Mixed Delivery in Healthcare Services


Any experience you are likely to have in receiving healthcare services in Central Oregon will probably come with mixed impressions.

On the one hand we have one of the highest rated hospital systems in the country. St. Charles Health System, for instance, recently received the American Heart Association/American Stroke Association’s Gold Quality Achievement Award. The award recognizes St. Charles’ commitment and success in implementing a higher standard of stroke care.

In 2011 for the third year in a row, Thomson Reuters recognized St. Charles Health System as one of the top performing health systems in the country.

St. Charles Bend is the first hospital in Oregon to offer a new kind of technology that helps physicians better diagnose and treat patients with coronary artery disease, or blockages in the arteries that feed the heart muscle.

In addition to the area hospitals’ exemplary systems, the variety of services offered by top experts in Central Oregon range from dermatology, audiology, urology and orthopedic care to at home and hospice care. Generally speaking, depending on the clinic or medical office, you’ll receive quality and expert care. If you are treated well by the clinic receptionist at check in, by the nurse or physician assistant and then by the doctor and they show understanding and concern for your condition, you might be a happy patients.

On the other hand if the greeters are rude or understaffed, if the nurse is in any way discourteous (especially if you’re feeling bad) and the doctor seems ill-suited to help you, you won’t be satisfied with the visit.

And all of the things you go through just to get treated are only a mirror of what you’ll encounter with your insurance company, if you have one. (A 2009 Harvard study estimated that 44,800 excess deaths occurred annually due to lack of health insurance.)

In addition to the medical services you’ll receive you will be treated differently at the clinic check-in point depending on your age, your sex (men and women are not allotted the same level of preventive care) and insurance. If you’re 65 or over you’ll be on Medicare, but if you don’t have extra (and adequate) insurance you won’t have full coverage and you’ll need to pay something upfront. So bring your checkbook and be prepared to wait for the insurance to pre-approve many of your treatments.

In you’re under 18 and not covered under a family insurance plan you’re covered under the Children’s Health Insurance Program. But arrive early there’s a lots of paper work, even if it’s an emergency.

If you’ve been in the military you’re covered under the Veterans Health Administration. But be prepared to drive to Portland for most services.

For the rest of you, between 19 and 64, you’re fortunate if you have health insurance. As the U.S. Census Bureau reported 49.9 million residents, 16.3 percent of the population, were uninsured in 2010 (up from 49.0 million residents, 16.1 percent of the population, in 2009). Over the past few years at least 62 percent of filers for bankruptcies claimed high medical expenses. Health costs and the numbers of uninsured and underinsured continue to increase.

For those with health insurance it’s not cheap. According to the World Health Organization, the United States spent more on healthcare per capita ($7,146), and more on healthcare as percentage of its GDP (15.2 percent), than any other nation in 2008.

The United States had the fourth highest level of government healthcare spending per capita ($3,426), behind three countries with higher levels of GDP per capita: Monaco, Luxembourg and Norway.

We pay twice as much yet lag behind other wealthy nations in such measures as infant mortality and life expectancy. Currently, the USA has a higher infant mortality rate than most of the world’s industrialized nations. The United States life expectancy is 42nd in the world after many other industrialized nations.

Why do we lag so far behind in healthcare? In December 2011, the administrator of the Centers for Medicare & Medicaid Services, Dr. Donald Berwick, asserted that 20 percent to 30 percent of healthcare spending is waste. He listed five causes: (1) overtreatment of patients, (2) the failure to coordinate care, (3) the administrative complexity of the health care system, (4) burdensome rules and (5) fraud.

The United States is among the few industrialized nations in the world that does not guarantee access to healthcare for its population. Our healthcare system is so bad it’s compared to Mexico and Turkey. Even with the passage of the Patient Protection and Affordable Care Act (Obamacare) we are not even close to providing adequate care for all Americans.

The Affordable Care Act has numerous components that can improve our healthcare system but also has a tax penalty for those who do not obtain health insurance. The concept has become a political nightmare with Republicans vowing to completely abolish it than even try to fix it. And yet the Congressional Budget Office estimates that the net effect (including the reconciliation act) will be a reduction in the federal deficit by $143 billion over the first decade. But who cares about that?

Oregon is ahead of the curve by most state standards and is working to improve the health and healthcare of Oregon Health Plan clients through a patient-centered approach. Coordinated Care Organizations, or CCOs, are a new type of health plan that bring together all types of care under one group.

CCOs are set up to make sure that anyone who provides care – doctors, counselors, nurses – are better able to focus on prevention and improving care overall. They will help you find ways to stay healthy and manage existing conditions, if needed.

Meanwhile in Central Oregon even if you are not fortunate enough to have health insurance, you do have options, to receive health benefits including programs like Sharedcare at St. Charles, Volunteers in Medicine and Mosaic Healthcare. And the quality of care you will receive from the various clinics, surgery departments and medical experts is most likely to be exceptional.


About Author

Founded in 1994 by the late Pamela Hulse Andrews, Cascade Business News (CBN) became Central Oregon’s premier business publication. CascadeBusNews.com • CBN@CascadeBusNews.com

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