Physicians: Health Care System Broken

In Colorado, the medical profession is sounding alarm bells over the state of our health care system.  The August 2006 issue of Colorado Medicine provides some insight, in a series of articles about how the profession feel about those problems.  Perhaps the place to start is with the comments of Micahel J. Pramenko, MD, the President-Elect of the Mesa County Medical Society:

It’s broken.  Simply stated, the healthcare system in the United States is broken.  For patients, it is often unattainable, impersonal, or devastatingly expensive.  For providers, it is dysfunctional and burdensome.  For the country, it is increasingly becoming more of an economic handicap.

Private Health Insurance

Dr. Pramenko notes that:

Because of our current system, the insured pay much more to cover the unisured through the process of cost shifting.  Some experts estimate that 40% of your insurance premium is to cover the cost of the uninsured.  At the same time, the uninsured or underinsured are forced to ignore their health problems or they end up in an emergency room or hospital where costs for care are exponentially more expensive than at a doctor’s office.

Pramenko explains that this is why the profession’s trade association has thrown its weight behind Senate Bill 208, a bill that is the brainchild of Democratic State Representative Anne McGihon and was sponsored by twenty other state legislators to convene a Blue Ribbon Commission to comprehensively reform Colorado’s Health Care system.

The Colorado Medical Society, representing thousands of physicians across the state, voted by a margin of 91 to 9 to support a comprehensive change to Colorado’s health care system.  In effect, they have said we are done tinkering — we want real change with real results . . . The Colorado Legislature agrees.  They passed Senate Bill 208 this summer.  This bill provides a legislative mechanism for studying options and recommendations for comprehensive change at the state level.


The Executive Director of the Colorado Medical Society, Alfred Gilchrist, noted in another article that Medicaid in Colorado is in trouble:

A recent study at Children’s Hospital in Denver disturbingly found . . . uninsured children and children enrolled in Medicaid are twice as likely as those with private insurance to die after hospitalization. . . . regular preventative care for uninsured children and children enrolled in Medicaid would save Colorado $46 million. . . the number of Colorado pediatricians who are willing to see Medicaid beneficiaries fell from 41.4% in 2000 to 23.9% in 2003, based in part upon the fact that 83% of Colorado pediatricians in 2003 said Medicaid reimbursements did not cover the cost of office visits.

Gilchrist further notes that the 2005 Deficit Reduction Act cut Medicaid by a further $10 billion, and that:

Since 1996 Colorado’s Medicaid case load has grown by 59%.  According to the legislative budget office, nearly half a million Coloradans were in Medicaid in FY 2005-2006.  This equated to approximately one out of 11 Coloradans: one of out of three births, one out of six children and six out of 10 patients in nursing homes.


Medicare, the primary health care program for senior citizens in the United States, is also in trouble.  The magazine juxtaposes an August 8, 2006 quote from Bush Administration Medicare and Medicaid Services Administrator’s testimony before a House subcommittee that:

I think there’s a good chance this will be the year that we’ll really move away from the current formula, adding that the current system is “not sustainable.”

With a rule announced the following day:

The Bush Administration proposed a federal rule that would cut Medicare reimbursement for physician servics by 5.1% for 2007.

It further notes that in Medicare “physician payments will be slashed 37 percent over the next nine years, as practice costs increase 22 percent.”

Bottom Line

All this is just a sampling, but the bottom line is that physicians are joining patients in increasingly finding fault with the status quo in health care.

Full disclosure: Andrew Oh-Willeke practices law with Anne McGihon.  She is the current chair of the State House Health and Human Services Committee.