Polis: Bridging the rural-urban divide in health care requires bold action (column)
March 1, 2018
There are half as many mental health providers in Colorado's rural areas as in urban ones, and two entire counties in our state lack a single mental health provider. As a result, folks outside the Front Range experiencing a mental health crisis frequently have to drive hours for care. Oftentimes, they simply go without it.
The lack of mental-health providers only scratches the surface of the challenges mountain and rural communities face. In 2016, 36 of Colorado's 48 rural and frontier counties qualified as "Health Professional Shortage Areas," meaning that in these communities there is both a high rate of poverty and a significant shortage of qualified health care professionals. Eleven of these counties don't have a hospital, and two don't have a hospital or a rural health clinic.
In resort towns like Aspen and Vail, the provider shortage is compounded by astronomical premiums and out-of-pocket costs. For too many Colorado families, the gains from our booming state economy are far outweighed by the rising cost of living. That's especially true for folks living in places where the health care they need is not only far away but also unaffordable.
Part of the solution is bringing more health clinics and health providers to our communities. As governor, I will work with the Legislature, health foundations and providers to develop financing opportunities for mobile health clinics, which are specialized vehicles equipped to travel and provide health care services to underserved areas. It's been proven that these work, with studies showing a return of $20 for every $1 invested due to reduced re-admissions and emergency room visits. We also should create more health care "special districts," which are government entities specifically designed to fill unmet public needs in certain counties. These would help our towns to build permanent health care clinics, which can then be rented to providers at a low cost to bring high-quality, full-service medical care — including mental-health care — to underserved Coloradans.
Twenty-first-century technology means that it's now possible to consult with a health provider without leaving your home. Telemedicine is especially important for rural and mountain communities that lack facilities and providers. Sadly, the Coloradans who could most benefit from telemedicine are the ones most likely to lack high-speed internet.
Internet access today is not a luxury but a necessity — an economic necessity, an education necessity and, yes, a health care necessity. We can create statewide universal internet access by making it easier for local communities to build their own broadband infrastructure, fostering more public-private partnerships to bring broadband to tough geographic areas, and getting rid of outdated red tape that makes it hard to deliver funds to broadband projects.
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While access is important, it's only part of the health care puzzle. You can live next door to a world-class health clinic, but that does you little good if the clinic's services cost you more than your mortgage or rent. We must tackle affordability.
In this publication Monday, I outlined my proposal to bring an affordable, high-quality, single-payer health care option to Colorado by joining with other Western states to form a regional consortium.
Other cost solutions are specific to rural or mountain communities. We need to do a better job implementing the Affordable Care Act to reduce the exorbitant price of health care in the exchange for mountain communities. I've been calling on Colorado for years to redefine its geographic rating system to reduce the expenses facing mountain area families, and I'm prepared to solve this issue as governor.
We also should expand the Rural Colorado Venture Capital Fund to invest in cutting-edge, data-based solutions to rising health care costs, and incentivize entrepreneurs to open markets to combat food insecurity.
Rural Coloradans have almost 60 percent less access to reliable, healthy and affordable food than urban residents. By further developing public-private partnerships with grocery stores, health-focused foundations and public transit agencies, we can refurbish unused buses, for example, and turn them into mobile fresh-food markets in food deserts. We also should expand the mission of the Venture Capital Fund to help young farmers explore entrepreneurship opportunities in farming, ranching and food delivery in distressed areas.
Making your home in one of our state's beautiful rural or resort counties shouldn't require you to sacrifice access to affordable health care or healthy food. It's time for bold action here in Colorado to ensure the resources and services needed to stay healthy are available to every family, no matter where you live, where you work or how much money you have.
Jared Polis is a Democratic candidate for Colorado governor and currently is the U.S. representative for Colorado's 2nd District.
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