Put your mind at ease. St. Michael Medical Center is certainly secular healthcare saved. The recent Kitsap News Group article need not have been ambiguous; the data is clear. Let’s walk through some of the topics:
1. Women’s Health: Ranging from ectopic pregnancies to tubal ligations and beyond, Harrison Medical Center before it and St. Michael now provides the same range of women’s health treatment as it has for decades. Hospitals report data each year on discharges to the state Department of Health. These reports — more than 30,000 rows of data — predate the sale of Harrison Medical Center.
These spreadsheets provide a snapshot of each acute care hospital in Washington in detail. Examined over time, these spreadsheets prove that women’s health needs at SMMC remain in line with other facilities statewide. As a part of its purchase, SMMC committed to the state that it would remain secular. The data show that “Catholic” acute care hospitals across the state do likewise.
2. Abortion: Harrison did not provide abortion on demand. Planned Parenthood has been meeting requests for abortions on demand in Kitsap County since 1993. According to DOH, requests for on-demand abortion average roughly 550 per year in Kitsap County. Nationwide, acute care hospitals are not the common provider for abortions on demand. Rather, outpatient clinics like Planned Parenthood are. Teaching hospitals, however, must include access to clinical experience in abortion as part of training OB/GYNs.
3. Death With Dignity: Approved by Washington voters, this law went into effect in 2009. It permits those who have less than six months to live to seek a prescription from a doctor to end their own lives. The process has waiting requirements (15 days) and witnessing requirements, but it must be self-administered. DOH reports that, of the 252 patients statewide who took these drugs in 2020, 91 percent passed away at home. Taking this step not only does not need a hospital, you actually do not want hospital intervention at all. The process is structured to permit us to surround ourselves with the nurturing environment we prefer. While any physician may prescribe lethal medications, they likewise retain — as they do with abortion — a personal right not to participate. For details, go to the DOH website.
4. Advance Directives/Living Wills: Our local hospices and hospital seek to honor your wishes for end-of-life care. SMMC has a palliative care team of doctors and social workers who work with you, your documented wishes, or, if you’re unable to communicate and have not documented your wishes, your family to respect your wishes regarding end-of-life care. This includes everything from comfort care and “do-not-resuscitate” to wanting medically appropriate intervention until you die. It is important that you speak with your loved ones about your wishes; your family may not understand or agree with the care path you have chosen.
Washington has a fragile healthcare network. Nearly half the hospitals are not acute care but are remote, rural, 25-bed limited critical access hospitals — most owned by “public hospital districts.” Our hospitals form a network: critical access hospitals transfer patients to acute care facilities; they transfer patients to other acute care facilities; all transfer certain trauma patients to Harborview Medical Center. Our acute care hospitals posted $1.66 billion in losses the first nine months of 2022. Costs for everything from supplies to nursing staff have increased while reimbursements have not.
Many things contribute to that: hospitals get paid, generally, “all-inclusive.” Hospitals are required to discharge patients safely. When patients who no longer need to be in the hospital stay there, it creates challenges for admissions and uncompensated care — a patient in the ER cannot be moved to a floor; a patient in surgical recovery cannot be moved into a room; patients queue up outside the ER; the insurer for the patient extending the stay is underpaying for the acute care bed, and so on. To make matters worse, Washington has one of the poorest Medicaid reimbursement rates — covering only 45 percent of costs.
Finally, much of Washington, with the exception of the I-5 corridor, is a Health Professional Shortage Area. In Kitsap County, we have a shortage in mental health, dental and primary care physicians. As beguiling as “choice” is, competing with Planned Parenthood on abortions or with hospice providers on end-of-life care or with SMMC through a new “secular” public hospital taxing district will not magically result in more doctors and nurses on the peninsula.
We need our elected officials to pressure the state this session on Medicaid reimbursement and discharge planning, nursing education and means to attract physicians to our state. I’d drop the “secular” altogether. Let’s “Save Healthcare.”
Jennifer Korjus, J.D., served as Medical Center Legal Counsel to George Washington University Medical Center, including schools of medicine, nursing and public health. You may reach her at firstname.lastname@example.org.