By John Aguilar
The Camera, Tuesday, May 22, 2007

Emergency rooms as primary care facilities, thousands of eligible children cut out of the county's health care network and convoluted medical bills that in no way reflect the true cost of services provided.

Those are just a few of the issues that came up at a Boulder forum Monday that brought together state legislators and dozens of health care professionals for a half-day discussion on improving health care access for Boulder County's poor and underserved residents.

Dr. Gary VanderArk, chairman of the Colorado Coalition for the Medically Underserved, said the focus, first and foremost, should be on children who aren't getting proper health care.

"It's so embarrassing when you look at how many children in Colorado are not covered," VanderArk said. "Why aren't they signed up?"

VanderArk said that out of the 180,000 children statewide without health insurance, 120,000 are eligible for various community health services — but their families don't know how to access them or they face a language barrier.

VanderArk was one of four members of the state's Blue Ribbon Commission for Health Care Reform, otherwise known as the 208 Commission, at Monday's meeting. The commission was created by the Colorado Legislature last year to study and establish health care reform models, especially for underinsured and uninsured residents. The commission is supposed to come back to lawmakers with a final report in November.

According to the Colorado Children's Campaign, more than 12 percent of the county's residents under the age of 18 were uninsured in 2000, the most recent year from which statistics are available. Nearly 19 percent of residents under 18 in the county — or 11,762 children — were enrolled in either the state's Child Health Plan Plus or Medicaid in 2005.

Connie Holden, interim chief executive officer for the nonprofit People's Clinic in Boulder, said one way to reach the families of poor children would be to inform them of the county's community clinics when they enroll for the free or reduced lunch program at school.

Rep. Paul Weissmann, D-Louisville, said that a lack of awareness of preventive medicine and low-cost medical services at community clinics among many of the county's most indigent families has led them to see expensive hospital emergency rooms as the answer to all of their medical needs, both urgent and everyday.

"We have a lot of people being serviced in emergency rooms who frankly don't need to be," he said.

John Sackett, CEO of Avista Adventist Hospital in Louisville, said Avista has forged a tight relationship with Clinica Campesina in Lafayette and redirects patients who don't have serious injuries or illnesses there for treatment.

Several of the participants Monday regaled each other with increasingly frightening tales of medical billing gone bad and called for a reapportionment of health care money away from administrative costs and overhead and into medical care.

Rep. Claire Levy, D-Boulder, said the costs of medical services and drugs must be made more transparent and less labyrinthine to the average patient.

"We don't know what things cost anymore," she said, referring to the myriad prices attached to medical procedures and prescriptions.

Many of the health professionals at the meeting said that despite the challenge of serving everyone in the county with quality medical care, 90 percent of Boulder County's residents had health care coverage as compared to the state average of 84.4 percent.

"The reason we do so well is because we do this kind of collaborative planning," said Chuck Stout, Boulder County's public health director. "We don't want to wait until people fall through the floorboards."


Contact Camera Staff Writer John Aguilar at 303-473-1389 or aguilarj@dailycamera.com.