Health Care Forum Highlights Systemic Faults

[Stock photo]

The nation’s approach to health care figured prominently in a Jan. 27 forum organized and hosted by Fourth District County Supervisor Natalie Arroyo.

Audience attendance was on an RSVP basis but the forum was livestreamed. It offered perspectives on the status of county health care from eight hospital and medical facility managers.

Posing questions from audience members, Arroyo asked the panelists what “the points of pain” are in providing local health care.

A systemic malaise was described.

Noting the struggles of patients, County Health Officer Dr. Candy Stockton, the county’s health officer, said frustration is “so understandable because as a person receiving healthcare, it sucks sometimes to be stuck within the system that we’re in.”

Drawing applause, she said there are “no easy answers to this but I would say that the pain point really fundamentally is that we won’t treat healthcare like a human right in this country in spite of the fact that that’s what we all want for ourselves and our community and our families.”

Matthew Rees, CEO of the Southern Humboldt Community Healthcare District, highlighted reimbursement inadequacy.

“Medicare and Medi-Cal financing and payment structure, and other things, are kind of ridiculous,” he said. “When a Medi-Cal person comes in my ER, I get about 15 percent of my cost – that’s my cost, that’s not out of my charges.”

Despite the skimpy reimbursement rate, “They expect us to meet the seismic requirements, they expect us to meet the new minimum wage for health care workers – $25 an hour – they expect all these things to just happen magically without any reimbursement to us and so that’s a real struggle that we have,” he continued.

“Everything he just told you, I can’t add to it,” said Mad River Community Hospital CEO Doug Shaw. “It’s miserable trying to run a business – besides in California, besides in health care – you as patients, neighbors and friends, it’s difficult on all sides. And we know that it’s difficult to make the system work. And it doesn’t really work.”

“It’s just that health care is incredibly complex, it’s not easy and it’s hard to communicate that to people,” said Seth Whitmer, CEO of Redwoods Rural Health Center. “And when people are frustrated with it, it’s like – look, this is health care working exactly as we’ve designed it to be and that’s the unfortunate story and none of us can really fix that.”

“People do what they get rewarded for, that’s just a fundamental part of human nature, so our reimbursement systems determine our reward systems,” said Tory Starr, CEO of Open Door Community Health Centers. “And so we get forced to actually do things that may not necessarily be in the best interests of delivering care and every one of us will have some type of story around that – we have a byzantine system of reimbursement in America that is not conducive to delivering good care.”

Retaining medical and nursing staff is challenging and Chris Meyers, chief clinical officer of United Indian Health Services said it’s particularly important for his organization.

“Our population are the local American Indians who for good reasons distrust some institutions in healthcare,” he said. “We’re primarily staffed by American Indians but still the distrust is there and with a lack of trust, that rapport is everything for educating and persuading to make good healthcare decisions. So when we have issues with retention, all of that time that it took to get that trust, that relationship, is now out the door.”

Reiterating earlier comments on systematic flaws, he added that he believes burnout has less to do with long work hours and “complex patients” than “working in a system where you’re so well trained and so highly educated, yet you don’t have the capacity to make the changes to improve the healthier patients.”

The forum began with Arroyo’s presentation on what she learned from interviewing 57 local health care providers.

She said demographic and financial trends are leading to a national physician shortage which is starting to be felt in Humboldt after years of relative “abundance.”

Health care providers are increasingly entering retirement, she continued, and morale is an issue for providers who feel helpless dealing with patients’ frustrations.

But panelists had a lot of positive things to say.

Shaw related Mad River Community Hospital’s evolution from being based in a four-story Arcata home in 1911, then expanding to a 48-bed hospital in 1943 and being developed at its current site in 1972.

“We came from, in essence, from the neighborhood, from the earth,” he said, adding, “I see nothing but blue sky for a lot of things here in Humboldt County because we are like an island and it is different, we don’t have all those outside influences, we can make things work here and we have – during Covid this community came together like I’ve never seen.”

Starr said the county’s health care capacity is more robust than people may think and the Open Door network had 35,000 more visits last year than the prior year.

“I totally believe that if we continue to lean in together, that we can overcome any of the challenges that we have,” he continued.

While appreciative of the “positive spin,” Arroyo tempered it.

“I feel like I’d be remiss if I didn’t acknowledge that a lot of people are tuning in today or going to watch this footage or are here today because they’ve had a lot of difficulty,” she said. “And you all have had a lot of difficulty – in interviewing each of you, I’ve heard the part that’s less rosy and even sounded, at times sort of like desperate to get up your head above water.

So I don’t want to be cavalier about that.”

She added, “I just want to acknowledge to all of you and to the community that we’re hearing a lot of serious challenges for people in our community, where they’re just not getting what they need.”

Arroyo said she’s “committed to continuing the conversation” and another forum is planned.