Guest Opinion: Spending more wisely — not just spending more — is the key to better health care |

Guest Opinion: Spending more wisely — not just spending more — is the key to better health care

Dr. Alan-Michael Vargas

We all hear regularly that our health care system is broken. Costs are out of control. Premium prices are beyond the pocketbooks of many families. People aren’t getting the treatments they need. And our overall health isn’t improving.

With health insurance premiums on the rise again, this year as much as 27 percent on the Western Slope, maybe it’s time we stopped simply spending on our health care system and instead started spending more wisely.

There is a proven way to deliver better care at a lower cost. We’ve known for years how to do it, but we’ve never really been willing to invest in it. Every study and analysis done tells us that connecting people to a family doctor, pediatrician or other front line health care provider they see regularly saves money and improves health.

These providers, who give preventative care and monitor and treat chronic conditions, provide the foundation to healthier communities and a health care system that operates at a lower cost. I see this in my practice every day. Our own Medicaid program here in Colorado has shown what the outcomes can be. By investing in family doctors and other primary care givers, emergency use fell 5 percent and costly hospital readmissions declined too, saving Colorado taxpayers $139 million.

Because we have underinvested in primary care — resources to help the family doctors, pediatricians and others who provide front-line preventative care, lower-cost medical treatment and monitoring and treatment of chronic conditions — we have been forced to invest in more expensive parts of our health care system to simply save lives.

Lack of funding has our primary care system overloaded, without the resources needed to connect every patient to a primary care doctor. Right now only 5 to 7 cents of each dollar we spend on health care goes to primary care. Increasing our investment slightly so that just 15 cents of each health care dollar goes to primary care would make a big difference. That’s what we’re asking Colorado lawmakers to do. Put Colorado on a path to invest in this lower cost alternative.

Before you decide I am somehow motivated by simple self-interest, let me explain what this investment would do. It would allow front line providers to expand the offerings in their offices including social workers and others who can help patients track their appointments and health outcomes. It would allow us to invest in better mental health services, a key to improving overall health. And it would allow us to expand our practices so that all of us can spend more time with each patient, allowing for better health care for every individual.

I have 24 patients scheduled each day, giving me just 15 minutes with each of them. When someone comes in with a sore throat, but they also have high blood pressure, diabetes, asthma, or some other condition, those 15 minutes are just not enough to give them the care they need and deserve. All too often, patients find themselves in the emergency room for something that would be better taken care of in a primary care office.

My primary care office is a better, much more affordable place to get care than the emergency room. On average, it costs about $90 to treat an ear infection or $100 to treat a sprained ankle in a primary care office. In the emergency room, the cost is $1,100 for that infection and $1,200 for that sprain. About one in every three visits to the emergency room could be taken care of by a family doctor at much lower cost.

It’s time we stopped arguing about our health care system and started implementing changes we know will improve health and cut costs.

Dr. Vargas has served as a family medicine doctor with Grand River Health in Parachute since 2013. He also serves on the board of the Colorado Academy of Family Physicians.

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