“We’re living longer, but we’re living longer with more chronic diseases,” said state Department of Health Director Mary Selecky, who also spoke in the forum. She pointed to the spread of diabetes.
“We have a lot more kidney-dialysis machines in this state than we did in 2001, a lot more. So people are living with this ailment, but only with the assistance of technology. Technology is a good thing, but it costs more.”
Sens. Patty Murray and Maria Cantwell will take part in a community discussion about health care Monday. Since their most recent appearance, the costs have increased and the number of people without insurance has grown to an estimated 738,000 in the state.
“If it weren’t for the Iraq War, this clearly is the most prominent issue in America today. We’ve got health care statistics that look closer to Third World countries,” said State Insurance Commissioner Mike Kreidler, who also attended the 2001 forum.
Improvements, but few rewards
There have been improvements in some areas. For example, the government has moved to shore up the finances of rural hospitals, which were on the brink of closing in 2001, Selecky said.
“Our greatest success in the last six years is the reduction in the use of tobacco-use rate in this state. It will have the longest-term impact on health,” she said.
In 2001, Washington had the 20th-lowest smoking rate in the country. Now it has the fifth-lowest, Selecky said.
The improvement shows society can change its behavior for the better, Selecky said, adding that how a person lives determines about half of his or her overall health.
But the health care system doesn’t reward people enough for staying healthy, said Tom Curry, president of the Washington State Medical Association.
Curry also took part in the 2001 forum with Cantwell and Murray and said the big issues facing doctors have worsened since then.
In addition to rewarding patients for staying healthy, the system should reward doctors who keep people healthy, rather than pay based on the number of office visits a patient makes, Curry said.
More important to doctors, however, are the low payments by government plans such as Medicaid for the poor and Medicare for the elderly, he said.
The state has moved to increase access to Medicaid for children in particular, subsidizing families of four that make up to $62,000 a year.
But the programs generally don’t pay doctors enough to survive on, Curry said.
“You may have a participating agreement with Medicaid or Medicare, and then be forced by economics to limit patients,” he said.
And rather than seeing increases in Medicare payments for seeing elderly Americans as they hoped six years ago, doctors are lobbying Congress to stop cuts in payment rates, he said.
“The political imperative for elected officials … is to expand benefits and coverage. The economic imperative is to reduce costs,” Curry said. “So our elected officials always end up promising more than they can pay. How do we break that?”
