Grand County leaders, providers discuss health insurance problems facing county
April 18, 2008
Grand County health care leaders gathered at a community roundtable Wednesday to explore ways to make health insurance more accessible to everyone in the community.
About 20 people participated in the forum hosted by the Sky-Hi Daily News.
“This is something near and dear to my heart,” said Cindy Frith, a nurse at Granby Medical Center Family Practice. “Every day I talk to somebody who has some health care concerns (that) almost always revolves around financial issues.
“I’ve been on the phone for up to two hours on one patient, only to have them say, ‘Well, we’ll get back to you.’ And this is somebody who is not doing very well that could justifiably be in an emergency room and they’re begging not to go there because their insurance won’t cover them.”
Frith said the health care industry spends a lot of money to be in compliance with regulatory agencies that overlap each other.
“I’m not advocating that we don’t have regulation,” she said. “But I think there is over-regulation and a lot of money could be saved.”
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Eric Murray, public relations manager of Kremmling Memorial Hospital, said health insurance is complicated.
“I believe the provider is wedged between what is essentially an insurance company customer and Wall Street,” he said.
Dorri Penny, executive director of Grand County Rural Health Network, agrees.
She cited a statistic that one-third of health care dollars don’t go to health care, and that even as profits for the biggest health plans rose last year, the percentage of revenue they spent on health care was cut.
“So, the money is not going where it needs to go,” she said.
About 15 percent of residents in Grand County are uninsured, which is similar to the rest of the country, Penny added.
“We also have quite a few seasonal workers who don’t have any health insurance, who probably (aren’t part) of this 15 percent we have documented.”
She added that many small businesses can’t afford health insurance premiums.
“I just see us in a spiral that is pretty scary at this point in time,” Penny said.
Some small businesses can’t afford health insurance because premium costs are too expensive, she said.
“‘Then what do you do?’ You skip that primary care, that preventive care that’s so important to you,” she said. “Before you know it, you’re in that emergency room in a crisis.”
She said the cost could then be passed on to others or patients end up with bills they can’t afford.
Medical bills contribute to half of all personal bankruptcies, according to a 2005 Harvard study. And 75 percent of those people had health insurance when they first became ill, Penny said at the forum.
“All of that creates a social stigma for health care in general,” said Jen Giacomini, community health program coordinator for Grand County Rural Health Network.
“People who are insured think that it becomes too hard to get anything done, any form of preventative care, and even in a crisis it becomes hard so they avoid it. And people who are uninsured just avoid it like the plague.
“And that’s not how we can create healthy people,” she added. “Healthy people work on prevention, and preventative attitudes and healthy lifestyles.”
Dr. James G. Kennedy, of Byers Peak Family Medicine, listed some of the factors he sees driving up health care costs.
The focus on primary care has gone by the wayside, he said.
“Every other country in the world that has a successful health care system has a focus on primary care,” Kennedy said. “We’re very much leaning towards some specialty practices that by all accounting is much more expensive … Some specialization creates a tremendous burden on the health care system.”
He said in countries such as Scotland or England, everybody has a primary care doctor, and that’s where they have most of their care done.
Kennedy said technology also adds to the cost.
“We’re the technology drivers of the whole health care system of the world, but it’s expensive,” he said. “I have people with no insurance, but when I see them after they’ve fallen on the ski hill, they all want their MRIs, no matter what it costs them.
Whether they have insurance or not.
“We as consumers of the Unites States want the Cadillac, but want to pay for the Volkswagen,” Kennedy said. “It’s a driver of health care costs that causes the premiums to go way up, and then causes people not to have health insurance.”
He said a Gov. Bill Ritter’s commission is looking at different health care solutions for the state.
“Basically that’s not going to go anywhere for the foreseeable future right now because roads and education are more important, in the governor’s eyes … There is a lot of talk going on but there’s not a lot of action.”
Wendy Mielke, office manager for Grand County Rural Health Network, said community members also have to be held accountable.
“Where is self-responsibility in this discussion,” she asked. “You can also make informed decisions on how you spend your money.”
She said people should prioritize their spending, and set cash aside for insurance.
“I’m more than glad to help those that really need the help, but those that choose to spend their money elsewhere ” it really aggravates me,” Mielke said.
Grand County Commissioner James Newberry said many families seeking care have “nothing.”
“They have no insurance and they are bringing some of these kids into our public health department and they need help, not just their kids … The whole family needs help,” he said.
Nancy Stuart, Grand County commissioner, said some patients are trying to heal after they’ve been to the doctor, but they have to worry about their health insurance coverage.
“Stress does not help you heal,” she said. “It’s not really helping anything. If anything it’s going to cost the insurance companies more because you’re going to end up back in the hospital on something. None of it makes sense except for the fact that the insurance companies are some of the richest companies in the world.”
Stuart said the commissioners looked at ways to provide the whole community with health insurance.
“Why couldn’t we somehow be an umbrella that we could get everyone insured here?” she said the commissioners looked into finding out.
The insurance commission then pointed out some of the downfalls and “little bombs” started dropping on them, she said.
“We’re going to still be talking about this,” Stuart said. “I still think there’s got to be something. We were talking maybe a clinic, and people could see the doctor and pay on a payscale of how much you make. All of us are trying to do something at least for our county.”
The Grand County Rural Health Network is looking at community care clinic models in other communities, Penny said.
“Our goal is to try to put together a business plan for that this year,” she said. “We also have basically tried to try to identify some space in the Granby Medical Facilities as a potential location for this.”
She said access to health care for residents in Grand County is the Network’s “No. 1 priority.”
“This little roundtable, is a huge starting point,” Giacomini said. “A great starting point for awareness in the county.”
She said she hopes also to hear from providers and concerned community members.
“We’re going to need those people to help us figure out this model, whatever it looks like and whatever is going to work for the county.”