Play doctor, help find a cure for health care reform

Dr. Michael J. Pramenko
December 10, 2007

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    Are you interested in health care reform? Try it. The 2008 Colorado Legislature is about to take a shot at it. However, if you dare take on the task, you must remember the hurdles that current policy-makers are struggling to address.

    The Libertarians (like Linn and Ari Armstrong) would simply take the government out of the equation. Unfortunately, this leaves a significant number of people without health care. I think that's their objective.

    Conservative Republicans will simply repeat the refrain that the free market will correct the problem. Never mind that the free market has chosen repeatedly to ignore the problem of the uninsured. Certainly, there is no money to be made insuring lower- to middle-income Americans.

    Liberal-leaning Democrats continue to repeat the need for universal, all-encompassing health care. In this case, it's the cost of the program that stands in the way of reality.

    And to the folks who want the uninsured to just use the emergency room for their health care, I'll keep repeating the same refrain. We all pay for this unbridled use of the emergency room. Plus, it is the most expensive place to access the health care system.

    So now you are the policy-maker. You are king for a day. But remember, you must address a few critical questions and problems.

    • If your plan is not universal in nature, will those without insurance still be forced to use the emergency room as their only means for health care?

    • You must control the inflation rate of health care — often in the double digits. If you decide to allow inflation rates to continue, you must decide what other state programs you will cut to pay for health care. Even if the Tabor Amendment did not exist, current state law restricts Colorado spending increases to 6 percent each year.

    • You must correct the growing problem of access for care. Many areas have a shortage of doctors, and a growing number of physicians do not see Medicaid or Medicare patients because of poor reimbursement.

    Restricted budgets; high-tech, increasingly expensive medicine; and an aging population do not make for an easy exercise in health care reform. Even a king would have a tough time deciding how to fix the current mess we call the American Health Care System.

    That doesn't mean we should not try.

    Once a person starts studying the problem closely, it becomes more clear how the problem needs to be addressed. During the last two years, the Colorado Medical Society and the 208 Commission have studied and debated the issue. Countless hours of study have led to many similar findings and recommendations.

    There is agreement on universal coverage, mandates on participation and benefit packages that provide essential levels of coverage. Club 20's plan also includes similar provisions. In addition, there is wide-ranging agreement that a new system needs to save money by stemming administrative costs and by utilizing more electronic medical records.

    One thing is certain: More taxes will be needed to correct the problems of our current health care system. The payoff: Better health care for a greater number of our neighbors within a more sustainable system. That's a prescription a growing majority of Americans seem willing to accept.

    Dr. Michael J. Pramenko is a family physician at Primary Care Partners. A graduate of Dartmouth Medical School, he did his residency training in Grand Junction at St. Mary's Family Practice Residency. As immediate past president of the Mesa County Medical Society, Dr. Pramenko currently serves on the Colorado Medical Society's Congress for Health Care Reform as well as Club 20's Health Care Committee.