As a physician in a busy hospital emergency department in Tacoma, I hear dozens of patients’ stories each week. Some of the narratives stand out because they show how we, as a community, could do a better job taking care of our neighbors.
There’s the homeless schizophrenic who’s having a hard time accessing the routine care that he needs, especially now that Washington state ranks last in the nation for mental health services.
I also think of the 20-year-old woman who said she realizes she’s made some poor choices. But now she’s crying out for help with a drug addiction and wants to get her life back on track – if only she could find someplace to go for treatment.
And then there’s the 50-year-old father who almost dies on the gurney, five days short of his daughter’s wedding. Lacking health insurance, he’s never been treated for the high blood pressure and cholesterol that caused the heart attack which almost claimed his life.
These patients’ stories are on my mind as I become the only physician in the Legislature during this critical session when the state is implementing the new Affordable Care Act (ACA). Last month, I was honored that Democratic precinct committee officers in the 26th District selected me for appointment to the state Senate seat vacated by Derek Kilmer, who was elected to Congress.
The ACA is not perfect. But now that it is the law of the land, it is serving as the catalyst for a long overdue conversation about fundamental reforms that are needed to address the costs of health care.
Why? Because in order to fully serve neighbors like the patients mentioned above, we cannot simply focus on delivering more of the same kind of care in the same kind of ways.
Instead we need to look at the whole system and understand all of the opportunities for increasing effectiveness, especially at the level of the individual patient and health care provider. In the end, such comprehensive reform will make our health care system work better for everyone – even those who have been blessed to have the best insurance.
The need to address costs while improving quality is evident. Even before implementation of the law, health care spending accounts for 30 percent of our state budget. Nationally, the United States spends 18 percent of our gross domestic product on health care. And these numbers are on the rise, and at a rate that outpaces inflation.
For our state, this means health care costs are eating away at the resource base that we could otherwise devote to public priorities like fully funding our schools and colleges, protecting the environment, and investing in research and innovation. And for our private companies, it is becoming harder to compete globally when the U.S. is spending twice as much as other industrialized nations on health care.
I have two young children, and my wife, Jessica, is expecting our third baby this summer. So entering partisan politics was far from my mind at this point in life. However, an experience advocating for Medicaid patients in Olympia over the past two years led to this opportunity to serve the citizens of the 26th District.
Working with physicians and hospitals from across the state, the group I led created a set of best practices to reduce the overutilization of emergency departments by Medicaid patients.
The Washington State Health Care Authority has released a report showing that the state is on track to save nearly $34 million in Medicaid payments this year as a result of adopting these practices. The changes included better coordination of care and increased use of technology in the patient registration process.
This experience has shown that it is possible to improve care while reducing costs. And it has given me confidence that, working together, we can achieve what we set out to do: build a health care system that works well for all Americans, especially the ones who need it most.
State Sen. Nathan Schlicher, D-Gig Harbor, is an emergency room physician and attorney.
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