Holding Hospitals Accountable in Washington State

Washington Can Protests Budget Cuts at the State Capital

Washington Can Protests Budget Cuts at the State Capital

Little Rock        Like most people, I’m pretty sure the quality of my life is directly improved in proportion to my ability to avoid this strangely named thing called “webinars.” Surely, that’s a weapon that is used in some old Star Wars movie, not an organizing tool?

I’m not going to change my mind about webinars, I don’t think, but this one organized by the Alliance for a Just Society was playing our song about how to force hospital accountability, and all of our team wanted to learn every chorus. Listening to the presentations by Will Pittz of various hospital campaigns waged in recent years by Washington Citizen Action Network was a joyous sound. It was almost embarrassing how many questions our folks were asking, but we were hungry for this.

Washington CAN detailed campaigns that they have fought in Tacoma, Seattle, and Spokane with both nonprofit and for profit hospitals, including some in the huge Catholic and Deaconess networks that are among the largest in the country. One early insight Pittz shared that was worth the price of admission was that they had found for profits more responsive to meeting about improving charity policies than nonprofits, and not only did that resonate with our own initial experience where letters to nonprofits in Little Rock, Dallas, and Houston asking for a meeting to discuss these issues has thus far been met in silence, but was convincing that we needed to target them equally even though the Affordable Care Act handle on nonprofits is so much stronger. The nonprofits, rules and tax exemption be damned, are hunkering down hoping that they can continue to do business as usual and the patients and communities be damned.

Amazingly Washington CAN in fact had won a financial assistance policy at one for profit that set us back on our heels: 300% of poverty guideline eligibility for full charity care and at 500% of poverty 75% charity care. We had been assuming that we might be lucky to win a clear standard in Texas, Louisiana, and Arkansas at 200% of poverty for charity care from nonprofits, and the notion that anyone, anywhere could win this 300 to 500% standard is a game changer, and with a for profit unheard of.  At one point in the webinar, and OK, I’ve used it in a sentence, so I guess I’m now saddled with this preposterous word for life, Pittz asked the listeners if anyone had won or heard of a higher standard because it would be helpful to him to know. I don’t know Pittz, but he delivered the line sincerely without seeming to brag, but, believe me, there was nothing but silence in response to his call. This will be the gold standard for holding hospitals accountable in this campaign, trust me on that!

None of the Washington campaigns seemed easy. Their efforts were significantly resourced and determined, involving hitting 2000 doors in the area of one hospital, putting up 500 yard signs, and essentially throwing the kitchen sink at them. Not quite the sink, the PowerPoint, and, yes, I’ll admit I studied one of those bad boys carefully, too, it featured a cute tactic of holding a “debtor’s carnival” under a canopy on the grounds of Swedish Hospital in Seattle.

Washington CAN’s experience has led them to distill some standard demands not only on poverty guidelines, but also on brass tack items like the length and detail of the applications, which many of the nonprofits are using to discourage and disqualify desperate people, winning a straight forward 2-pager in some cases. They also have fought for – and seem to have won in some cases – the ability for patients to back file for charity care and by doing so extricate themselves from court and debt collection procedures, which is also huge. They did a group filing for charity care, which was right up our alley as well.

We’re going to drink this Kool-Aid and share it with as many thirsty organizers as possible!

 

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