Vail Daily letter: Realign priorities
Recently, the Vail Valley Medical Center published its annual Health Needs Assessment report. A link can be found on my website: http://www.vvmcmoney.com
In considering the conclusions of the Health Needs Assessment report done by the VVMC, readers need to realize that this study is in large part based upon the responses of 81 individuals from a highly selective list determined by the management of the VVMC. While the demographics of the respondents are not noted, it is virtually impossible that such a small sample was inclusive of a statistical cross section of the demographic makeup of the county in terms of ethnic, racial, economic and geographic differences.
For example, 81 percent of the 81 respondents stated they had a routine physical exam this year — it’s doubtful that carries over to the general population count.
The 82-page study lists seven primary needs of the community. They are (in order) access to care, cancer, heart disease, unintentional injury, chronic respiratory disease, mental health and substance abuse. Curiously, orthopedic care, which is the cornerstone of the VVMC, is not listed as a primary need. Also the ranking of three of the top four needs (cancer, heart disease and unintentional injury) correspond to the three areas the VVMC is providing services for in a reasonably adequate manner.
Seventy-one percent of the respondents cited access to health care as their major concern, with 82 percent citing the cost as the chief barrier to care. The study notes upwards of 22 percent (about 12,000 people) in Eagle County lack health insurance with cost cited as the main reason. That is double to triple the statewide average.
Although not addressed in the report, checking http://www.connectforhealthco.com and running a scenario for a family of four shows health premiums can run as much at 85 percent more than in the Denver metro area. Having participated in several discussions organized by the Division of Insurance and Gov. Hickenlooper I can attest that there is clear evidence the difference in premiums is directly tied to the costs charged by local health care providers, with the VVMC leading the way. Health insurance executives have demonstrated that costs here are 40 percent to 60 percent higher than on the Front Range; this assertion is backed up by studies done by the Colorado Division of Insurance.
The concern expressed by the VVMC in its report on access to care and costs seems at best to be superficial, and the problem could be easily addressed by the VVMC, but would require an earthshaking change in the culture of the organization from its current goal of making some of the highest profit margins and likely holding proportionately the largest amount of liquid assets of any similarly sized nonprofit hospital in the U.S. In other words, the VVMC could drastically lower its prices and still be a financially viable hospital and drastically improve affordability and accessibility to health care.
Alternatively, VVMC notates resources such as the Eagle County Public Health program and Vail Valley Cares, the Vail Valley Charitable Fund as resources, and offers no proposed involvement on the part of the VVMC, which is very disappointing.
The discussion of mental health and substance abuse in the VVMC report documents a prominent and largely unaddressed problem in Eagle County and is certainly a need deserving discussion and solutions.
But the recent closure of the detox center in Vail for lack of approximately $250,000 a year in additional funding did not seem to concern the VVMC and was not mentioned in the report. That amount of money would be a pittance to the VVMC. As a result, as reported in the Daily, those in need of a safe place to detox must now do it in a jail cell.
In terms of mental health services, the VVMC recognizes that as many as 25 percent of the residents of Eagle County may need mental health treatment at some point, but states they have only two social workers on staff, and can at best, only offer stabilization while finding a facility out of the county to assist those in need.
Respiratory disease is listed as a priority need in the assessment and the fourth leading cause of death in Eagle County, but the report notes there are approximately one-quarter the number of respiratory therapists in Eagle County per 100,000 people as compared to the rest of the state. The VVMC report states the only resource they provide to the population is a monthly program with an out-of-town provider visiting. As I have a close family member who suffers from severe asthma and allergies, I can attest that this is a grossly inadequate level of service.
What is very disappointing, and indicative of the culture at the VVMC, is that they are completing a $300 million expansion with a focus on orthopedic care (which is not even listed as a priority) and have vast financial resources in the nine digits. They have a net tax free income of more than $50 million a year and yet are not making any substantive effort to address the issues of substance abuse or support a local detox center, mental health care, respiratory disease or lowering health care charges and subsequently insurance premiums. The VVMC is, effectively, shrugging its shoulders in terms of dealing head on with these needs of the community.
And what is disturbing is that they are doing all of this while cloaking themselves in the respectability of a nonprofit institution, enjoying tax free status and asking for (and often receiving) large amounts of philanthropy from the community.
As the Vail Homeowners Association recently noted in its first comments about the VVMC, to those whom much is given, much is expected. It is time for the community to stand together and ask the VVMC to realign their priorities. I’ve started an online petition at http://www.vvmcmoney.com where residents can learn more and ask for change.