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April Christensen

April Christensen

In rural Colorado, families too often see that what makes a good campaign slogan or promise doesn’t translate well into good public policy that helps struggling communities. This is especially true in the case of government-run health care proposals. Particularly for community-based oncology clinics in rural communities throughout Colorado, a government-run health care insurance system could undermine access to life-saving medicines and more.

As executive director of the Coalition of Hematology and Oncology Practices, I work with practitioners in these fields to help them strengthen their practices in order to improve and enhance patient care while strengthening their individual businesses. One of the major issues facing oncology and hematology practices—especially the ones providing care in one of Colorado’s many rural communities—arise from patients covered by Medicaid and how the program reimburses providers.

Under our existing health care system, it is already difficult enough for Medicaid patients to access the medicines they need. Medicaid reimbursements are often insufficient to cover the full costs of care — and there can be significant delays in the process, burdening both providers and patients alike and delaying treatment for serious health issues that require a more responsive system.

Under a Medicare for All, public option, or single-payer regime, I worry that these issues could get exponentially worse. Government-run programs are not known for their efficiency or speed, and a one-size-fits-all approach to health care would be no exception.

In rural Colorado, small clinics — like most small businesses in rural Colorado — operate on a razor-thin financial margin. These providers would be hard pressed to survive the increased taxes, decreased reimbursement and the guaranteed expansion of expensive federal regulatory red tape.

What would be the effect in rural Colorado?

It is not unusual for rural patients to drive hours each way from their farms or ranches to a clinic to get their treatment. Our member clinics may be the only facility available for a hundred miles or more. And cancer patients may have to make this trip a few times per week. So whether a patient lives on a farm on the Eastern Plains or on a ranch in the northern mountains on the Western Slope — or like many of our patients drive in from rural Nebraska or Wyoming — small clinics are literally their lifeline.

When a clinic that patients rely on goes out of business, there simply aren’t a range of other facilities in communities like Craig, Rangely or Rifle to step into the void. Put yourself in the shoes of a patient who now faces driving to the Front Range — to Fort Collins or Denver for example — to find the treatment they need. Their wait times to receive treatment will increase. All while suffering the effects of their disease and the treatment needed.

This is a real world issue in rural Colorado; not a theory. According to a study released this summer, introducing a government insurance program that reimburses at Medicare rates as a public option to compete with private and employer-sponsored health care plans could put up to 55 percent of rural hospitals across America “at high risk of closure.”

Moreover, whether we’re talking about rural hospitals or smaller clinics, we know that they are critical players in the economy in communities across Colorado. When we look across the country, the 1,000 rural hospitals that will face closure under a public option represent some 420,000 jobs.

Instead of clamoring to replace the Affordable Care Act with a government-run health care system, our elected officials and candidates running for office should take a closer look at ways in which we can build upon and improve the ACA in order to lower costs and expand access to care. When all is said and done, that is the best way to strengthen health care in rural Colorado without undermining access for anyone.

April Christensen is executive director of the Coalition of Hematology and Oncology Practices in Fort Collins.

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