Susan Birch, executive director of the Northwest Colorado Visiting Nurse Association, is part of a rural advisory task force, an arm of the state Legislature-created Blue Ribbon Commission for Health Care Reform. Commission members will host a meeting Saturday in Craig to discuss reform proposals with local residents. Birch considers health care the most pressing issue facing state and national lawmakers today.

Photo by Hans Hallgren

Susan Birch, executive director of the Northwest Colorado Visiting Nurse Association, is part of a rural advisory task force, an arm of the state Legislature-created Blue Ribbon Commission for Health Care Reform. Commission members will host a meeting Saturday in Craig to discuss reform proposals with local residents. Birch considers health care the most pressing issue facing state and national lawmakers today.

Unweaving a tangled mess

VNA director: Health care reform critical to providing for rural communities

If you go

What: Blue Ribbon Commission for Health Care Reform public meeting

When: 1 to 4 p.m. Saturday

Where: Holiday Inn of Craig ballroom

Other: The meeting, which includes an overview of five proposals under review for health care reform, is open to the public.

— It's no secret that health care reform is a hot-button issue.

The subject is debated on television news programs and among the throngs of presidential hopefuls on the campaign trail. It ranks near the top on most public opinion polls, somewhere in the same neighborhood as the Iraq war, education and Social Security.

Susan Birch, executive director of the Northwest Colorado Visiting Nurse Association for 16 years and a health care professional for more than three decades, is no different. For her, reforming a health care system she referred to as dysfunctional is the most pressing issue facing Americans today.

Leaving health care untended does "a disservice to future generations," she said.

"It's critical," Birch said, "that people understand the magnitude of what we're facing."

The Visiting Nurse Association, an agency that implements and oversees health programs in Moffat, Routt, Jackson and Rio Blanco counties, sees a significant number of patients who are either uninsured or underinsured. Providing everyone with a basic coverage package would be part of the solution, Birch said.

But not all of it.

"Coverage doesn't necessarily mean access," said Birch, citing the at-times limited availability of health care facilities and services in rural communities. "We need not only the access, but also the buildings."

Birch, who works in both the Craig and Steamboat Springs VNA offices, has shared her views on overhauling the state health care system for the past two months with a rural advisory task force, an arm of the state Legislature-created Blue Ribbon Commission for Health Care Reform.

Commission members will host a meeting Saturday in Craig.

The commission's task is to make recommendations to lawmakers "with the goal of increasing health care coverage and decreasing costs for Colorado residents." Saturday's meeting will run from 1 to 4 p.m. at the Holiday Inn of Craig, and is open to the public.

Commission spokeswoman Edie Sonn said commission members view the public feedback as a critical component in crafting the recommendations, which will be made to the general assembly in January 2008.

The commission "wants to know what the public thinks we should be focusing on," Sonn said.

Birch said better health care and more easily available access to it are vital for rural area patients and communities to improve economic conditions.

"It goes hand in hand with economy, job creation," she said. "Employers look at that. That's why I'm a huge proponent of both ballot initiatives (November proposals asking voters to approve money for a new hospital and improving schools). Those are both bedrock issues for communities."

She credits local city and county governments for recognizing the important role health care plays in the community, and also private foundations for allocating grant money. It's now time for state and federal governments to do the same by allocating needed resources and implementing programs, Birch said.

State and federal assistance has been either "inadequate or fluctuate," she said.

Birch said she is relieved to know that at least statewide, if not nationally, the health care issue has garnered the attention and discussion necessary for lawmakers to begin fixing a broken system.

"There has been a tremendous awakening to this issue," she said. "I personally think Colorado and our Legislature were really smart in taking a proactive stance in coming up with a solution."

The process - finding a permanent fix to a multi-tiered quandary - will be neither easy nor quick, she said.

"It's a very comprehensive problem," Birch said. "It's going to be a slow, incremental process to reform this tangled mess. This is going to take a long time."

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