tag:blogger.com,1999:blog-1509187841033628660.post8824313516575387172..comments2024-03-28T22:28:39.087-07:00Comments on Medicine and Social Justice: Lower Costs in Grand Junction: More Primary Care, Less High TechJosh Freemanhttp://www.blogger.com/profile/10248920527894775520noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-1509187841033628660.post-16150017093220291702015-05-28T08:38:10.105-07:002015-05-28T08:38:10.105-07:00I've been trying to understand the Grand Junct...I've been trying to understand the Grand Junction situation since moving here in 2011. After reading Dr. Gawande's New Yorker article, I was looking forward to low cost, high quality health care. Unfortunately, although quality of care is probably high, the low per-beneficiary cost for medicare patients listed in the Dartmouth Atlas does not extend to the rest of the patient community. RMHP's insurance costs (see CO's health insurance exchange website) are consistently 30% higher than insurance available on the Front Range, and I was stunned to find that employer-provided insurance for a 60 year old would run $14666 per year (and yes, that's for one person). Those are McAllen, TX costs! <br />In trying to research the details, I've concluded that it's likely that RMHP is pooling reimbursements and premiums in such a way that the individual/employer market is subsidizing the medicare market. I am still trying to learn how this all works, as I saw a 40% increase in my RMHP individual insurance premium in 2013, and am looking forward to another 20% increase next year. This is truly a concern since I have 8 years to go before Medicare kicks in. The real conundrum in this case is why medicare patients can cost so little while the rest of us cost so much!Canyon Countryhttps://www.blogger.com/profile/10270487209120243960noreply@blogger.comtag:blogger.com,1999:blog-1509187841033628660.post-75396206541036523312010-10-19T09:48:33.683-07:002010-10-19T09:48:33.683-07:00Reading this made me think of a recent report that...Reading this made me think of a recent report that our UNC Healthcare System just raised the salary its lead heart surgeon a reported (though possibly remembering the exact figure incorrectly it was in any event a huge figure) $600,000 from $375,000 in order to keep him around. The reasoning was that the hospital could not afford to lose the revenue that the heart transplants and other major heart operations bring in. This, to me, represents a good example of how we magnify the costs of our services while ignoring the duplication that comes in a region such as ours, where Duke and Wake Medical Center also offer these same costly services. If the medical centers at UNC, Duke and Wake County were working cooperatively to provide the health care services for the Triangle instead of competing with one another, I suspect, as in Grand Junction, we would be able to reduce the costs simply by virtue of making efficient use of the available resources and not duplicating expensive facilities. It is an example where the application of capitalistic principles is not the best solution.<br /><br />I am also struck by the virtual single payer system that has been formed in Grand Junction. That is probably the single most powerful factor in the control of costs in that system. It's so obvious that a single payer system would make such a difference nationally. I continue to be amazed at the obdurate resistance on the part of politicians in accepting it. Such a good example of how big business (here health insurance corporations) are controlling what we are getting by way of policy.bds43https://www.blogger.com/profile/05076824396113898147noreply@blogger.com