Meeting Review

Public Roundtable: Local solutions for accessible & affordable health care

January 14, 7-9 pm at the Summit Community and Senior Center.

Moderators: Howard Hallman and Dr. Rosanne Shaw

Attendees included Jeff Gorley, DDS; Brad O’Neil, Roaring Fork Community Health Plan/Van Gilder Insurance; Chris Johns, retired United Benefits advisor; Rhonda Koehn, High Country Health Care; Scott Vargo, Summit County government; Barbara Davis, St. Anthony Summit Medical Center; Justin Pollack, ND; David Gray, MD; Bernie Zurbriggen, Rob Waterman, Summit Chamber; Tom (Kathy) Castrigno, Mountain Rose Acupuncture, Shirley Willis, Sharon Russell.

Howard Hallman outlined the evening’s goals: a discussion aimed toward the underserved residents in Summit County . How can a small community like Summit County establish greater access to healthcare and health maintenance programs? Can a greater affordability and more choice be made available? The present system is not considered consumer-friendly, and those without insurance do not have access to physician-monitored wellness programs and regular check-ups. Out of cash flow necessity, the non or under-insured adhere to an illness-based regime vs. a wellness-based regime. The entire system is based on rewards for sickness vs. wellness.

Programs emphasizing wellness are increasing in Summit County. Scott Vargo, assistant county manager, explained their self-insured program My Care. The County has 900 participants (employees & dependents), and a health-risk appraisal is required. The health reimbursement account pays back employees according to such factors as BMI, whether or not they smoke, blood pressure, med maintenance, etc. The aim is to catch medical issues before they escalate and to treat existing issues. The program does not incur insurance administrative costs.

Discussion touched on the following:

In the United States , the legal system and insurance companies contribute to the stagnant attitude toward change in our healthcare system. Physicians adjust their “Standard of Care” policies to avoid being sued should there be less than a good outcome. There appears to be little transparency in fee for service as well as quality outcomes.

In describing the Roaring Fork Valley Health Plan model, Brad O’Neill spoke about instances when small businesses and individuals tap into the power of localized purchasing health packages.

A Summit County Chamber of Commerce health plan initiative met with complexity and resistance. Those who assume they have control over their own plan do not want to change.

Premiums are typically dependent on risk assessments based on for-profit companies. Physicians are reimbursed for taking care of sick people, not promoting wellness. There are only four major insurance carriers left in the United States. There is a strong need for greater competition and transparency to price shop. Typically self-insured plans depend on a minimum 10,000 lives with a stop-loss provision.

What is the role of a patient advocate?

Publication of usual and customary fees for office visits

Diagnostic tests, inpatient/outpatient procedure

Gunnison County public health voucher system.

Our Future Summit plans to conduct future gatherings to discuss local solutions for accessible & affordable healthcare. Those interested in being part of the conversation may contact OFS executive director Sandy Briggs or president, Howard Hallman.

Our Future Summit is a “quality of life” institution dedicated to creating a better Summit County by providing monthly opportunities for informed discussion on topics of community interest.