Writings and observations


Here’s what public affairs news made the front page of newspapers in the Northwest today, excluding local crime, features and sports stories. (Newspaper names contracted with location)

West Ada plans new construction funding (Boise Statesman)
Another look at the Snake Dam breaching debate (Lewiston Tribune)
Breakfast program at Vallivue at risk (Nampa Press Tribune)
Why Idaho has a low vaccination rate (Nampa Press Tribune)
Where does Old Town Pocatello go next? (Pocatello Journal)

Activists urge Kitzhaber to drop death sentences (Eugene Register Guard)
Feds go after the fisher weasel in Kkamath area (KF Herald & News)
Pot public hearing planned next week (KF Herald & News)
Incoming governor Brown profiled (Medford Tribune)
Evaluating punishments in schools (Medford Tribune)
Another look at Kitzhaber (Portland Oregonian, Salem Statesman Journal)

Clearwater Casino planned to open in June (Bremerton Sun)
Teaching review proposals at issue (Everett Herald)
Family of Pasco cop shooting victim sues city (Kennewick Herald)
Why health exchange enrollments lag (Longview News)
Longview rail project looking for funds (Longview News)
Labor secretary comes to west coast ports (Seattle Times, Tacoma News Tribune, Olympian)
Legislators try moving WA away from coal (Olympian)
Scant snow seen on Olympic peninsula (Port Angeles News)
Street parking in Seattle getting more scarce (Seattle Times)
Most who work for Spokane outearn city median (Spokane Spokesman)
Class size ballot issue may reurn to voters (Vancouver Columbian)
Evaluating measles vaccinations (Yakima Herald Republic)

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First Take

idaho RANDY

The St. Luke’s Idaho Health System web site lists “facilities” – mainly meaning hospitals – at locations around Idaho including Boise (two hospitals there), Nampa, Caldwell, Eagle, Fruitland, Mountain Home, Jerome, Twin Falls, McCall, Meridian and Ketchum.

That’s some major reach. The main barrier keeping St. Luke’s from monopoly status is the St. Alphonsus organization, with hospitals in Boise and Nampa, an emergency room as well in Eagle, and other facilities in Caldwell.

These are not unusual cases: Nationally, health care is seeing major consolidations. The day of the independent, more or less, local hospital is at twilight, and more health businesses and non-profits (the differences between them can be subtle in some cases) are becoming Wal-Mart behemoths. And where will that take health care?

This question was peripheral – though it did relate – to the 9th Circuit Court decision handed down last week upholding Idaho District Judge Lynn Winmill in his order that St. Luke’s divest itself of the Saltzer Medical Group. The court described Saltzer as “the largest independent multi-specialty physician group in Idaho, [which] had thirty-four physicians practicing at its offices in Nampa.”

There’s a sense among many health providers that moving toward integrated systems, unifying the networks of physicians and health care organizations, is the best avenue toward controlling and maybe reducing health care costs. There’s some logic to this. The efforts underway to some extent nationally and to a larger degree in some states (Oregon and Washington for two) toward coordinated care are aimed at focusing on better health results for patients and a reduction of the pay-per-service approach, and systems that routinely bring people into the system via emergency rooms, which between them help drive up many costs. These efforts rely on bringing broad networks of health providers together to seek out efficiencies, rather than pit everyone individually to grub as much money out of the system as they can.

The 9th Circuit noted that “Saltzer had long had the goal of moving toward integrated patient care and risk-based reimbursement. After unsuccessfully attempting several informal affiliations, including one with St. Luke’s, Saltzer sought a formal partnership with a large health care system.” That turned out to be St. Luke’s. And leadership at St .Luke’s has mentioned as well the idea of more cooperative systems as a way to control health costs and improve results.

There’s some tension here between that possible improvement and concerns about monopoly. From the 9th Circuit decision again: “The district court expressly noted the troubled state of the U.S. health care system, found that St. Luke’s and Saltzer genuinely intended to move toward a better health care system, and expressed its belief that the merger would “improve patient outcomes” if left intact. Nonetheless, the court found that the “huge market share” of the post-merger entity “creates a substantial risk of anticompetitive price increases” in the Nampa adult PCP [primary care physician] market. Rejecting an argument by St. Luke’s that anticipated post-merger efficiencies excused the potential anticompetitive price effects, the district court ordered divestiture.”

There’s some sense here that the tension is between the opportunity for reasonable cost control on one hand, and monopoly (with all its attendant problems) on the other. Something like this happened a century ago with the electric power industry, which led to a compromise which generally has worked since – a series of profitable monopoly businesses that have been tightly regulated.

The time may be coming when we need to look at health care providers in a new way. Maybe that way.

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Idaho Idaho column


Here’s what public affairs news made the front page of newspapers in the Northwest today, excluding local crime, features and sports stories. (Newspaper names contracted with location)

Boise still has no police ombudsman (Boise Statesman)
New Senate concealed weapons bill (Boise Statesman)
Youth boot camp passes, opposed by local rep (Lewiston Tribune)
Kitzhaber resigns as governor (Lewiston Tribune)
Washington looks at police body cam use (Moscow News)
Urban renewal bills reviewed in legislature (Nampa Press Tribune)
Dixie Drain projects cleanup en route (Nampa Press Tribune)
Leader for jail expansion effort chosen (Nampa Press Tribune)

Kitzhaber resigns as governor (Portland Oregonian, Eugene Register Guard, Salem Statesman Journal, Medford Mail Tribune, KF Herald & News, Pendleton E Oregonian)
Brown prepares to become governor (Eugene Register Guard, Salem Statesman Journal, Medford Mail Tribune, KF Herald & News)

Senate passes bill to mesh pot medical, other markets (Vancouver Columbian, Bremerton Sun, Longview News)
Another move to commercial air at Paine Field (Everett Herald)
Property tax increases likely at Snohomish (Everett Herald)
Oregon Governor Kitzhaber resigns (Seattle Times, Spokane Spokesman, Tacoma News Tribune, Vancouver Columbian, Olympian, Longview News)
Sawmill hours reduced at Longview (Longview News)
Lacey loosened commercial sign rules (Olympian)
Effort to restart Bertha comes next week (Seattle Times)
Many in WA still can’t afford health insurance (Seattle Times)

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First Take

trahant MARK


Congress has recognized the importance and the value of tribal colleges. A Senate resolution sets Feb. 8 as the “National Tribal Colleges and Universities Week.”

There are 32 fully accredited tribal colleges and universities on some 75 campuses across the country, reaching thousands of students, delivering higher education for a fraction of the cost of other public institutions.

“All across America we have teachers helping students in some of the poorest, most remote corners of our nation. We have students who are committed to persevering, have been raised with the cultural strength of their tribe, and are determined to shine brighter to make this world a better place,” said U.S. Sen. Heidi Heitkamp, D-North Dakota, and sponsor of the resolution. “In North Dakota, I’ve been awestruck by the commitment I’ve seen from our educators and staff at all five of our tribal colleges to engaging with our Native kids – to showing them that they can achieve higher and grow stronger both personally and professionally.”

But when it comes to public policy, tribal colleges do not get the resources required.

A few weeks ago, the Atlantic published a critical report about tribal colleges and called them a “poor return on more than $100 million a year in federal money.” And, a top line of a hundred million sounds like a lot of money. The primary complaint was that the schools’ graduation rates are lower than other institutions.

But here is the rub: The same report acknowledged how much less is being spent on Native students. “Congress sets tribal college funding and is authorized by federal law to give schools a maximum of $8,000 per student. But in reality the schools get $5,850 per student on average. And that funding can be used only for Native American students; nearly a fifth of those enrolled don’t identify as Native,” wrote Sarah Butrymowicz for The Atlantic. “Howard University, a historically black college, by comparison averages more than $20,000 per student from the federal government.”

And that’s just the beginning. A report by the Century Foundation estimates the total cost for a community college averages $10,242 per student.

But The Atlantic piece seemed to blame tribal colleges themselves for inadequate resources — and a performance metric based only on graduation rates.

Fortunately there is another way to look at this issue. The Montana Legislature is considering legislation that would boost funding non-Indian students who attend tribal colleges on a per student basis. A bill by Rep. Susan Webber, D-Browning, would match the amount of funding that state community colleges receive on a per capita basis. Under current state law tribal colleges — seven based in Montana — receive about half as much per student as community colleges. Non-Indian students make up nearly a third of the student body at Montana’s tribal colleges. As Blackfeet Community College President Billie Jo Kipp put it: “Compared to what Dawson Community College gets, we get $3,000. They get $6,740. We provide similar services, we provide similar—if not more—training programs, workforce development programs, to non-Natives as well.”

Tribal colleges remain, in my mind, an unfair bargain. A bargain because they deliver higher education at a much lower cost per student. And an unfair bargain because they should not have to do that. There should be the resources available to get the job done.

Tribal colleges serve another critical role. Let me explain. If you look at the economy of a local community, pick the town, you’ll find that there are often four pillars of activity that create jobs. These are: government, health care, higher education and private sector. We know that government (tribal and federal) plays a huge role in any reservation economy. It’s the same with Indian health (now Indian Country’s single largest employer). In communities with strong tribal colleges, that becomes a third leg for economic development because there’s an infrastructure surrounding a campus that creates good gigs ranging from professors to maintenance workers. The fourth leg, the private sector, is usually the weakest link for a lot of reasons.

Tribal colleges already contribute to a reservation economy. Economists call these “anchor institutions” because of their payroll and other infrastructure building characteristics. (In fact, if you look at just about any community, the largest employers are hospitals and universities.)

I also see a role for tribal colleges that’s growing more important because higher education has the power to generate ideas that turn into something else, especially private sector jobs. Yes, graduation rates are important and should be improved. But that’s just the beginning of what a tribal college does. Mostly, I think, these are institutions where ideas grow. It takes good ideas to create permanent, sustainable tribal communities.

Mark Trahant serves as the Atwood Chair at the University of Alaska Anchorage. He is an independent journalist and a member of The Shoshone-Bannock Tribes. For up-to-the-minute posts, download the free Trahant Reports app for your smart phone or tablet.

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Here’s what public affairs news made the front page of newspapers in the Northwest today, excluding local crime, features and sports stories. (Newspaper names contracted with location)

Six same-sex marraige licenes in Idaho invalid (Boise Statesman, Nampa Press Tribune, Moscow News)
More Idaho drone companies plan their move (Boise Statesman)
Legislature reviews open meeting penalties (Boise Statesman)
Whitman farm cleared for pot planting (Lewiston Tribune)
WA justices agree with WSU golf on water (Moscow News)
12th avenue gets development attention (Nampa Press Tribune)
Bill would pull Idaho from common core group (Nampa Press Tribune)
Concealed weapons bills hit legislature (TF Times News)

State officials urge Kitzhaber resignation (Portland Oregonian, Eugene Register Guard, Salem Statesman Journal, Medford Tribune, KF Register Guard, Pendleton E Oregonian)
Property manager and money vanish (Eugene Register Guard)
Salem warns about owl attacking joggers (KF Herald & News)
Medford area eagle killed by poison (Medford Tribune)
Senators moving on timber payment bill (Medford Tribune)
Fed budget could cut conservation research (Pendleton E Oregonian)

School districts review vaccination policy (Bremerton Sun)
State roads bill hits $570m (Seattle Times, Vancouver Columbian, Everett Herald)
Campbell named city manager (Longview News)
Chorus of calls for Kitzhaber resignation (Vancouver Columbian, Longview News)
Legislature sees push for gas tax increase (Tacoma News Tribune, Yakima Herald Republic, Olympian)
Big new Amazon fulfillman center at DePont (Tacoma News Tribune, Olympian)
Bill would limit lawsuit awards in records cases (Olympian)
Another measles case on the peninsula (Port Angeles News)
North Idaho waters near flooding (Spokane Spokesman)
Building book seen in Kootenai apartments (Spokane Spokesman)
Tacoma graduation rate exceeds the state’s (Tacoma News Tribune)
Leaders in Washougal oppose oil terminal (Vancouver Columbian)

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First Take

ridenbaugh Northwest

A statement released this morning from Oregon Secretary of State Kate Brown. The third paragraph is the most notable.

Late Tuesday afternoon, I received a call from the Governor while I was in Washington, DC at a Secretaries of State conference. He asked me to come back to Oregon as soon as possible to speak with him in person and alone.

I got on a plane yesterday morning and arrived at 3:40 in the afternoon. I was escorted directly into a meeting with the Governor. It was a brief meeting. He asked me why I came back early from Washington, DC, which I found strange. I asked him what he wanted to talk about. The Governor told me he was not resigning, after which, he began a discussion about transition.

This is clearly a bizarre and unprecedented situation.

I informed the Governor that I am ready, and my staff will be ready, should he resign. Right now I am focused on doing my job for the people of Oregon.

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Oregon Oregon column

An . . . unusual video ad for a candidate for the Seattle City Council.

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Here’s what public affairs news made the front page of newspapers in the Northwest today, excluding local crime, features and sports stories. (Newspaper names contracted with location)

School broadband shutdown nears (Boise Statesman, TF Times News)
Portland loss of Hanjin shipping hits Lewiston (TF Times News, Lewiston Tribune)
Asotin County likely home to a wolf pack (Lewiston Tribune)
Multicultural center set at WSU (Moscow News)
Corrections seeks staff pay raise (Nampa Press Tribune)
Canyon sued by ambulance company (Nampa Press Tribune)
Bannock fair future returns for consideration (Pocatello Journal)
Superintendent at Gooding quits (TF Times News)

Kitzhaber: I won’t resign; Brown returns early (Portland Oregonian, Eugene Register Guard, Salem Statesman Journal, Medford Tribune, KF Herald & News, Pendleton E Oregonian)
Big housing firm turned over to received (Eugene Register Guard)
Uber trying for Eugene entry again (Eugene Register Guard)
Weather makes wolf tracking hard (KF Herald & News)
Finally, new snow at reopening Mt Ashland (Medford Tribune)
New viticulture area at Milton-Freewater (Pendleton E Oregonian)
Portland Haijin loss hits inland too (Pendleton E Oregonian)
Brewers ask to use purified sewage water (Portland Oregonian)

Suquamish will work with state on pot regs (Bremerton Sun)
Inslee proposes property crime bill (Vancouver Columbian, Bremerton Sun)
Oso slide land placed for sale (Everett Herald)
Scant snow in Csacades (Everett Herald)
Weyerhauser ends Longview layoffs (Longview News)
Tons of smelt seized after illegal fishing (Longview News)
School bond failures prompt review (Port Angeles News)
Port Angeles plans for Navy ships (Port Angeles News)
Hepatitis C drugs get less expensive (Seattle Times)
Fagan won’t quit health board (Spokane Spokesman)
Tacoma port near shut down (Tacoma News Tribune, Yakima Herald Republic)
Students fall ill from candy (Vancouver Columbian)
City redistricting plan still possible (Yakima Herald Republic)

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First Take


Here’s what public affairs news made the front page of newspapers in the Northwest today, excluding local crime, features and sports stories. (Newspaper names contracted with location)

Firefighter foundation blasted for spending (Boise Statesman)
Grove Plaza may be available this summer (Boise Statesman)
Bill would allow car registration local hikes (Nampa Press Tribune, Lewiston Tribune)
Clarkston squabbles over pot (Lewiston Tribune)
More mumps cases around Northwest (Lewiston Tribune)
Examining lottery contribution to schools (Nampa Press Tribune)
9th Circuit rules St Luke’s to divest Saltzer (Nampa Press Tribune)
Idaho firm making ag drones (Pocatello Journal)
Broadband fed fund at risk $245m (TF Times News)
Former prison inmate sues judge and others (TF Times News)
TF airport renovation in long-range plan (TF Times News)

Kitzhaber denies ethics authority on Hayes (Eugene Register Guard, KF Herald & News)
Vehicle fee increase heads to May election (Eugene Register Guard)
Irrigators in Klamath get a few more options (KF Herald & News)
Talent irrigation project gets $1m grant (Medford Tribune)
Umatilla port will sell large tract (Pendleton E Oregonian)
Milton-Freewater schools may consolidate (Pendleton E Oregonian)
Another look at Hayes’ roles (Portland Oregonian)
New fish/wildlife director faces funding mess (Portland Oregonian)
AG inquiry first of an OR governor (Salem Statesman Journal)

Narrows tolls expected to rise (Bremerton Sun)
Bainbridge Island passes park, other bond (Bremerton Sun)
State sets new rule on logging (Everett Herald)
Plan released on protection from Hanford vapors (Kennewick Herald)
KapStone says mill will run, strike or no (Longview News)
Legislature looks at drone law (Olympian, Longview News)
Kalama and several others pass school bonds (Olympian, Longview News)
Peninsula school bonds on bubble (Port Angeles News)
Port Townsend Paper mill sold to Alatana firm (Port Angeles News)
State looking into First charter school (Seattle Times)
Health board member asks to quit over vaccine (Spokane Spokesman)
Most Spokane area school bonds passing (Spokane Spokesman)
Clark ‘In god we trust’ motion defeated (Vancouver Columbian)
Mixed responses on Yakima-area school bonds (Yakima Herald Republic)

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First Take

carlson CHRIS


This is an “open letter” expressing my deep gratitude to Jon Huntsman, Sr., the Utah billionaire, who founded the Huntsman Cancer Institute at the University of Utah, and has contributed almost a billion dollars to the Institute.

He and the top-notch staff he assembled have enabled me to manage the rare and always fatal form of neuroendocrine cancer I was diagnosed with in November of 2005. It was already Stage IV. There was a large tumor mass over the stomach wrapped in and around the artery and blood vessels going to my intestines. There were numerous tumors on my liver and most were already large. The cancer had also attacked my heart’s tricuspid valve which in turn was deteriorating. I’d lost 80 pounds almost ovrnight.

When doctors cannot find the generating tumor in 80% of the cases that patient is dead within six months. Mine was a case where the generator could not be detected. Thus, I was given the proverbial six months and told to put my affairs in order, which I did.

My wife and I did what most couples do after receiving such news: we cried, we prayed, we talked about bucket lists, and we did our homework. We ferreted out who the best doctor was for treating this rare form of cancer. We also found which cancer treatment hospital was the best in the world for treating it. Supposedly it was M.D. Anderson in Houston, Texas.

The best doctor was affiliated with Louisiana State University in Baton Rouge. This was serendipitous because it gave us an excuse to drop in on an old friend of mine, Jay Shelledy. He was teaching and advising in the Journalism School at LSU.

While visiting with Shelledy we also heard back from M.D. Anderson. We’d sent my complete file to them—the MRI’s, the CT’s, the blood work, x-rays, colonoscopies—the works. The doctors at M.D. Anderson examined it all and sent word back that they were not going to see me, there was nothing they could do.

I was stunned. I’d never heard of one being refused an appointment to obtain a second opinion. The Lord works in mysterious ways, however, because it gave Shelledy the opportunity to pitch the relatively brand new Huntsman Cancer Institute in Salt Lake City adjacent to the University of Utah Hospital.

As editor of the Salt Lake Tribune for ten years, Shelledy had become good friends with the Huntsman family, particularly Jon Senior and Jon Junior as well as David. He placed a couple of calls and the arrangements were taken care of. With my team of doctors at Cancer Care Northwest in Spokane we had worked out an attack strategy which the team at Huntsman concurred with, which was to attack the lesions on my liver first as they were the most immediate life-threatening.

The day came for my first visit. Once again I was stunned. Perhaps if I had known that Jon Senior was a cancer survivor, that he knows only one way to do things, and that is first class with meticulous attention to details as well as creating a soothing and reassuring ambience, I would not have been so surprised.

David Huntsman himself greeted me at the entrance. The facility itself looked like a five star hotel, and with its modern design and a spectacular view of the Wasatch Mountains as well as a view to the west of the Salt Lake Valley, the lake and the mountains beyond, it looked like something out of a futuristic Star Trek movie.

Almost immediately I was in a meeting with the Institute’s director, Dr. Stephen Prescott, and my interventional radiologist, Dr. James Carlisle, who over the course of the next year would handle five chemoembolism procedures. My room was larger than a hotel suite, with plenty of comfortable chairs, lamps, tv’s, lovely original paintings, all color coordinated.

One long hallway leading to my section had a fantastic display of Navaho rugs and other artifacts collected over the years by Karen Huntsman. The staff nurse’s and other medical personnel were all wonderful—patient, kind, thoughtful. Dr. Carlisle’s lead nurse, Lei Allison, was simply outstanding.

I felt like visiting royalty, and that because of Shelledy’s connections, I was receiving special treatment. I soon found out I wasn’t, that every patient is treated the same way. From his own experience Jon Huntsman knows how important a peaceful, serene atmosphere is, and one that conveys a subliminal message that with the team they have and the research they do, while you may not be cured the cancer can be stymied and in many instances, managed for a good number of years.

What really counts is the result. A fifth and final procedure I had at Huntsman was a then experimental procedure that is now almost standard that involved placing Ytrium-90 radioactive pellets flown in from Australia on the day of the procedure and placed on the remnants of the shattered tumors on my liver.

That seemed to do the trick because the generating tumor’s “production rate” dropped considerably and that coupled with the monthly shot of a sandostatin called octreotide that I take has enabled me to manage a fairly normal life far beyond the six months I was once given.

In that time I’ve been able to see two grandchildren born and grow, write three books and do a fair amount of fly fishing.

The Huntsman Cancer Institute along with the Mayo Clinic are the two facilities I always recommend to anyone facing cancer. Thank you, Jon Huntsman, for your vision. The Good Lord granted a miracle but you and your skilled doctors were the instrument. You know you have helped save thousands of lives. When your time comes I have no doubt you will hear the words “Well done, thou good and faithful servant. Enter into the joy your heavenly Father has prepared for you.”

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