Health care has voters’ attention


Herald Writer

It was a first-time experience for this 74-year-old Everett resident. Even weeks later, her voice cracks, her words halting and temporarily derailed, as she recalls the emotional impact.

A woman who worked in the accounting office of a downtown Seattle hotel, who prides herself on being able to "make a meal for a few dollars," was forced by desperation to go to the Everett food bank last month so she could have something to eat.

"I had to because I was ill and the medication was so expensive," she said.

"I felt so ashamed to go in there. Tears came to my eyes. I never had to do that in my life."

For all these reasons, she asked that her name not be disclosed.

The Everett resident is just a single example of one of this year’s biggest election themes: a retiree who has to choose between eating and paying for medications.

On Page 4A you’ll find a list of state and federal candidates who want to represent Snohomish and Island counties, and how they stand on some of the pocketbook issues.

Every day through Saturday, The Herald will run a grid with the candidates’ opinions on a variety of topics, such as health, transportation and campaign finance. The issues were derived following an informal community survey this summer by reporters who asked residents what was most important to them.

This year, prescription drug costs, and whether drugs should be included as a Medicare benefit, have vaulted to the top of the issue lists of both candidates and voters.

"We have to go back to the origin of Medicare in the 1960s," said Ray Crerand, chief executive of Providence Everett Medical Center and its allied health care organizations in Snohomish County.

Prescription drugs weren’t included in the original Medicare proposal, primarily because the relatively limited amount of prescription drugs available at the time were relatively cheap.

"It was $5 for a 30-day prescription," he said, so the paperwork costs of processing such a small claim didn’t make it worthwhile to include as a Medicare benefit.

"It’s a whole different ballgame now," Crerand said. "Drugs are incredibly expensive," and seniors on multiple prescriptions can face out-of-pocket bills of hundreds of dollars each month.

Prescription drug costs have been a symbol for the problems and frustrations that voters of all ages feel over a range of health care issues:

  • The power of HMOs to dictate the type of health care patients receive.

  • The millions of adults and children in the country without health care.

  • The rising costs of medical care that threaten both working adults and retirees.

  • The question of how to help seniors pay for medications.

  • The upheaval caused by health plans abruptly dropping whole markets, such as individual health insurance plans for the self-employed in Washington, or the pullout of most Medicare HMOs for seniors in Snohomish County.

    There’s one final factor pushing health care onto the short list as the election’s hottest topics.

    Health care has become so confusing that understanding all the do’s and don’ts has become a prescription for frustration.

    "There is a tremendous reservoir of goodwill between patients and doctors, hospitals and communities that’s getting eroded by some of the bureaucratic processes," Crerand said. "We’re running on empty."

    One of those for whom the reservoir of patience for health care issues has run out is Harlon Strinden of Everett.

    "It makes me so mad," he said, "you work all your life."

    Strinden, 71, a retired carpenter, lives in a low-incoming housing complex for seniors in Everett. Had it not been for his son-in-law, who insists on picking up the bill, he said he wouldn’t be able to afford a phone.

    Strinden is frustrated by a health care environment where initially Medicare HMOs were actively recruiting seniors only to abruptly pull out of the county a few years later.

    "If you go to the doctor before, they were tickled to death to have you," he said. "Now they don’t want you."

    With four major Medicare HMOs leaving the county at the end of this year, options are limited and, to someone like him living on $1,000 a month, expensive.

    "When you pass 70, they should shoot you," he declared. "That would simplify the whole thing."

    Asked to speculate if, after all the attention health care issues have received this year, any substantial changes will result, Strinden responded: "You want to know the truth?"

    "It just drops," he said of what he thinks will happen to the momentum on health care issues after the election.

    "Then, four years from now, the same thing. Senior citizens. The fight over the money and it’s a big issue.

    "I’m in good health," he said. "Tomorrow I might wake up with a heart attack. If you’re just on Medicare … it scares you," he said of the financial implications of major health problems for those on limited incomes.

    Back in her Everett apartment, the 74-year-old retiree’s food emergency has passed. In fact, she was fixing an after-school snack for her 7-year-old great- grandson one recent afternoon as she discussed health care issues.

    Although she has family in the area, she said she didn’t tell them that she had run out of food last month. She didn’t want to worry them.

    "I’ve been turning pennies since I came to this country," she said, explaining that she lived in Europe before marrying an American GI after World War II.

    "I go to the stands and get fresh fruit and vegetables. I can make a meal for a few dollars."

    She said she "reads everything" on the elections, has watched all three presidential debates and always votes.

    Recently, she wrote Gov. Gary Locke, telling him of the squeeze that the increase in her monthly Medicare HMO premium, medications and medical co-payments put on her budget.

    When asked what message she would like to give to voters, she responded: "I would tell them to go and vote and write, like I did, to Gov. Locke."

    Prescription drug prices, she said, are the biggest problem seniors face.

    "If you go the senior citizen centers, they’ll tell you," she added. "It’s hard for all of us. Not just me."

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