Phyllis Coletta: Wealth care not health care |

Phyllis Coletta: Wealth care not health care

I appreciate Steven Hofman’s recent letter to the editor regarding the new Steamboat ER. The fact that he went there just to investigate and get information is typical of the truly conscious consumerism of Steamboat. 

This community supports what is best for everyone, and I love that about Steamboat. But, free-standing ERs, prominent in Texas and now Colorado, is more wealthcare than health care, and we need to all be aware of the potential impact of a healthcare business that only accepts people with commercial insurance or private means of pay.

According to a study published in the Journal of Health Affairs, business decisions are being made about the location of these non-hospital affiliated free-standing ERs “in areas with high incomes and insured patients.” The study suggests that policy-makers need to look closely at this trend, “to prevent the exacerbation of disparities involving the medically underserved.”

This year, State Sen. John Keflas, D-Fort Collins, will re-introduce a bill that requires all free-standing ERs to be transparent about charges, billing and services. Often, these facilities look like hospital emergency rooms, but they do not accept Medicare and Medicaid patients — that is, the poor and the elderly.

Approximately 32 states allow free-standing ERs and regulations vary widely. Colorado, like Texas, allows an extremely wide latitude with free-standing ERs, not requiring a “certificate of need” or a showing of any kind that the community would benefit from such a service. Walden or Yampa, for example, may certainly have needed more ER availability, but according to the study demographics noted above, owners concentrate on “high income and insured” patients.

Competition is terrific in retail, but we’re not selling shoes here; we’re talking about open access for health care emergencies. Is it truly “competition” when one ER accepts everyone, rich or poor, old or young, and another can be selective about whom it serves?

According to the study in Health Affairs, owners of these free-standing ERs set up shop in demographics where they may more easily avoid the lesser-paying patients. The Colorado Hospital Association notes that the free-standing ERs unaffiliated with a hospital are not regulated by the federal government and not subject to the same standards and scrutiny.

From a business perspective, I believe a free-standing ER can make a lot more money than a hospital ER required to accept all patients. Fine for retail, not for health care.

Our UCHealth Yampa Valley Medical Center ER is a nationally ranked, top-tier Level III emergency room that continues to see people quickly (fewer than eight-minute average wait) and with the ability to get immediate life-saving treatment through hospital access. Maybe not shiny, but as dedicated and efficient as any hospital in its class, nationally. 

Every patient who goes to a for-profit ER potentially drains resources available to a whole community, and while our hospital ER clinicians continue to provide outstanding care to everyone, this just doesn’t seem fair or in the best interest of this huge rural region. It is, however, very illustrative of the continuing divide in this community (and this country) between the wealthy and everyone else.

So, if you are the typical Steamboat resident who works three jobs just to pay bills, it’s likely you can’t afford the pillow-fluffing and fireplace ambiance offered at a free-standing ER. This is not healthy competition. It’s a continuing fracture in the economic gap here and everywhere. It’s wealth care, not health care.

Phyllis Coletta

Steamboat Springs

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