A4
THE ASTORIAN • TUESDAY, OCTOBER 29, 2019
OPINION
editor@dailyastorian.com
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Publisher
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GUEST COLUMN
Bill could harm air ambulance service
I
n Clatsop County, we are home to
beautiful landscapes like beaches,
state forests and mountains. We’re
also home to one of the world’s deadli-
est bars — the Graveyard of the Pacifi c
— the Columbia River Bar.
Unfortunately, we’re over 100
miles away from the nearest high-level
trauma center. This leaves us in a chal-
lenging situation. When someone is
in need of a high-level
trauma center, we rely
on air ambulances to
provide life saving care
and fast.
Even as s heriff, I
can’t call an air ambu-
lance to the scene of an
TOM
incident. T hat call needs
BERGIN
to be made by a med-
ical professional. The
decision to utilize an air ambulance is
a serious one. I t is not a resource we
want to waste. Along with life saving
care, air ambulances come with a hefty
cost — they are expensive to operate.
Unfortunately, patients often get hit
with the bill, a “surprise bill.” Accord-
ing to a 2019 YouGov poll, 87% of
people (93% of people that live in rural
areas) feel that health insurance com-
panies should cover services like air
ambulances instead of pushing back on
decisions from the medical profession-
als who decided the service was medi-
cally necessary.
Still, over half of all air ambulance
claims are originally denied by insur-
ers. That same poll said that nearly
60% of people expect that any remain-
ing or “balanced” bills should be the
responsibility of the insurer, not the
patient or the provider. After all, what
is the point of having health insurance
if it doesn’t cover your health care?
Right now, there is proposed legis-
lation in Washington, D.C., that I think
intends to address the issue of “surprise
billing” but doesn’t really get it. The
The Astorian
A bill in Congress could impact air ambulance service.
Lower Health Care Costs Act, while
well-intentioned, misses the real issue
responsible for the surprise billing of
air ambulances. Instead of encouraging
the coverage of these emergency ser-
vices, the bill makes it easier for insur-
ers to keep air ambulances out of their
networks and deny claims while the
cost of health care continues to rise.
Luckily, there is a better way.
Some states have implemented pol-
icies that allow insurers and provid-
ers to negotiate a cost that works for
them while guaranteeing patients aren’t
billed for unforeseen, emergency ser-
vices. This approach incentivizes
in-network agreements and makes sure
that patients can focus on recovery
instead of worrying about paying med-
ical bills they were never expecting.
This issue is so important to me
because air ambulances are especially
vital to rural communities, like ours.
Nearly 90% of patients transported
by air medical services live in a rural
zip code. If the Lower Health Care
Costs Act is passed, it will eventually
force air ambulance bases all over the
country to close. This would be leav-
ing the 85 million Americans in rural
areas that rely on air medical transport
to access a Level I or Level II trauma
center within 60 minutes in a dire
situation.
I hope U.S. Sen. Ron Wyden under-
stands the issue and votes against this
potentially harmful bill.
Tom Bergin is the Clatsop County
sheriff.
GUEST COLUMN
A moral perspective on pollution
H
onolulu’s Moana Surfrider Hotel
on Waikiki Beach made a pic-
ture-perfect setting for Jacques
Cousteau’s speech in 1980. At an outdoor
American Bar Association luncheon near
the historic century-old b anyan tree, Cous-
teau talked passionately about pollution
of the oceans. With the deep blue Pacifi c
as a background, he explained how land-
based industrial pollution around the world
affects life under the seas.
No one on that occasion 40 years ago
could have foreseen that by 2019 Amer-
ica would be closer than
it has ever been to resolv-
ing our industrial pollution
problems with a balance
between economic and
ecological concerns accept-
able to most folks. Or
that vast amounts of plas-
DON
tic waste would threaten
HASKELL
ocean life everywhere. Or
that huge amounts of pollu-
tion would be generated by “undeveloped”
countries around the world — like China,
for example, was undeveloped in 1980.
Cousteau was a world-famous televi-
sion personality with a delightful French
accent. He died in 1997 at the age of 87.
People remember his illustrious career as
a renowned ocean explorer, developer of
the Aqua-Lung and fi lm maker. By 1980,
Cousteau had gained world wide respect
for his views about pollution’s impact on
life under the seas. And his warnings 40
years ago about the ocean environment
strike home today, especially to our fi shing
industry and to fi shermen everywhere.
Cousteau explained that all pollutants
on land, air, or in the rivers eventually fi nd
their way into the oceans of the world.
There can be no doubt life under the sea is
adversely affected by pollutants of all land-
based industries and waste systems. And
Cousteau believed environmental safe-
guards can be economically sound as well
as protective of the environment.
Cousteau referred to United Nations
reports that predicted by the year 2000 the
world’s population would increase from
4.5 billion in 1980 to 6.3 billion. To Cous-
teau, that 50% increase meant even more
pollution.
By the year 2000, the world’s popula-
tion did increase to an estimated 6.1 bil-
lion. And the world experienced more
pollution. But only 10 years later, world
population had grown to 6.8 billion. And
today it’s projected to be almost 7.8 bil-
lion by the year 2020. And close to 10 bil-
lion by 2050. Increased world population
Surfrider Foundation
Plastic pollution is a growing problem worldwide.
CHINA’S POLLUTION IN ITS CITIES KILLS AN
ESTIMATED 1.1 MILLION CHINESE EVERY YEAR.
of this magnitude inevitably means a lot
more pollution down the road than most
folks realize.
During his career, Cousteau experi-
enced thousands of dives in all the world’s
oceans, and saw fi rst hand the damage to
undersea life. He described himself as a
“man-fi sh,” using the Aqua-Lung he devel-
oped. Because of land-based pollution, the
world will lose up to an estimated 1,000
different species of undersea life. And
nature takes millions of years to bring back
ocean vitality. And to replace fi sh species
and coral reefs damaged or destroyed by
pollutants and human misuse.
Reports issued by United States envi-
ronmental agencies about American indus-
trial pollution troubled Cousteau. The
agencies forecast environmental catastro-
phes around the country by the year 2000
if Congress didn’t take remedial action.
Congress and presidents of both par-
ties, however, did take action. And today
we have the Clean Water Act, Safe Drink-
ing Water Act, Clean Air Act, Toxic Sub-
stances Control Act, along with many
other legislative efforts to combat pollution
of all kinds. And since 1980, the adoption
of thousands of federal regulations also
helped to substantially decrease industrial
pollution in America.
But since 1980, many other countries
vastly increased pollution. They were
helped by Washington, D.C., politicians of
both parties who adopted tax and trade pol-
icies to enable China and other undevel-
oped countries to build wealth and indus-
trial might with American know-how and
technology. And American politicians
turned a blind eye to a huge increase in
world pollution those policies inevitably
generated.
Today, the most polluted cities in the
world are in China, closely followed by
cities in Mongolia, India and Pakistan.
China’s cities and other far eastern cities
make up most of a 2018 listing of 500 of
the most polluted cities in the world. And
the list doesn’t include a single American
city!
China’s pollution in its cities kills
an estimated 1.1 million Chinese every
year. It’s true China is beginning to spend
money on wind and solar power. But
China is the world’s biggest polluter and
isn’t doing anywhere near enough to guard
against the pollutants that seriously dam-
age so much life under the seas.
It seems to me too many American pol-
iticians in the past didn’t fully appreciate
that China’s dictatorship form of govern-
ment is much different than ours. Amer-
ica has frequent elections that determine
public policy. China’s priorities about a
cleaner environment are made by its lead-
ers’ insatiable personal lust for industrial
and world power.
Cousteau emphasized the need for a
global view to industrial pollution. He
even suggested several principles that all
world governments should adhere to. For
example, safer ocean transportation and
equal use of all oceans.
But it seems to me we’re nowhere near
close to world wide remedies to ocean pol-
lution as envisioned by Cousteau 40 years
ago. And we won’t be close for many gen-
erations to come. For two very simple rea-
sons. Half the world’s governments are
dictatorships that have different priorities
than democracies. And dictatorships don’t
have the same moral conscience about
the environment that America and most
democracies have.
Cousteau wondered aloud why man-
kind is unable to properly manage use of
the environment. And why mankind has
so much diffi culty in fi nding remedies to
pollution problems. His response stirred
the crowd: “W e need a moral perspec-
tive to the problem.” He explained how
his love of the sea and his ability to use the
Aqua-Lung and explore the ocean depths
allowed him to discover many unknown
facts about undersea life, including the
extent it was being damaged. And it was
time at his stage of life to assess the dam-
age and to answer questions raised by his
conscience .
Forty years ago, Cousteau had a vision
for the future of the world’s oceans free of
pollutants. But that vision appears to be
shared only by America and most democ-
racies in today’s world. And that’s a cry-
ing shame.
Don Haskell is a retired attorney and
former Clatsop County commissioner who
lives in Astoria. He arranged for Jacques
Cousteau’s appearance in Honolulu in
1980.