Western Colorado living the health-reform dream

As Congress slugs it out over health-care reform this week, hopeful eyes are on Grand Junction, CO., where low-cost, high-quality near-universal health care is the norm.

You can find my new five-part series on Grand Junction's health care system here.  

The doctors in Grand Junction, a western Colorado city of 53,000, say their system can become a national model, and there are doctors in dozens of communities ready to replicate the system that uses a non-profit insurance provider but allows doctors to work for profit.

Both the Senate and House versions of the health-reform bill allow communities to form co-operatives, such as the one formed in Grand Junction. Proponents hope whatever other changes fired-up Congressmen make to the bills, the co-op feature remains in place.

It's a return to a time when doctors didn't become millionaires, didn't have a stake in the drugs they were dispensing or the tests they were recommending, says Dr. Michael Pramenko, newly elected president of the Colorado Medical Society.

It requires a community of doctors that feels a collective responsibility for the health of all the residents, not just those with the right kind of insurance, say the executives at Rocky Mountain Health Plans, the non-profit insurer formed by the doctors in Mesa County, Colorado.

It's a cradle-to-grave system that assures that every pregnant woman gets pre-natal care, that every child gets vaccines, every person with a chronic disease gets high-quality efficient care, and every person on the verge of death gets dignified hospice care.

Crucially, it requires monthly accountability meetings where protocols are examined and doctors have to justify why they ordered expensive tests when most of their colleagues did not. 

There is a clinical home for the uninsured, an emphasis on keeping people healthy rather than waiting for them to become sick, and incentives for doctors and hospitals to make money by saving the system money.

There are legitimate questions of whether the Grand Junction model can be replicated, whether it needs a combination of geography, demographics and community buy-in that is rare. Still, the doctors, nurses and patients I visited in Grand Junction while writing this series were almost universally enthusiastic about how their system can light the way toward a healthier, easier-on-the-wallet system.

"Any community can do it, but they have to want it," was the refrain. And that means that every component -- doctors, patients, hospitals -- has to give up a little to gain a lot, they say.

My series on Grand Junction as a possible model for national health care runs all week at www.kbdi.org/news.