By Clint Purvance

Long ago, physicians would make house calls to families and individuals in need. In the last several decades, patient’s needs were met by visiting the doctor through an individually owned facility, called a private practice or they were seen in a hospital setting. This model continues to change throughout the nation.

Today, many specialists and primary care physicians are taking on a new kind of health care model and are affiliating themselves with medical groups or large hospital systems such as Barton Health.

Clint Purvance

Many people have expressed their concerns to Barton staff and myself that Barton is purchasing most of the health care facilities around Tahoe and that we are building a “monopoly” to charge our patients more. This is far from the truth. In the last few years, physician practices such as Emerald Bay Center for Women’s Health, Tahoe Women’s Care, Barton Family Physicians and Tahoe Orthopedic and Sports Medicine have affiliated with Barton in order to keep their individual practices viable due to increasing overhead expenses. This model does not alter medical decisions — each physician is independent to provide medical care in the best interest of his or her patients.

At Barton we pride ourselves in recruiting and retaining primary care and specialty physicians for our patients and our community, which might otherwise be difficult due to the rising expenses in private doctor’s offices. Physicians want to continue to live here and our community continues to need their great care. Barton Health provides the partnership that makes it feasible for physicians to stay in our great community.

“Private practice overhead is quite high and I would not want to employ people and not be able to provide my employees with adequate benefits due to rising costs,” Allison Steinmetz, internal medicine physician with Barton Health, said.

Steinmetz recently joined Barton Internal Medicine after 10 years of medical practice in Santa Cruz with Dominican Hospital. She is a perfect example of “the new model” which enables physicians to focus on the most important task-at-hand – quality patient care.

“My goal is to be able to treat families and help them with their medical decisions. I want to focus on being a doctor, not on the business side of medicine,” Steinmetz said.

Barton proudly partners with more than 140 physicians, nearly 40 departments and oversees numerous facilities in Tahoe and in the Carson Valley, including our acute-care facility, Barton Memorial Hospital.

By managing the business side of medicine for physicians, physicians can focus on their patients and Barton is able to utilize the talents of its staff in business, finance, contracting, billing, building maintenance, purchasing and marketing in the private office setting. This allows our doctors to focus on their patients and creates a more efficient and cost effective business model that will be sustainable into the future. This new business model enables Barton Health to continue to meet the community’s health care needs through improved access to a wide range of physician services. In 2011 alone, Barton is proud to have added much needed services to our small community including cardiology, audiology and physiatry.

As the health care industry continues to change nationwide, Barton Health is committed to providing consistently exceptional care to our community.

Clint Purvance is chief medical officer for Barton Health.

To the community,

Bread & Broth would like to share our gratitude to Heavenly Mountain Resort for recently adopting a Day of Nourishment.

Heavenly has given service to our community “above and beyond” the call of duty in our opinion. Throughout the year they have helped financially and with staff. Volunteers from Heavenly spent the day helping Bread & Broth volunteers serve those in need a hot meal on a cold night just before Christmas.

Bread & Broth is able to continue its mission of feeding the hungry of South Lake Tahoe in large part because of the generosity of the local community. A $250 sponsorship covers the cost of food and beverages for the approximately 100 people who visit each Monday evening. To find out how your family or business can Adopt A Day of Nourishment, contact Connie Blue at midwest2tahoe@yahoo.com or (530) 544.4945.

David Smith, Bread & Broth

To the community,

Austin’s House recently received a fantastic donation of $65,000 from Patty Clark, founder of the Austin Kirby Foundation. Patty and her colleagues at Century 21 Clark Properties work vigorously the entire year to raise donations for Austin’s House with fundraisers and direct requests.

The Austin Kirby Foundation is the largest single donor for Austin’s House. The nonprofit emergency shelter home is named in honor of Patty’s grandson, Austin Kirby.

The generosity of our community built Austin’s House and continues to sustain it through donations of cash, food, clothing and other basic necessities. Austin’s House is the only emergency children’s shelter in rural Northern Nevada. The children are placed at Austin’s House after being removed from their homes due to abuse or neglect. These children have no place else to go. Austin’s House provides the basic living necessities including proper nutrition, hygiene, rest, nurturing, recreation, companionship, education, and life skills training. Austin’s House has cared for more than 200 children since opening in September 2007.

Thanks to the community and individuals like Patty Clark, the staff at Austin’s House will continue to provide compassionate care for the children in crisis who need it the most. If you would like to know more about the Austin Kirby Foundation, please contact Patty Clark at (775) 782.7111.

Conrad Buedel, Austin’s House

Publisher’s note: This editorial is from the Dec. 18., 2011, Reno Gazette-Journal.

Once, it’s been said (by Auric Goldfinger, in Ian Fleming’s “Goldfinger”), is happenstance.

Twice is coincidence.

And three times is enemy action.

Having been the target of jokes in “Glee,” “The Muppets” and “Saturday Night Live” (let’s not even waste time on “Reno 911”), Reno residents should admit that there’s some enemy action going on.

At the very least, someone is trying to tell us something … and we should be listening.

The essence of comedy writing is stereotype and exaggeration.

Stereotype saves the writer a lot of time and effort. “The Muppets” didn’t have to go to a lot of trouble to explain that Fozzie Bear was down and out as the movie began. All the writers needed to do was put him in a tribute band in a dive casino in Reno. The viewers got the message.

That’s the stereotype.

Those of us who live here also know that it’s exaggeration. No one took Seth Meyers literally, after all, when he announced on “SNL” last week: “According to a new list, the least happiest city in America is St. Petersburg, Florida. But that’s only because Reno, Ne-vah-da, finally killed itself.” Everyone understands that it’s an exaggeration based on a commonly held stereotype.

Fair enough. Let no one say that we in rundown Reno don’t have a sense of humor.

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Publisher’s note: This editorial is from the Dec. 16, 2011, Los Angeles Times.

The White House said this week that President Obama will sign a controversial $662-billion defense authorization that permits indefinite detention without trial for some terrorism suspects and broadens the authorization for the use of force against people and groups “associated” with Al Qaeda anywhere in the world. It’s the wrong choice.

The bill, which passed the House Wednesday and the Senate Thursday, is being advertised as a compromise with the administration, and indeed it includes provisions designed to avoid a veto. But several are vague or confusing. For example, although it requires that foreign suspected Al Qaeda terrorists be placed in military custody, it seems to allow FBI agents to interrogate them. On Wednesday, FBI Director Robert S. Mueller III said that the compromise left “uncertainty as to who has the role and who’s going to do what.”

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Publisher’s note: This editorial is from the Dec. 18, 2011, Sacramento Bee.

The $1.1 trillion spending bill passed by the House of Representatives on Friday includes all kinds of necessary spending and all kinds of earmarks that are far more questionable.

According to U.S. Sen. Tom Coburn, R-Oklahoma, the omnibus spending bill includes:

• $40 million for a “National Bio- and Agro-defense Facility” sought by outgoing Sen. Sam Brownback of Kansas.

• $30 million for the “Interdisciplinary Science and Engineering Teaching and Research Corridor” at the University of Alabama, solicited by Sen. Richard Shelby, R-Alabama.

• $21 million for the “Yazoo Basin, Mississippi Delta Headwater Project” sought by both senators from Mississippi.

And that’s just the start of it. As analysts look deeper into this spending bill, they are sure to find other earmarks far more porky than the ones listed above.

One thing they won’t find is authorization of levee work in Natomas that is essential to protect lives and property. The Sacramento region, to be sure, did receive more than $42 million in appropriations for flood control work already authorized by Congress, and it should be thankful for that. But because of Republican rules restricting use of “earmarks” in the House, Congress has yet to act on the authorization needed to continue the Natomas levee improvements.

The Republican restrictions on earmarks would be easier to swallow if the House enforced them uniformly. Yet that’s not the case. Just this month, Sen. Claire McCaskill, D-Mo., released a study that identified 115 earmarks in this year’s defense authorization bill worth $834 million. House Republicans sought 40 of these, and Democrats sought 75.

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To the community,

As we dance for snow, there are people in our community who can’t get enough food to eat. So Squaw Valley and Alpine Meadows are engaging in a friendly little competition to raise money for Project MANA, Truckee/North Lake Tahoe’s hunger relief organization.

To kick things off I will donate $1,000 – $500 on behalf of each resort and now we are going to see who can raise more money – Squaw or Alpine. Through New Year’s Day employees and guests can make online donations on behalf of either Squaw or Alpine. One hundred percent of all donations go to Project MANA. While each resort hopes to be the one to raise the most money, the winners will be the hungry people that Project MANA feeds.

We’ve heard from many of you about the rituals you have to make it snow. From not washing the car to leaving your summer stuff on the lawn. Some of you have gone so far as to leave your powder boards at the shop so they won’t be accessible when it dumps snow. That’s dedication. We hope you’ll join us in our new snow dance effort and make a donation today to Project MANA. Hunger happens every day to people in all walks of life. Organizations like Project MANA help them through the hard times so they can land solidly on their feet.

Several years ago Project MANA helped a husband and wife who moved here from Colorado for his job. They quickly realized they could not survive on his salary alone and came to Project MANA for food while she looked for work. Eventually she got a good job and between the two salaries they no longer needed Project MANA’s services. A couple of years later she became the president of a community charity that provides grants to local nonprofits and Project MANA is one of the recipients. True story.

We hope you’ll join us in helping those in the Truckee/Tahoe community who are not getting enough to eat. Make your donation today.

Kindest regards and snow filled thoughts,

Andy Wirth, president and CEO Squaw

By Steve Kubby

Local medical marijuana patients are in a panic, because of the new South Lake Tahoe city ordinance that takes effect today. Frustrated and frightened patients complain that it is impossible to get their landlords to sign notarized letters giving permission for them to grow — even though they already know and allow their tenants to do so. Apparently, landlords are reluctant to sign something that would incriminate them for violating federal law and the Controlled Substance Act.

Patients must also register in public records that they are growing, a clear violation of their Fifth Amendment rights. Too bad for you if the city decides you are not in compliance, their ordinance allows them to publish your name in the newspaper and fine you $1,000 per day. As a result, few patients have registered and are now on alert for an unwelcome visit from the city.

Steve Kubby

The current cultivation ordinance punishes bona fide patients by creating expensive and difficult barriers to rights already granted to them by the voters of California. In contrast, the city rewards illegal growers, because nearly anyone can qualify, provided they have enough money and time to jump through all the hoops, give their landlords money under the table, and get a medical recommendation for the right price. Under the new system that starts today, illegal growers and out-of-towners will be flocking to the city of South Lake Tahoe by the thousands, something none of us wants.

We believe our best option at this point is to put our own model ordinance on the ballot instead. We have already verified that we need 856 validated signatures to qualify. Below is the current version of the citywide voter initiative that we will be filing.

South Lake Tahoe Marijuana Cultivation Ordinance

The People of the City of South Lake Tahoe, California, do enact as follows:

Section A. Findings, and Orders

The People of the City of South Lake Tahoe find and order all of the following:

(1) Adults 21 years and older, who are bona fide medical marijuana patients, may produce up to 6 mature outdoor flowering plants, or up to 12 mature indoor flowering plants per person; or a total number of plants cultivated per household not to exceed 12 mature flowering plants outdoors or 24 plants indoors. The cultivation shall take place in an indoor or outdoor space or area not visible to the public.

(2) No taxes, fees, laws, rules, regulations, zones, local city or county zoning requirements may be adopted or enacted to defeat, deny, or prohibit the purposes of this Act, or to defeat, deny, or prohibit adult medical marijuana patients, 21 or older or from engaging in the activities authorized and protected by this Act.

(3) Nothing in this section shall prevent a property owner from prohibiting marijuana cultivation on their property or conduct that damages their property, so long as that is clearly stated in their rental agreement or lease.

(4) This Act preempts and nullifies any and all conflicting local regulations, but allows for a greater number of plants if a physician has written a letter or recommendation that states that these limits are insufficient for their patient.

(5) No regulations, taxes, or fees shall be enacted or imposed upon marijuana for qualifying patients or their caregivers.

(6) Elected, appointed, hired employees, officers, and officials of the City of South Lake Tahoe shall not directly or indirectly cooperate with or assist federal, state, or county officers or officials, volunteers, or employees who eradicate marijuana, act for seizure or forfeiture, or demand entry without a warrant or to defeat any liberally construed purpose of this Act, nor may any state or local agency contract to eradicate marijuana that is being grown, manufactured or stored under the provisions of this Act. Violation of this clause shall be a felony, punishable by up to one year in prison.

(7) The City of South Lake Tahoe is ordered to protect and defend all provisions of this Act from any and all challenges or litigation, whether by persons, officials, cities, counties, the state or federal governments.

(8) Child Protective Services is hereby enjoined from seizing any child or infant, based in whole or part on the cultivation or presence of marijuana in a home.

(9) South Lake Tahoe City Police are hereby enjoined from arresting anyone age 21 or older for any marijuana related offense, which is protected by this Act.

(10) This Act shall become effective immediately upon passage and may be applied retroactively to protect patients or caregivers from civil or criminal prosecution.

(11) Patients and caregivers shall have the right to transfer their marijuana to other patients or collectives and be paid a non-taxible remuneration for their out of pocket expense and their time.

(12) The City of South Lake Tahoe is hereby enjoined from banning or limiting the number of medical marijuana collectives, dispensaries or delivery services operating within the City.

Section B. Severability

If any of the provisions of this Act, or any part thereof, is for any reason held to be invalid or unconstitutional, the remaining provisions shall not be affected, but shall remain in full force and effect, and to this end the provisions of this Act are severable.

Steve Kubby is CEO of Strategic Campaigns LLC and serves as chief officer and campaign chairman for a new California voter initiative to Regulate Marijuana Like Wine.

To the community,

Looking at the fuss over the bonds to bail out the private management of the ice rink, it appears to be a new chapter in Alice in Wonderland. Who will pick up the cost of turning the non-taxable bonds into the taxable bonds at a price tag of over $400,000?

JPA staff, John Upton, says the city must cough up the dough. City manager, Tony O’Rourke, claims private management must pay the piper.

Bill Crawford

Tweedledum and Tweedledee decided to have a battle over a new rattle. Of course there was lots of nonsense in it just as there is in the bond shenanigans.

The problem is the city manager who rushed to contract out management of the ice rink. Now having been the pied piper that led the city into a faulty deal he attempts to place the burden for his mistake onto the back of the private party to break the contract.

In his haste, Mr. O’Rourke acted mindlessly thinking that he is infallible. He has a master’s complex, and the city is his plantation. But he is fallible, and he is incapable of acknowledging it much like the Red Queen in Alice in Wonderland. The result of his behavior is he sows mistrust because he has shown a lack of concern for the social fabric and under his leadership the fabric is thread bare. The community cannot have confidence in Mr. O’Rourke when he has displayed incompetence in managing the city’s business.

Finally, in the nursery rhyme the walrus and the carpenter did deceive the oyster and had them for lunch. It is time to stop Mr. O’Rourke’s feast on the city.

Bill Crawford, South Lake Tahoe

Publisher’s note: This editorial is from the Dec. 15, 2011, Reno Gazette-Journal.

Only time will tell whether President Barack Obama was right on Wednesday when he told troops recently returned from Iraq that “we are leaving behind a sovereign, stable and self-reliant Iraq …”

But there can be no disagreement with his tribute (spoken in a TV interview) to the men and women who gathered in a hangar at Fort Bragg, N.C.:

“We must not forget the men and women who gave their lives, tens of thousands wounded, all those missed birthday parties, missed soccer games and missed dinners because folks were on their second or third deployment. We should not take that for granted.”

It would behoove all of the politicians in Washington, D.C., to remember the president’s words while they are glibly tossing around threats to take action against this nation or that — most recently it has been Iran.

The sacrifices made by the men and women of our armed services, many of them from the Guard and Reserves, have indeed been great. The war in Iraq has taken the lives of more than 4,400 Americans. (By some estimates, more than 100,000 Iraqis have lost their lives because of the war in the past nine years.) Many more have been injured. All have seen their lives drastically changed by the call to duty.

They have paid a high price to leave behind a “sovereign, stable and self-reliant Iraq,” and we must never forget what they did.

When President George W. Bush announced nearly nine years ago that the U.S. military had invaded Iraq in an effort to rid the country of its belligerent dictator, Saddam Hussein, and destroy his weapons, no one imagined that the troops would still be there in 2011.

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