Nobel winner in economics will study health care system

The Grand Junction health care system has been studied from afar for years now.

It’s about to get the equivalent of a house call.

This examination, though, is aimed not so much at diagnosis as finding a medium for a vaccine that might be injected elsewhere in the national health care body politic.

Indiana University Professor Elinor Ostrom, the 2009 Nobel Prize winner in economics, will head a research team looking at Grand Junction and three other locations, all in the Midwest, that have health care systems roughly comparable to that of Grand Junction.

Grand Junction’s reputation for its delivery of Medicare services at the nation’s lowest costs and highest positive outcomes was part of the attraction for Ostrom, said Claudia Brink, assistant director of the Workshop in Political Theory and Policy Analysis at Indiana University.

Researchers also were attracted by a less-than-shining moment in Grand Junction history — the economic collapse of 1982, when Exxon’s Colony Project closed overnight. Grand Junction lost 10 percent of its population and saw its economy battered. Somehow, Brink said, the city bounced back in the intervening 28 years.

“We’re thinking there’s magic, but not a simple magic” in Grand Junction, Brink said.

The region’s health care system, as well as other factors, seems to be a part of the rebound, said Steve ErkenBrack, president and chief executive officer of Rocky Mountain Health Plans.

“It’s an extraordinary thing about this community,” that there are multiple examples of collaboration, he said. “We see the hallmarks of collaboration in the Colorado Riverfront project to JUCO to tutoring kids in high school.”

One of the significant elements of the health care system is the willingness of its various parts, from physicians to hospitals to Rocky Mountain Health Plans and others, to relegate short-term advantage to long-term gain, said Laura Landy, president and chief executive of the Fannie E. Rippel Foundation, which gave Ostrom a $295,000 grant to study Grand Junction and the other communities.

Ostrom’s Nobel Prize stemmed from her work that contradicted previously accepted economic theory about the “tragedy of the commons.”  The theory was that any pool of common resources would be destroyed by overuse.

In her 1990 book, “Governing the Commons,” Ostrom showed how communities collaborate in ways that enable them to manage critical resources. In examining common resources such as forests, fisheries, oil fields and irrigation systems around the world, Ostrom observed that many communities worked together if members trusted one another and had the ability to devise and enforce their own rules.

“There’s a middle ground between markets and government,” Brink said. “That’s well proven now in the world.”

The Grand Junction system seems to operate on just that middle ground, Landy said.

“Grand Junction has been an interesting model of collaboration,” Landy said, “and people across the country are hungry for those tools.”

Two researchers will live in Grand Junction for three months, gathering information about the community as well as the health-care system, Brink said. Senior researchers also will visit the city on occasion, she said.

Ostrom is “probably the perfect person to do this work,” Landy said.

Ostrom began her career studying the way rivers are managed and worked for 15 years in police cars around the country, studying the merits of small and large police departments, Brink said.

In addition to Grand Junction, the project will include studies of Cedar Rapids, Iowa, and Bloomington and Bedford, Ind.

The Grand Junction phase of the 18-month study probably will begin in March, and by the time it’s done it could affect national debates on health care, Landy said.

The options that have been explored about health-care issues “are top down or leave it to markets,” she said.

The study is “a potential conversation shifter in the debates we’re having,” Landy said.

The Fannie E. Rippel Foundation promotes new ways of thinking about the nation’s health-care system to achieve better health, better care and lower costs.



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