Nightly News   |  November 04, 2009

Finding hope for health care in Colorado

Nov. 4: Grand Junction CO, a city of 120,000 people halfway between Denver and Salt Lake City, boasts what these days is a welcome distinction: It's a place where, for the most part, health care works. NBC's Tom Brokaw reports.

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but this sure says a lot: roadside assistance and courtesy transportation,

>>> finally tonight, tom brokaw continues his east to west tour of the country along highway 50 this year, a road that winds its way from the maryland shore to sacramento, california. it's all part of his series of reports for nbc and the usa network on the american character. and tonight we find tom stopping in colorado in a city where they figured out how to work together to solve some of the biggest problems facing the entire nation.

>> reporter: there's a lot to like about grand junction , colorado . besides the majestic setting, the city of 120,000 people, halfway between denver and salt lake city , boasts what these days is a welcome distinction. it is a place where for the most part health care works. dr. mike pramenko, a colorado native, returned here 15 years ago after dartmouth medical school , fired up about health care reform .

>> if we did away with all the insurance companies tomorrow, we'd still have this huge escalating cost of medicine through technology and pharmacology. and how we utilize that technology is so incredibly important.

>> reporter: overall, grand junction 's residents have access to high-quality care at some of the lowest average costs in the united states , and that does include medicare.

>> we sit down, and we compare, you know, as peers who's spending the most amount of money.

>> reporter: more than three decades ago grand junction 's medical community agreed to an innovative arrangement. regular review of patient charts and hospital practices to root out problems and cost overruns . they also agreed to be paid the same, whether they saw medicare, medicaid, or privately insured patients.

>> it's not a model you can pick up and stamp and move somewhere else . but there 's wonderful lessons to be learned from grand junction on how to organize medicine so we can drive quality and we can drive cost.

>> do you get some resistance from older physicians who like doing it the old way and maybe making more money that way?

>> even here in grand junction along the way through the last three decades of this model there's been a significant amount of resistance.

>> reporter: and it is not perfect. not by a long shot.

>> you look pretty uncomfortable.

>> i'm very sick.

>> reporter: beverly koon knows that better than most. here in the emergency room for at least the 20th time in the last four months for an agonizing problem doctors can't pinpoint.

>> it makes you sleepy but --

>> have you ever had health insurance ?

>> yeah, i did when i was working in the oil fields . and then the oil field shut down and --

>> so you come here when you need help, right?

>> yeah.

>> reporter: beverly's husband makes too much in unemployment benefits to qualify for medicaid. it's a trap that even grand junction has not been able to solve.

>> i'm seeing people fall through the cracks more commonly here. i can only imagine how bad it is out there elsewhere.

>> reporter: younger doctors such as bill hilty and mike pramenko aren't shying away from trying to make it better.

>> i think my generation is more open to change. we have time left in the system, and we have more energy. and maybe a little more hope that we can somehow solve this together.

>> so from here tom heads west to fernley, nevada, which as you may know has been called ground zero for the foreclosure crisis. for now that's our broadcast for this