Obama heads to Grand Junction for town hall meeting Saturday
DENVER – For three decades, doctors in a small Colorado town have agreed to share the expense of treating the poor, lowering costs for everyone and recently gaining praise from Democrats as a model of what health care overhaul should look like.
But as President Barack Obama prepares to visit Grand Junction for a town hall meeting Saturday, opponents of the overhaul point to the town of 50,000, too, saying it proves doctors can improve patient care and reduce costs without government meddling.
Both sides in the bitter debate say the city’s unusual health system backs up their argument.
Physicians in the mining town near the Colorado-Utah border agreed in 1974 to treat patients with any insurance, public or private. For patients with no insurance at all, Grand Junction doctors set up a free clinic.
“Some doctors pick patients and say they only want patients with good insurance,” said Janet Grant, a certified nurse midwife whose practice delivers 450 babies a year. “Not here. Here, everyone agrees to take a little less money from the HMO, but we know we get paid. It works out.”
Today, Mesa County boasts the most cost-efficient Medicare delivery in the nation, according to a 2006 study by Dartmouth Medical School and the Robert Wood Johnson Foundation.
Among the highlights: Medicare spending in the county over a two-year period was less than $21,000 per person, compared with $60,000 in other areas of the country. The average number of hospital days for Medicare recipients over a six-month period was 6.5 days, less than a third of the average in some parts of the country.
Physicians collaborate on treatment, sharing patient histories and following up with patients to see how they’re doing, sometimes tracking people for decades.
The Rocky Mountain Health Plans has grown to include several other Colorado towns and now serves 160,000 patients with 10,000 providers. State officials say it’s so efficient that 100 percent of children on Medicaid in Grand Junction see a doctor once a year, and 95 percent of pregnant women see a doctor in their first trimester.
“It’s kind of through the roof from an access point of view,” said Colorado state Medicaid Director Sandeep Wadhwa.
But plenty of folks in Mesa County say Democrats are missing the point. They say Grand Junction’s system works precisely because the government isn’t involved, and that the plan proves the private sector can lower costs and improve patient health care on its own.
“The model they’re using in Grand Junction is a private model. They’re taking care of their own,” said Jeff Crank, president of the Colorado chapter of Americans for Prosperity, a right-leaning group that opposes the administration’s overhaul plan.
Several hundred people are expected at a Saturday-morning rally a few hours before Obama’s town hall on health care.
Even doctors in Grand Junction say they’re not sure their model is applicable nationwide.
“We have a lesson, but it’s going to be difficult to apply what we do here to big cities, where you have a less homogeneous group of doctors,” said Dr. Joel Dean, a Grand Junction neurologist who has been one of the HMO’s specialists for about two decades.
“Here, we share data and we cooperate. We talk about what works and what doesn’t work,” Dean said. “Can you do that nationally? I don’t know.”
Steve ErkenBrack, president of Rocky Mountain Health Plans, warns the lessons from Grand Junction are limited, even though he supports the health overhaul effort.
“You have to realize that every community is different, and every community has to want to do this,” ErkenBrack said.
“The fact of the matter is, what we have here in Grand Junction is a very good system,” he said. “But our health care system in this country is in need of reform.”
On the Net:
Rocky Mountain Health Plans: http://www.rmhp.org
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