Ccargill

Residents throughout Washington state are going to find something out this week that people in Spokane and Bellingham already know- dishwashing detergent without phosphorus doesn't always do a very good job washing dishes.

Starting July 1st, a state-wide ban on dishwashing detergent with phosphorus goes into effect. The ban is nothing new in Spokane and Whatcom counties, which yanked the detergent from the shelves in 2008. The phosphorus, environmental groups say, degrades water quality in lakes and streams. Before the ban, detergent like Cascade had phosphorus levels of roughly 5-6%. After the ban, dishwashing detergent companies sold a phosphate-free product, but it left dishes looking dirty with a cloudy substance caked on glasses. Some of the initial problem was because of Spokane's 'hard water.'

In Spokane, since the ban went into place, estimates have varied as to how effective it has really been. One estimate, from this Spokesman-Review article, says there has been just a 10.7% drop in the phosphorus levels in the Spokane River. The Spokane office of the Washington State Department of Ecology says it’s doing a 'quality assurance report' to see exactly what kind of impact the ban is having on the water.

But the results may not be that much more promising. The reason? Like crossing state-lines to avoid Washington's high tobacco tax, dishwashing detergent smugglers continue to make their way into Post Falls and Coeur d'Alene to buy detergent with phosphorus. At one Wal-Mart in Idaho, a cashier said she could tell who was from Idaho and who was from Washington, simply by looking to see how much detergent they were buying. Recently, stores in Idaho have begun selling only phosphorus-free detergents.

Also, water in the Spokane River comes from North Idaho- where phosphorus detergents are still widely being used.

In Spokane County, any environmental benefits gained by banning the phosphorus detergents have been lost by people who jump in their cars and travel the 10-20 miles across state lines to buy their dishwashing detergents, and by people who are actually washing the dishes twice.

Furthermore, the ban has cost the state of Washington sales tax revenue and cost many grocery stores business. All of this effort is not worth just a 10.7% drop in phosphorus levels in the Spokane River.

It’s sad when hospitals that went into business to help people be healthy, have to battle over expansion efforts that would create more jobs and better access to health care. But that’s what is going on in the Tri-Cities right now.

The headline in the weekend edition of the Tri-City Herald says it all; “Tri-City hospitals at war.” The fight is required by an outdated, unneeded state process called the ‘Certificate of Need.’ It puts state officials, not medical professionals, in charge of deciding how large a medical facility a community needs.

In this case, Kadlec and Kennewick General Hospitals are both being forced to criticize the other to get a thumbs-up for expansion from the state. Kadlec wants to add 114 beds, while Kennewick General seeks an additional 25. Chances are slim that both expansion permits would be approved, because the state believes adding more hospital beds to a community drives up costs. This has been proven to be untrue and the information the state uses to decide the expansion process is unreliable.

So instead of concentrating on providing the best and most cost-effective care for patients, the hospitals have been questioning the other’s occupancy rates for weeks. More public hearings are planned in the coming month. The state says the CON process, usually taken one-by-one, helps keep other hospitals in business. But what happens when two hospitals apply at the same time? The answer is simple- government officials pick the winner.

Last year, state officials rejected a much-needed expansion of Sacred Heart Medical Center in Spokane which would have created hundreds of jobs, expanded medical care and made Sacred Heart the largest hospital in the state.  The next time someone in the Tri-Cities can’t get adequate medical care because of a lack of hospital beds, we’ll know who to blame.

More than 300 people showed up to a public meeting last night in Kennewick to urge the state to approval bed expansion requests by both Kadlec Regional Medical Center and Kennewick General Hospital.

Both hospitals want to expand; Kadlec by 114 beds and Kennewick by 25. However, because of state laws that limit expansion of hospitals, most in the community believe one request is likely to be denied. The ‘Certificate of Need’ makes it illegal for hospitals to expand without permission from the government. Washington is one 37 states that require specific government permission to open, expand or modify most kinds of health facilities. CON laws have grown out of the belief that a surplus of medical facilities and services meant providers would pass the excess cost onto patients.

The federal government saw the failure of CON laws and repealed them in 1982. Fourteen states have followed suit and Washington should do the same.

The ‘need’ for these beds is clear. It has become routine for beds to be full at Kadlec and Kennewick, and for patients to be sent to hospitals outside the area. Doctors at the meeting said they have been averaging 10% growth in patient numbers for the past 15 years because of the Tri-Cities population boom. Doctors entered their profession to help patients, not fight state regulations. Other medical experts who testified said the state is putting them in a position to fight other medical institutions for beds. Instead of medical experts and the communities they serve, the state then becomes the ‘decider’ in determining how much care should be available in each community.

As pointed out in the WPC Policy Guide, “CON laws create the opposite of their intended purpose, actively blocking citizens’ access to health care choices and modern health care facilities. The laws also bog down health care providers in stacks of regulation and paperwork.”