2006 New hospitals, high costs, no nurses

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Memorial North is one of three hospitals under construction in the Pikes Peak region. All will be competing for a limited supply of health care professionals.

Health care — its costs and its availability — led the news in 2006, as the number of health savings accounts grew, groups explored universal health care and hospitals prepared for a possible pandemic or other natural disaster.

The nursing shortage was again in the news, as both Memorial Health System and Penrose-St. Francis began construction of new hospitals. Woodland Park is also building a new hospital, with all three competing for staff.

But alternative reports said the nursing shortage was caused by nurses leaving the profession because of poor hours and low wages.

Insurance alternatives

From health savings accounts to individual plans, insurance coverage — and the high costs of health care — was a major issue in 2006.

More than 50,000 HSAs are opened every month in the United States, according to account administrators, showing the dramatic effect of a relatively new insurance alternative.

“This is the best thing I’ve seen in health care — and I’ve been doing this for 31 years,” said Tom Voake, a partner in Effective Choices, a group benefit specialist team that is part of Strategic Financial Partners. “The HSA concept is a strategy, one that allows people to plan for the future by putting the money aside today. In my opinion, this option is perfect for people who have chronic illness.”

Health savings accounts are generally combined with a high-deductible health insurance plan. Once the deductible is met, the insurance companies pay 100 percent of covered medical costs.

But for some, health insurance remained just out of reach through their employers’ plans. That’s why many major insurers are focusing on the individual — forming plans for healthy people in their early 20s and 30s that are often much less expensive than company sponsored plans.

The number of people enrolled in small-group coverage is declining each year, said Peggy Brown, deputy commissioner of insurance. But the number of people taking individual insurance policies is rising.

“Two thirds of Coloradoans get health care coverage through an employer,” she said. “But the number of uninsured is rising — about 14 to 17 percent of the population doesn’t have insurance. As premium costs rise, employers face the economic condition of not providing coverage. We’re seeing some service companies broadening their product offerings to try to offset this.”

All the major insurers in Colorado are seeing increased interest in their individual product offerings. Two companies released new products aimed at that market in recent months — Rocky Mountain Health Plans and Anthem Blue Cross and Blue Shield.

“It’s not unusual to offer individual insurance,” she said. “The marketplace is definitely open to it.”

Pandemic warnings

In early 2006, health officials feared a global pandemic of avian flu. Many economists projected a pandemic could be economically devastating for the country.

“In general terms, certainly specific sectors of the economy will be affected for a long time after the pandemic,” said Tom Zwirlein, professor of finance at the University of Colorado at Colorado Springs. “Tourism is definitely one of those, and in Colorado, 20 percent of our economy comes from tourism. Much of those businesses that rely on flights, hotels and people could be devastated.”

The Congressional Budget Office issued a 44-page report in December 2005 detailing the economic effects of a flu pandemic, which many health officials believe is inevitable. Focus has been on the avian flu, known as H5N1, possibly mutating to allow human-to-human transmission.

“An avian flu pandemic could be thought of as a ‘shock’ to the economy, with both demand- and supply-side effects in the short run. In addition, the pandemic would have longer-term supply-side effects,” the report said. “… the economic effects would be greater than recent recessions and roughly the same size as the average postwar recession.”

Nursing shortage in focus

Colorado Springs health systems are scheduled to open two new buildings next year, and a hospital under construction in Woodland Park places the three groups in direct competition for nurses, as the nursing shortage continues to grow in Colorado.

Hundreds of new positions need to be filled at the hospitals. At Memorial, health care officials are trying to fill 450 vacancies. The Woodland Park hospital is trying to fill 150.

Both groups say the competition is fierce, but they plan to work together to meet the community’s medical needs.

Those needs are compounded by the Colorado nursing shortage, which is twice that of the rest of the country. Some nursing groups claim the shortage is an artificial creation caused by staffing ratios and low pay in the state’s hospitals.

The Nurses Alliance of Colorado, part of the Service Employees International Union, represents 1.3 million hospital employees nationwide, says there is no real shortage of nurses, but that there is a lack of nurses willing to work at the bedside in hospitals.

It is estimated that there are 100,000 nursing vacancies in Colorado.

Army goes rolling along

The Colorado Springs health care community is ramping up to ensure services are available for the 30,000 soldiers and dependents who are expected to move to the area during the next two years as part of the Defense Department’s base realignment plan.

While most soldiers and their families use military hospitals and clinics for health care, some services are not available. For example, soldiers see dentists at the military treatment facility on Fort Carson, but family members must see civilian providers.

Family members also can choose to use private health care providers as part of the Tricare program, a civilian enterprise that provides health care and dental services to soldiers, sailors, Marines and airmen, as well as their families.

“We’ve added 4,260 health care providers to the network,” said Dave McIntyre, CEO of Tricare West. “That’s an increase of 30 percent over a year ago. We’re adding them based on an analysis with the military, what we’ll need as we go forward.”

Bioscience bandwagon

Colorado is following the example of other states by funding bioscience research in hopes of creating more jobs — but at a much smaller level.

The state legislature passed a bill that provides $2 million of gaming money to create small grants to encourage bioscience research and the development of new technologies. That money, available only once, could be the catalysts for job and industry growth, said Brian Vogt, director of the Colorado Office of Economic Development and International Trade, the state agency responsible for administering the grant.

“We’re looking at projects and research institutions now,” he said. “We’re developing a fairly comprehensive list of groups that are eligible for the grants — mostly research institutions, but a few private organizations as well.”

Immigrant costs elusive

Colorado’s Medicaid program will spend more than $53 million for acute emergency needs for non-citizens, according to the state program. But total figures for caring for illegal immigrants remain elusive.

“We only track figures for emergency room care,” said Holly Stevenson, spokeswoman for the state agency. “Illegal immigrants aren’t eligible for any other kind of Medicaid help.”

State officials estimate that 5,746 non-citizens will visit emergency rooms or other acute-care clinics this fiscal year, for an estimated per-capita cost of $9,240.20. But Stevenson cautions: Medicaid doesn’t separate illegal aliens from non-citizens who are in this country legally.

Hospitals, clinics and the public health department also refrain from asking immigration status — new HIPPA requirements don’t allow it, they say.

“We just list people as indigent, if they don’t have insurance,” said Memorial Health Systems spokesman Bradd Hafer. “We can’t ask for green cards or visas. We just don’t have hard and fast information, unless it surfaces through the filtering process for people who can’t pay. It’s difficult to find clean answers; the questions are so vague there’s not way to attain accurate numbers.”