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Obamacare has so arrived through WAHA, Game of Monopoly

12/5/2012

2 Comments

 
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Because the feds, the State of Washington and Whatcom County don’t provide much hands-on healthcare service to the public (unless you’re in jail), you may wonder who may be making decisions “on our behalf” now that the Affordable Care Act is rolling ahead.  Who’s putting Obamacare into action here?


The answer is Whatcom Alliance for Healthcare Access (WAHA).  Effective November 30, 2012, its name was updated to “Whatcom Alliance for Health Advancement.”  
Their website says the organization will remain the same, with a new look. 

While WAHA says it’s non-partisan, it has long claimed our medical system was (or is) broken, and WAHA’s issue advocacy has only supported one solution (ahem), Obamacare.  Since last year, WAHA has been directly involved in transforming the healthcare delivery system from the free-market to the new ACO (accountable care organization) model.  Take a look under the hood of the preliminary plan (in particular the "Vision for Payment Reform" on Page 7) to see the sweeping changes in store.

WE did some background dredging to turn over rocks as we generally do, and discovered that Regina Delahunt – this county’s own Public Health Director – is also the agent and president of this non-profit, which is also technically a charity.  As such, WAHA has been doing pretty darned well.  It received a massive multi-year grant from the feds for up to $5.7 million to coordinate work that’s coincidentally tied to Regina Delahunt’s day-job.

WE don’t besmirch, but we do wonder if that pushes the boundaries of "public-private" partnership.  It seems odd and complicated that a public employee, who’s a department head with a direct interest in the county’s relationship with an organization, should also be the organization's official “agent” and “president.”

Delahunt introduced the "Community Transformation Grant" grant, a federal CDC (Centers for Disease Control and Prevention) program that was awarded in January to WAHA.  Without question, the federal government is hell-bent on helping "communities implement policies that sustain environmental and systems changes" to  "achieve health equity."  The minutes of the February 7, 2012 “Board of Health” committee meeting fail to mention Delahunt's central relationship with WAHA.

This 2007 report page named Delahunt in the “partner” role:

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Given the number of doctors, dentists, labs, and specialty care centers here plus PeaceHealth St. Joseph Hospital which is a first class medical center, who believes that Whatcom citizens have ever been systematically deprived of access to healthcare?

It doesn’t matter.  WAHA is here, it’s Obamacare central, and they say they’re representing you, me, and all of us.  Ever hear of them?  A lot of decision making about what care we should get, from whom, and at what cost will be run through WAHA.

Whether you love it or hate it, the healthcare system seems headed toward something very monopolistic with all this central guidance (that's extremely expensive).

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Have you noticed how many doctors have changed their shingles lately, and that more than ever say “PeaceHealth”?   WE don’t have a beef with PeaceHealth, but we understand that most small practices and practitioners have had little choice but join-up to become part of an ACO (affordable care organization) just to stay afloat.  Some say a lot of docs will retire soon.  Who knows if that’s true; only time will tell.

Whatever your position, WE thought we’d encourage people to pay attention to WAHA and its relationship with (and within) Whatcom County.  It’s hard to know how “auditable” the effort will be.  Most of what’s available about WAHA is its own glowing hyperbole.  Ever hear of the “Care Transitions Project” or “Project Impact”?

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They say they’re providing “a community process.”  Does that mean anything to ya?  Community process, how?   But here's what they show in presentations...

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... who are the "community members"?   Mostly insurance companies and provider insiders.  Here’s what WAHA writes about itself at its website (it has a couple versions:  this, and this – take your pick):

WAHA Overview

The Whatcom Alliance for Healthcare Access (WAHA) is a nonprofit organization whose mission is to connect people to health care and facilitate transformation of the current system into one that improves health, reduces costs and improves the experience of care. 

WAHA is committed to collaborating with others in our community to develop solutions, both legislative and programmatic, to problems that exist in our health care system, so that all residents of Whatcom County have access to health care services. Health care access is not just a local problem. It is a symptom of a larger state and national crisis — a health care system that is broken. WAHA is committed to facing this problem and working together as a community to build legislative and programmatic solutions that ensure that all Whatcom County residents have access to health care services.

History and Leadership

In 2002 the St. Luke’s Foundation convened over 200 Whatcom County citizens for a Community Healthcare Access Summit in order to increase awareness about eroding access to health coverage and care, and to identify potential strategies for developing a community-based response.  Our alliance of providers, consumers, and community leaders is the outcome of that summit.

WAHA is governed by a Leadership Board of Directors comprised of health care providers, consumers and community leaders from public and private sectors. These leaders, as well as other community partners, serve on WAHA’s advisory committees dedicated to: 1) delivering health insurance and care connection services; 2) fostering public engagement; and 3) developing sound health care policy.

Whatcom Alliance for Healthcare Access has wanted only one thing for years – central command and control, and they’ve definitely got the lead seat.  Why would we expect them to write anything but a promising "outlook" as they go forward, spending millions?  Who will hold “affordable health care” accountable to us?

ALERT:  There's been talk that a "special facilities district" could be formed for the purpose of creating a countywide ACO.  Sound tame?  NOT.   Such a district created by council (not a public vote) would potentially (a) have only few token elected public officials on its board, (b) with "operative" appointees filling more seats, and [brace yourself] (c) such a district could have broad TAXING POWERS.   But this is wouldn't be like most special purpose districts.  This would have less citizen control.  Just as for the WTA, citizens wouldn't have direct accountability through the ballot box.   We have real local control over our fire districts, school districts, and water districts - but we wouldn't have it over a healthcare district like this.  A proposal is looming - probably coming early in 2013 by all accounts.

Last council session, on November 20th, the county (WE think wisely) turned down the opportunity to involve us in a demonstration for Washington State’s “Health Path Strategy 2.”  That would have put the county in the position of being responsible for the healthcare choices of people who are eligible for both Medicare and Medicaid (“dual” eligibility).   What other “strategies” will WAHA field and present on behalf of the state and HHS?

WE don't know how WAHA will horse-collar doctors and other providers, or if services will be more or less available through our health plans.  However this comes down, how much transparency there will be as price-setting negotiations occur?   The public should know more about that, but we doubt much if anything will ever revealed about the cost of all the new overhead that provides zero in terms of actual provider service.

There’s a lot about this that promises to be everything WE feared Obamacare would be; a big game of Monopoly with insiders at the helm, managing “Community Chest.”  Pay attention, ask questions, and stay tuned.  Here's WAHA's new look and URL - dig-dig!

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2 Comments
MaBear
12/10/2012 12:28:36 pm

I wonder who selected these "participants" - Regina Delahunt?

"There were over 50 participants in Phase I of the Transforming Health Care Project and over 70 participants in Phase II" says the website.

What if we don't like their decisions? The WAHA site doesn't tell us that either.

Reply
HonestAbby
12/10/2012 05:49:54 pm

They could takeover all our healthcare in one of these districts and run it like the WTA? Tax us? That is serious.

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