Soap Box

Protect patients from surprise bills

To the editor,

The American College of Emergency Physicians (ACEP) has been vocal about the need for a federal solution to protect patients from out-of-network, or surprise, billing. Despite the distraction tactics and big-budget ad spends that have recently hijacked these important conversations, ACEP has been involved in Congressional discussions on this issue since early 2018 and has consistently supported a ban on balance billing of patients, as long as the mechanism ensures patient access to care won’t be compromised.

ACEP serves as the voice of individual emergency physicians regardless of where they practice. Our membership comprises emergency physicians from all walks of life who practice and are employed in a variety of work environments that range from academic settings or teaching hospitals, to emergency physician groups that are either managed or independently owned and operated by the physicians. In fact, the vast majority (85 percent) of emergency physician groups are made up of 50 or fewer physicians.

ACEP’s leadership is as diverse as our members, and once democratically elected by peers, the ACEP president represents the entire field of emergency medicine. ACEP’s Council, a legislative body of elected emergency physicians, votes on resolutions that serve as the foundation for ACEP’s federal and state advocacy positions.

On behalf of all emergency physicians, ACEP is concerned by several proposals currently being debated in Congress. Not only will they fail to adequately solve surprise bills for emergency patients, they could severely affect small emergency physician practices and threaten access to the vital health-care safety net they provide, particularly in rural and underserved communities.

Granting insurers license to squeeze physicians harder will push even more doctors out of network and put access to emergency care at risk. Allowing insurers to further manipulate rates will shift even more of the burden to patients while driving physicians out of the market.

Smaller physician groups are already disadvantaged when attempting to negotiate contracts with insurers, and they have expressed their concerns to Congress. That’s why 60 smaller independent practices, which collectively provide emergency care to 7.3 million patients annually, sent a letter urging the House Education and Labor, and Ways and Means Committees to consider their unique perspective and the importance of making sure that federal legislation does not limit their ability to provide high-quality emergency care for patients.

ACEP will continue to work with Congress on behalf of all emergency physicians to find a federal solution to protect patients from out-of-network surprise billing that avoids any unintended consequences to the broader health-care system.

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– Steve Arnoff, The American College of Emergency Physicians

Joining the Clean Cities movement

To the editor,

Cities across America are taking the lead on climate change action – creating the new energy market and shaping our planet’s future. In July at Denver’s “Clean Cities Renewable Energy Procurement Summit,” I had the fortune to meet dozens of sustainability directors from Maine to California. Big cities like Los Angeles, Phoenix and Philadelphia joined Cincinnati, Tallahassee and Raleigh to articulate paths to energy solutions, progress to date and projected timelines to 100 percent clean electricity, heating and transportation.

To begin to comprehend what’s involved in shifting big cities to clean energy, I needed a scale of reference. I knew that every year our local co-op LPEA, which covers parts of five rural counties, uses almost 1 GWh (gigawatt hour, or billion watts for one hour) of electricity. My imagination staggered hearing that each year San Jose (the tenth largest U.S. city) consumes 500 GWh and that Los Angeles uses 26,000 GWh. In light of these cities’ 100 percent commitments, I feel certain that our area – with our abundant sunshine, wide landscape, need for industry and love for our ecosystem – can figure out how to produce 1 GWh per year. And Durango is the key leader to the success of any Four Corners clean energy effort. We have the sunshine; all we need is committed leadership and a truly supportive community.

Leading is no small enterprise; we underappreciate its difficulty. Any person would rather avoid discomfort, and follow a popular path. Pursuing a daring goal sets a leader up for criticism, resistance and possible failure. So “prudent caution” suggests a leadership style based on community consensus of following polls and reacting to pressure from constituents.

In normal times, this makes sense. But when exisIn normal times, this makes sense. But when existential danger – such as climate change – is on the doorstep, “prudent caution” is a recipe for disaster. That’s why I find deeply encouraging the courage displayed by our 100 percent committed cities. There are times in history when constituents need to be shown the path –persuaded, educated, then simply pulled by the hand through the crisis. Never in history has there been as much of a need for strong leadership as NOW.

Witness the strong leadership here in Colorado. Denver shares a commitment to reach 100 percent renewable electricity by 2030 with Boulder, Fort Collins, Golden, Lafayette and Longmont. Nederland aims for 100 percent by 2025. Breckenridge, Frisco, and the city and county of Pueblo commit to 100 percent by 2035. Of interest, Summit County has pledged to reach 100 percent renewable energy (which includes not only electricity but transportation and heating) by 2035. These great goals correspond well with Colorado’s worthy goals for utilities and communities.

My message to you, reader, is “take heart!” The Clean Cities Summit impressed me with the speed of progress by transitioning cities. I witnessed passionate commitment to confront the climate challenge, combined with comprehensive planning and technological expertise. Importantly, I found a culture of sincere readiness to share knowledge: “Any of us reaching the finish line alone has lost the race.” Durango is lucky to have our own committed Sustainability Director Imogen Ainsworth and a City Council ready to move on this matter. Our city is in a position to lead the Four Corners by example, forging a path that our neighbors can check out first-hand.

Let’s thank our forward-looking City Council for recently passing a resolution committing to renewable electricity goals (50 percent by 2030, 100 percent by 2050) and greenhouse gas emissions reduction goals (80 percent by 2050, 30 percent by 2030).

Responsive to resident comments, our Council is considering strengthening these goals by adding the criteria “locally produced” to “renewable electricity.” That would support the creation of good careers within a locally owned industry and the chance to keep local a big chunk of LPEA’s $70 million/year electrical bill. Many residents take to heart the dire warnings from the International Panel on Climate Change that urge rapid action within the next decade. We therefore hope that Council will follow the example of our sister cities and make its 2030 goals more ambitious, thereby front-loading progress.

Join us at 6:30 p.m., Tues., Sept 17, at City Hall to thank our City Council for its climate commitments and to express your views about clean, cheap energy, stronger local economy, conservation and caring for our environment. Also, from 3 – 5 p.m. Nov. 9 come to “The Clean Cities Movement and Durango’s Future” at the Durango Library.

– Kirby MacLaurin, Durango

Trade war hurting farmers

To the editor,

President Trump is trying to attain trade equity with China, but his trade war is having a devastating impact on U.S. farmers, which could lead to long-term losses of the Chinese market for our agricultural products since they are being replaced by competing countries. The $12 billion farmers subsidy is just a temporary reprieve for farmers.

China typically imports large quantities of U.S. fruit, pork, cotton, soybeans and other farm products. It imports 60 percent of U.S. soybean exports, about 30 million tons per year. Although the European Union agreed to import more soybeans, its 14 million tons falls far short of the 30 million tons to China.

Brazil is the largest exporter of soybeans to China. It has increased its soybean exports to China by 27 percent to 71 million tons, and it is clearing large swaths of the Amazon forest for soybean production. Unfortunately, the forest is being cleared with set fires that are out of control, and the clearing has a huge adverse impact on the world since the rain forest absorbs millions of tons of carbon emissions each year, along with trees throughout the planet.

Note: My wife’s father, Alton Jones, was a cattle farmer.

– Donald Moskowitz, Londonderry, N.H., via email

Children of the borderland

Cross the chihuahua’s freezing nights,
Sonora’s blistered desert sands.
Mothers holding tight to swaddled babies,
Fathers clenched to tiny hands.
Dreaming dreams of lives of freedom;
Go the children of the borderland.
Fences, walls, and rivers
Cold and swift and running wide.
People chased toward the open arms of justice;
Train top nights gone freezing by!
Gone to lands their father’s father s once possessed.
No time to wait, no time to cry.
Huddled masses breathing free,
Coyotes steal into the night.
The walk to freedom’s long,
It’s a deadly desperate flight!
With a baby in your arms,
Escape your homeland’s gruesome plight.
Dark money troops and weapons,
Pushed a fat cat’s greedy will!
Chaos births the gangs who target children,
Forcing them to kill!
We sowed the seeds of chaos
From fascists’ greedy hands.
The White House spins its circles,
Gives them all that they demand!
Now a mother and her son
Leave a world of fear behind.
Traveling toward the light of love and solace,
A vision etched onto their minds.
A vision full of promise,
From a land grown dark and blind!
California, clear to Texas;
Between the Arizona sands.
They suffer Santa Anna’s thievery!
The fascists forced a treaty, a military stand!
North to Colorado’s ribboned canyons,
These were once the people’s land.
Remember us to the ones who lived there.
They paved the way, they took a stand.
Crossed the peaceful Gila,
And they swam the Rio Grande.
Bless their passing with a welcome,
The sweet children of the borderland!

– David Singer, Durango

Meet Sen. Gardner's challengers

To the editor,

Frustrated by our current “representation” in Congress? We haven’t seen our U.S. Sen. Cory Gardner for over two years! Twelve people are currently running (against each other) to become the Democrat who will take on Gardner in 2020. Come meet them, Sat., Sept 7, 2-4 p.m. at the Durango Public Library in a moderated forum. Join us!

– Anne Markward, La Plata Democrats