Health groups can help District 51

By Michael J. Pramenko

Budget cutting is rampant these days. Governments, businesses and families are responding to fiscal reality by making sometimes painful cuts to services and programs. School District 51 is no exception.

According to its recent budget update, District 51 has reduced its budget by approximately 20 percent over the last three years. Certainly, cuts of that degree are not an easy task for any organization. No wonder the school board is contemplating a mill levy increase.

At the same time, and not as well known, our local school district is looking to save money on its health care costs. Who can blame it? Like most organizations, and like you, the school district is wondering how to manage the out-of-control cost of health care.

Indeed, many businesses and families continue to divert greater percentages of their budgets to health care. The school district is no different. District officials are deciding on reductions to staff in part in response to reduced funding and significantly higher health care costs.

School District 51, in direct response to these rising costs, is now looking to set up a primary care clinic for employees and their families. As readers may recall, the Mesa County commissioners voted to set up a clinic in a similar move last year. All of this activity has not gone unnoticed by primary care physicians in Mesa County as well as the Mesa County Physicians IPA. There is no question that this situation illustrates what is happening across America.

Certainly, I sympathize with the school board members and their desire to cut health care costs. Health care costs must be controlled. As partners in our community, organized medicine should step up and help business leaders with solutions to rising health care expenditures. The medical community does own some responsibility in this regard.

At the same time, the medical community should be given an adequate opportunity to respond in a thoughtful and productive fashion. As witnessed by data from state and federal agencies, our local health system has accomplished more in the arena of cost containment than most other medical communities in the nation. These efforts led to a presidential visit two years ago.

In addition, organizations should avoid decisions that would fragment patient care and move in the opposite direction of integrated medical care. Unfortunately, that is what results from newly created and isolated primary care clinics that do not coordinate care with the existing medical infrastructure. On the other hand, well-coordinated care in an integrated medical system has been proven to save money. Proof exists right here in Mesa County.

As I have previously outlined in this column, local business leaders have requested and encouraged the medical community to help with their ever-rising health care costs. They are not impressed by the national spotlight the local health system has received over the last few years. I agree, we should not be overly impressed until local health leadership can find a way to keep the inflation rate of health care closer to the overall inflation rate. This would be true success. It can be accomplished.

However, the school board should take note. Controlling health expenditures through fragmented care clinics that do not integrate with the existing health system will not achieve the fiscal savings they desire. While improving primary care delivery, the school board should focus on those areas in our health system where most of the savings can be obtained.

I believe the existing primary care physicians, the local physicians organization and the Mesa County Health Leadership Consortium are all poised for the challenge. We can deliver a product to local businesses that controls health expenditures and increases the economic growth and success of those organizations.

The catch: It will take considerable dialogue and time. Hopefully, School District 51 is aware it has a medical community that is far more in tune, more capable and more willing to engage local organizations in this discussion than most other medical communities in the country. The district should not squander the resources and good will that rests right in its own backyard.

Together, local organizations, working with the medical community, must take the next big step in health reform. And once again, the Grand Junction community could offer an example to the rest of Colorado and the nation on how local solutions and collaboration can help address a national problem.

Michael J. Pramenko, M.D., is a family physician at Primary Care Partners. Currently, he serves as President of the Colorado Medical Society and on the Health Reform Committee for Club 20.


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