While Colorado's Democrats are preparing to promote the (flawed) idea of a "public option" of medical care, there are some tremendous and bipartisan remedies that can reduce costs and increase access.
At the health conference of the State of Reform in Denver last Wednesday, I participated in a panel with an esteemed group of experts in the field. I represented the Millennial Policy Center and joined representatives of the Colorado Health Institute, the Center for Improving Value in Health Care and the Department of Local Affairs.
We all know about high costs. My presentation focused on one thing that is both cause and effect of rising costs: a growing difficulty for patients to access health care services.
In 2014, Colorado expanded Medicaid (Health First Colorado). This increased state healthcare by more than 400,000. Because Medicaid reimburses doctors and hospitals less than private insurers, almost 30% of providers do not accept it, especially a challenge for beneficiaries in rural and mountain communities.
For people with public and private insurance, access is linked to a crippling shortage in providers, both doctors and dentists. According to Merrit Hawkins, approximately 26% of Colorado doctors were over 60 in 2015.
In addition, the Kaiser Family Foundation calculated the number of Colorado residents in a "Health Professional Shortage Area" (HPSA), referring to areas and population groups that "experience a shortage of health professionals." They find that more than 1.1 million Colorado residents are in an HPSA for doctors, with more than 860,000 for dentists.
When the supply of a good or service decreases while demand increases, prices increase. That is the basic economy, and it works in medical care like anything else. Therefore, less available providers means that the cost of existing suppliers increases. The challenge, then, is to increase the number of suppliers.
Fortunately, increasing the number of doctors and dentists available is not the only solution. Both technology and other types of care providers can make a significant difference in people's lives.
For example, telemedicine uses telecommunications technologies to diagnose, treat and monitor patients remotely anywhere. It is especially useful for underserved rural, mountainous and urban communities, as it allows them to access medical care in a timely manner when it is difficult to reach office providers.
Research shows that the expansion of telemedicine results in greater access and better care at a lower cost. Fortunately, Colorado is a national leader in telemedicine. First Health Colorado reimburses things like phone and email exchanges, remote patient monitoring and live videoconferences. And Colorado eliminated its previous law that restricted patients' access to telemedicine in most rural communities.
Attorney General Phil Weiser (one of the conference's keynote lectures), lawmakers and other speakers from across the spectrum addressed the value of telemedicine. Policy makers should plug holes where there are weaknesses to ensure that the availability of public and private telemedicine is common and cross state Access to telemedicine is maximized. This can definitely be done bipartisanly.
Colorado has also made great strides in training qualified professional nurses (NP) to provide more medical care, such as facilitating their qualification requirements for prescribing medications. NPs are not doctors, but they receive rigorous training and meet high standards to operate. They are similar to primary care doctors but are less expensive. They do not practice beyond their certification and recommend to people when necessary.
Recently, the burdensome time frame was reduced for NPs to qualify for prescription capacity. That is good. But more must be done to unlock their potential as health care providers, including less unnecessary regulation.
Similarly, a dozen states are licensed by "dental therapists" (DT) to address their dental shortage. DTs are not dentists; They are well-trained, licensed mid-level providers, similar to NP. They provide preventive and routine care, but "unlike hygienists (DT) they can also perform irreversible procedures, including some restorations and extractions."
A 2017 study by the University of Washington on the long-term permission of DTs in Alaska concluded that DTs "resulted in a significant difference in general oral health in communities, with increasing preventive care rates and fewer extractions" .
State Sen. Dominick Moreno and Lieutenant Governor Dianne Primavera, both Democrats, said they are studying the DT license. That is good.
The key condition in medical care is access to care. Much is cost; Much of this is the availability of the provider. Fortunately, there are unique and bipartisan remedies that focus on stimulating the patient. choice and the competence of the provider and the release of the freedom of the patient and the provider.
Jimmy Sengenberger is host of "The Jimmy Sengenberger Show" on News / Talk 710 KNUS. He is also president and CEO of Denver. Millennial Policy Center. Your opinions are yours.
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