Most of us look at the national policy debate that is taking place in the other Washington as just that…Another debate taking place in Washington DC. There are no immediately perceived impacts or believed solvency on any of the issues regarding medical care here in Lacey by the average citizen. And nothing can be further from the truth.
Day in and day out, Lacey Fire District responds to dozens of emergency medical calls where we find and treat patients with a broad spectrum of maladies. And there are few common themes we would like to point out that we are seeing every day in our own community:
-We are seeing more patients every year.
-We are seeing an increasingly older patient.
-We are seeing patients who are increasingly underinsured or have no insurance.
-We are seeing patients who can’t find primary medical care and thus rely on the emergency room.
-We are seeing longer emergency room wait times even though the area’s main emergency room is well over 4 times its original size from even a few years ago.
-We are seeing a shortage of medical care providers across the spectrum from doctors and nurses, to EMT’s and Paramedics that provide care in the field.
Those who don’t have a doctor or routine preventative care, are of age to be more prone to emergent medical care needs, or simply can’t find a doctor or care provider that will take Medicare or Medicaid, will at some point most likely be dialing 911. Why? Simply, because what’s left and what’s available? Those of us in Thurston County need to catch on that solutions to some of these issues may not be addressed at the national level but will require a solution at the local level.
A senior manager of Olympic Ambulance recently told me that they receive 18 cents on the billed dollar by Medicaid and the rest is either a loss or direct bill to the patient who most likely can’t afford it anyway. Discussions with other medical providers say that for the most part that they are cautious about taking Medicare patients because “they can take over a practice”, and that reimbursement amounts for Medicare mean that they typically take a loss or no profit for each Medicare patient seen. As a result, many local physicians are limiting their number of Medicare patients, leaving to other states or cities where Medicare patients are fewer, or they have chosen to retire early. Other avenues by local medical practices are that they increase the amount of patients seen each day reducing the time with a patient so that they can increase the numbers to make a profit. Is that then good care or are we wasting money?
Regardless, access to care is a local issue, and we can tell you that we are seeing patients on an increasing basis whose medical conditions are preventable and chronic and who turn to the local fire department as the final choice for primary care. So it comes to this, ground zero of the medical care crisis is as much about the inner cities, to rural America, to the Indian Reservations, to right here on Lacey’s streets. So when you see a fire truck in Lacey, understand that it is a licensed emergency medical vehicle with the State of Washington and its as much a “soldier” in providing health care as doctor in a private office…Except we try to see you minutes instead of making an appointment.