Hospital District: “The same care my Golden Retriever gets.”

Spiritual Smart Aleck


Medical care on Vashon-Maury Islands is not what it used to be.

We used to have a few doctors here, plus the clinic up on the hill at Paradise Ridge. If your kid, or you, fell and broke a bone, you could have it x-rayed and put in a cast here on the island.

No more.

I recently sat down with Annie Miksch, who is one of the members of the Vashon-Maury Health Collaborative. This is a group of people that has been working for five years trying to answer the question, “How do we get and keep a stable health care presence on Vashon/Maury Islands?”

They have been having public meetings about health care on the island, at one of which a gentleman got up and said that he’d like to get “The same care my Golden Retriever gets.”
The point being, animals on this island have easier access to health care than people do at present.

In the past, Miksch said, “All we had to offer was, ‘come out here and lose money,’” when the island tried to lure providers to the island. “The providers wanted $1 million up front, plus $500,000 against their losses their first year. We could not offer that.”

“If a Hospital District passes, we’ll have money that can talk,” Miksch told me. “With a Hospital District the island could raise enough money to subsidize on-island health care. Whatever comes, it has to serve all of us, from the homeless on the island to the wealthiest.”
So what is a Hospital District? It does not mean we’ll have a hospital.

It is a taxing district, same as a Fire Department taxing district, or Parks taxing district, or School taxing district.

It is run by a board of commissioners elected by us. The commissioners are people who represent us, and have business, medical, and community knowledge. They would have public meetings, and answer to the public.

The commissioners would set the tax rates, and yes, our property taxes would go up. Can we afford that?

Can we afford having no urgent medical care for human beings on the island?
Why do we need a Hospital District? Glib answer: so we can have care as good as our animals have.

If you’ve been paying attention, you know that the clinic on the hill has been a revolving door as various providers have passed through.

Primary care clinics and urgent care clinics do not make enough money to pay their own way. They need a population of 25,000 to 35,000 to draw on, and Vashon/Maury has fewer than 11,000 people on a good day. Beyond that, clinics make money from their affiliations with specialists, surgeons, and hospitals, Miksch told me.

“We’re too small, we’re too rich*, and we’re too close to major health care,” Miksch said.
Swedish Hospital, for example, is only twelve miles away. That’s only a short drive, right?
The original clinic lost money, and Granny’s Attic was established to make up for the shortfall. It wasn’t enough. Highline came in.

Highline lost money, and Franciscan took over Highline.

Franciscan failed to calculate that most islanders went to hospitals and specialists in Seattle, not Tacoma, where most of their hospital and specialist connections were, so they lost money. Bye, bye, Franciscan.

For a time, the clinic was closed, and no provider would come to the island. If you needed a doctor, you had to go to the mainland, or call 911.

Neighborcare was willing to come to the island when no one else would. Yay, Neighborcare!
However, Neighborcare has limitations.

They cannot do urgent care. We can go to a hospital ER, or, those of us who go to Seattle know there is now a Franciscan urgent care clinic on Fauntleroy in West Seattle. These options require a trip off the island. Not everyone is able to drive themselves off the island or afford the ferry fare to get back. Not everyone is able to drive.

The Neighborcare clinic tends to be overwhelmed and understaffed. It can take a long time – weeks – to schedule an appointment at the clinic. You might be able to get a walk-in appointment, or you might be told they’re not doing walk-ins that day.

Neighborcare has established a school medical clinic here funded through Best Starts for Kids, and that clinic is a success, but at the main clinic they are losing money and they can’t keep that up forever.

When Miksch says, “losing money,” she is talking about $350,000 to $400,000 a year.
One of the major contributing factors to this loss is that both private medical insurers and Medicare do not reimburse medical costs with as large a percentage of the fee as they did in years past. Ironically, if most patients were on Medicaid, Neighborcare would receive higher reimbursements for their charges, but many islanders have private insurance. (*That’s the “We’re too rich,” part)

A Hospital District levy is not on the ballot yet. To get it on the ballot this November, many people will have to sign petitions asking to put it on the ballot. You will soon see petitions around the island – it is up to you to decide if you are going to sign a petition.

Once it is on the ballot, assuming enough signatures are obtained, at least 40% of the people who voted in the last election must vote on the issue to validate the election, and of those, 50% +1 must vote to pass it.

For some reason the island had a big turnout for the 2018 election, so if you are in favor of a Hospital District, you need to get out and vote for it.

The ballot would ask: Shall we have a public Hospital District? And: Who shall be the commissioners? Meaning, the commissioners would be elected at the same time the Hospital District is formed.

A Hospital District would mean that a health care provider at the clinic would to some extent answer to us, instead of the other way around, because we would be able to keep them afloat financially.

Meanwhile, we can drive to Seattle or Tacoma or call 911 if we must.

Vashon is not alone in the dwindling of medical care in rural communities. Forming a Hospital District will give us some traction to get stable medical care here.

When a Hospital District was put to the vote twelve years ago, it sank like a stone, because it did not benefit enough people. People did not want to have their property taxes raised for something that would not benefit them.

That has changed. Now a Hospital District has the potential to benefit most, if not all, of us on the island.