheck would prefer House Republicans to not abuse the power of the taxpayer purse by re-fighting a battle they lost.
Defenders argue this is just the messy democracy James Madison and other Founding Fathers envisioned with the whole “checks and balances” principle. Please! Someone show me where in the U.S. Constitution, the Federalist Papers or the Bill of Rights it is proposed that the losing side of a legislative debate shut down government until they get their way.
What may have started out as a crafty tactic by the tiny but powerful tea-party wing of the GOP has gone far afield. The Pentagon has turned to a charity to pick up the costs of burying dead American soldiers, this Associated Press story sadly reports. Another Associated Press story warns that the benefits of more than 500,000 military veterans and surviving spouses and children are at risk during the government shutdown.
Bruce, you ask rhetorically which side is willing to negotiate and then answer the Republicans. But it was Obama who invited the House Republican conference to the White House only to have 18 out of the 232 invited attend, reported the Daily Kos website.
Ever mindful of the 2016 presidential election, this New York Times story says GOP leaders may be softening their stance because they are starting to feel isolated from even their strongest supporters — business — and because backers like the Koch brothers are distancing themselves from the shutdown battle. It’s a timely shift in strategy inspired by tanking poll numbers.
October 9, 2013 at 6:00 AM
A European perspective on the shutdown
On Tuesday, our editorial board met with Joao Vale de Almeida, the first European Union Ambassador to the United States. On tour to promote U.S.-European relations, he expressed surprise House Republican leaders are holding a vote on a federal budget hostage unless Obamacare is repealed.
“People in Europe sometimes have trouble understanding your health care debate particularly after legislation was passed,” de Almeida says. “(President Barack Obama) was reelected and the Supreme Court ruled. In Europe, healthcare is much less controversial and ideological, so it’s unlikely to risk the functioning of the government.”
He acknowledges the recession has forced European countries to adjust their welfare programs, but “I still realize America spends more on health care than we do with less results.” (Sad, but true. Check out The Huffington Post’s visual charts based on 2013 OECD health data.)
As this map by The Atlantic shows, those nations that offer universal coverage accept a basic notion: the health care gap can only be narrowed when more people are covered.
Washingtonians embrace Obamacare
The Associated Press reports more than 9,400 people signed up for health coverage following the Washington Health Plan Finder‘s launch on Oct. 1. The Washington Post added to the news story by praising the site’s usability:
There are an additional 10,497 people who have submitted applications for health coverage through the marketplace but are not actually enrolled, meaning they have yet to pay their first month’s premium. All told, that’s about 20,000 people who have taken a step toward signing up for coverage in Washington. That’s a drop in the bucket compared to the 960,000 people there without insurance — but we are only seven days into a six-month open enrollment period.
This is a great start. Now, can we count on Washington’s Republican House delegates to accept reality (Obamacare is here to stay) and convince their caucus to pass a funding bill to reopen the federal government?
Lamentably, U.S. Rep. Cathy McMorris Rodgers, R-Spokane, continues to deliver old, tired talking points to the press. Here’s a short clip posted Tuesday on the House Republican Conference chairwoman’s Facebook page:
“We’re elected to govern. We’re elected to make the tough decisions, and yet the president and the Senate Democrats want to take the easy way out,” she said Tuesday. “That’s not acceptable to us. That’s not acceptable to the American people.”
Tell us, Congresswoman McMorris Rodgers, how is it acceptable to repeal or delay a law thousands of Washingtonians clearly want? Is placing their health and the nation’s financial credibility at risk really worth it?
August 13, 2013 at 6:00 AM
The choice of turning the old PacMed Center into apartments or classrooms is expected to be made Tuesday.
The Pacific Hospital Preservation and Development Authority, the public entity that owns the sprawling art deco-style building atop Beacon Hill, is holding a public meeting Tuesday starting at 6 . Afterward, the authority’s governing council is expected to vote on whether to lease the Pacific Tower building to Seattle Central Community College or to a Miami-based developer looking to convert the historic building into market-rate apartments.
For reasons underscoring the vital importance of education and healthcare, Seattle is better off if the college is chosen. Seattle Central’s plan to expand its nursing, dentistry, respiratory, surgical technical and optician programs would increase employment options for students entering the fast-growing medical fields. Healthcare providers would have access to skilled, locally-trained employees.
There is an appropriate interest in keeping the building consistent with its historic role as a place for good health care. The building was built in 1932 as a hospital for military veterans, merchant seamen and the Coast Guard. From 1998 to 2011, the building was the headquarters for Amazon.com.
A credible plan is not marred by the big feet of House Speaker Frank Chopp, who unilaterally earmarked $20 million from the state capital budget to pay for Seattle Central’s renovation of the building. An additional $4.8 million from the state operating budget would cover lease payments and other operating costs for two years.
Chopp’s rare public flexing of political muscle, detailed in this Times story, rankled some, including Senate Majority Leader Rodney Tom, D-Medina. Chopp’s 43rd legislative district includes Seattle Central and the Democrat found a workable way to preserve a historic building and help a fine educational institution grow.
Chopp is not the first legislator on either side of the political aisle to earmark money for a project in his or her district. That does not mean keeping an eye on the public debt created by capital spending is not a worthwhile endeavor. It is. But in this case, the spending is on an important and beneficial project.
May 29, 2013 at 6:30 AM
One in five U.S. kids currently has a mental disorder. That is a lot of kids and the number has been rising for more than a decade, according to a Centers for Disease Control and Prevention report, “Mental Health Surveillance Among Children.”
Even scarier, only 21 percent of these children are getting treatment because of a shortage of pediatric sub-specialists and child and adolescent psychiatrists, reports The Washington Post. The Post article points to troubled children living in rural and urban areas as the most likely to be under served because of the shortage and because few new doctors are specializing in pediatric mental health.
It should go without saying that 20 percent of people ages 3-17 undoubtedly places some of them here, making this a local issue that would benefit from attention by local schools, county and state governments.
The CDC relied on federal studies, medical insurance claims, public health reports, telephone surveys and other research from 2005 to 2011 for its first comprehensive look at the mental health status of children. One CDC-cited study found that from 1997 to 2010, mood disorders were among the main causes of hospital stays among children. The analysis of insurance claims found a 24 percent increase in children hospitalized for mental health and/or substance abuse between 2007 to 2010. Psychotropic drug use by teens increased over the same period.
This is a major public health issue and its prevalence, early onset, and impact on the child, family, and community is costly. The CDC estimates annual costs of $247 billion spent on health care, on services such as special education and juvenile justice, and for decreased productivity. Families without medical insurance often turn to public schools and community health organizations for help, underscoring the challenges faced by those institutions. Broadening access to mental health services is a clear need but the Washington Post story points out the difficulty of doing that with so few doctors and mental health professionals available. resources.
May 28, 2013 at 7:00 AM
Tuesday’s editorial argues there’s a difference between health systems that merge and those that are setting up a new working relationship. I urge us all to resist painting UW Medicine‘s latest community hospital ally, PeaceHealth, with the same broad brush that many might be tempted to apply to the entire Catholic hospital system.
The UW Medicine-PeaceHealth “strategic affiliation” announced last week is more or less a referral network that is intended to serve two major purposes. First, officials say their goal is to provide patients of all backgrounds with seamless care in an age of complex health care reforms that will demand better outcomes. Second, we’re looking at an opportunity to train the next generation of doctors, nurses and hospital employees.
The public should not confuse this “strategic affiliation” with the other emerging trend in Washington state that will soon lead to half of all hospital beds being run by Catholic-affiliated hospitals. I certainly have some concerns about this, as previously expressed by Seattle Times columnist Danny Westneat and tracked by MergerWatch.org. I believe patients in publicly-subsidized hospitals deserve to have access to the full range of health services — including abortion care, scientifically-proven stem-cell procedures and end-of-life services. At some point, lawmakers may have to set some parameters.
Of course, each hospital should be judged on its own merits. After spending considerable time on the phone with the key players in this “strategic affiliation,” including UW Medicine Chief Health System Officer Johnese Spisso and PeaceHealth Chief Strategy Officer Peter Adler, I don’t believe this particular alliance is an attempt by the Catholic church to take over the university’s venerable teaching hospital and limit what future doctors and nurses are trained to do.
March 12, 2013 at 6:05 AM
The Department of Health reports every county in Washington state faces “some type of health professional shortage area,” meaning there aren’t enough primary care physicians, dental workers or mental health providers to service the local population. This problem is all but certain to grow as federal health reforms require an estimated 500,000 more Washington residents sign up for insurance through Medicaid or the state’s health exchange beginning in January 2014.
We must start asking ourselves where all these new patients will go for preventive screenings, treatment of illnesses, and referrals to specialists.
I’ve found a few maps that provide more context for Monday’s Seattle Times editorial in support of SB 5615, a bill that would give the Washington Student Achievement Council the authority to strengthen its ailing physician loan repayment and scholarship program by pursuing private donations.
Take a look at the map below to get a sense of what percentage of Washingtonians live in a shortage area compared to the populations in the other 49 states. Between 19 and 33 percent of our population lacks access to health professionals. We’re in the same boat as many other states, but there’s plenty of room for improvement. Notice how states like California and Minnesota have more doctors? Both also offer numerous loan repayment programs. (Click here to see the Association of American Medical Colleges‘ searchable database of loan repayment and forgiveness programs by state.)
Physician loan repayment programs aren’t THE solution, but they are a powerful tool to recruit and retain health care providers to serve the state’s under-served residents. Washington state has embraced Obamacare, and it’s helpful to see lawmakers like state Sen. David Frockt, D-Seattle, take steps to ensure there are enough doctors around to treat an expanding patient pool. The Senate has passed SB 5615. The House should do the same.
Scroll down to see four other interesting maps that offer a visual, county-by-county look at health professional shortages in the areas of primary care, mental health, and dental care. The final PDF shows where medically undeserved populations and areas are located around the state.
February 22, 2013 at 6:53 AM
President Obama’s Affordable Care Act had no more zealous opponent than Florida Gov. Rick Scott. Guess who now backs Medicaid expansion?
Scott becomes the seventh GOP governor to move toward broader health-care coverage via the president’s plan. An estimated 1 million low-income Florida residents could become eligible for insurance, with the federal government picking up the tab for the first three years. Some 3.8 million Floridians do not have health insurance.
Scott is entitled to his opinions about Obamacare, but he exercised his practical political instincts to participate in something that was good for his constituents and his own political standing at home. Good for him. Scott won a federal dispensation to offer a managed-care plan for Medicaid recipients to save money.
He said he would only participate while the government pays for it all. The split eventually goes to 90-10 – still a bargain – by 2020. Scott needs legislative approval to participate at all.
The topic is health care, but the goofy so-called sequester pending in Washington, D.C., comes to mind. Scott lives in the real world, and he made a decision that is good for literally a million people in his state. Politicians in Congress, many of whom have never run anything but their mouths, are willing to crash the operations of government in the name of ideology.
They would rather furlough food inspectors than do the hard work of making cuts and raising revenues to balance the budget and pay off the government’s credit card.
Scott made a pragmatic choice that will benefit people very close to home.