A group of medical students looking in the same direction with Bear Breakdown written in the corner

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October 21, 2025

Written by Duard Headley

Bear Breakdown: How Healthy is Our Healthcare?

While most Americans rate health care quality below average — faculty discuss key topics like burnout, limited access to care and their hopes for the future

Bear Breakdown is an ongoing series where university experts share clear, thoughtful insights on today’s most talked-about issues. Each article connects headline news to real-world impact, helping readers better understand what’s happening and why it matters, while adding valuable context and sparking meaningful conversation for audiences of all backgrounds.

Few people like going to the doctor.

“An apple a day keeps the doctor away,” after all.

But while primary care checkups and a wide variety of other visits to healthcare providers can be uncomfortable, intimidating and, most of all, expensive, there’s no denying the vital importance of healthcare services for nearly everyone around the world.

From the cost of care to lack of access to services, personnel shortages and more, for such an essential industry, there’s a lot of uncertainty surrounding healthcare in America —and there has been for a while.

Faculty from the University of Northern Colorado’s Nursing, Business Administration and Communication Sciences and Disorders programs, as well as the proposed College of Osteopathic Medicine, share their expertise and experience in several aspects of America’s healthcare system.

“There’s an acute shortage of rural providers throughout Colorado — through the whole United States, really … I think until you’ve lived that, it’s difficult to imagine.”-Natalie Pool, Ph.D., RN

A Nursing Perspective

Quotes from Natalie Pool, Ph.D., RN, associate professor of Nursing in the College of Natural and Health Sciences.

There’s been a longstanding challenge of burnout and what we call “compassion fatigue” in healthcare. It seemed to be exacerbated by the COVID-19 pandemic, and we haven’t entirely recovered from that — especially in terms of the number of people that left clinical care because of burnout.

We are doing a lot more to start to build emphasis on resiliency, self-care and wellbeing into our nursing curriculum — and I think people are throughout health sciences education as well.

We’re really trying to view students much more holistically and recognize that they need to enter the workforce with some of these self-care and wellbeing practices in mind.

At the same time, I would like to see healthcare employers step up a little bit more in terms of addressing some of the things that we know can lead to burnout — things like high patient/nurse ratios, complex schedules and stressful working conditions.

Geographical isolation is one — the fact that you’re just a long way from any kind of health care provider or services is a reality.

But there’s an acute shortage of rural providers throughout Colorado — through the whole United States, really. That includes physicians, advanced practice providers like nurse practitioners and physician associates, as well as registered nurses and support staff.

So even when people are able to access services, a lot of times, those places are understaffed. We’ve seen rural facilities have to close down departments because they don’t have enough staff members. As a result, there are people in Colorado who have to travel hours to get the specialized care they need.

I think until you’ve lived that, it’s difficult to imagine.

Specialty services are often restricted in rural communities — particularly mental health services, despite a high demand for them.

There are some incentive programs in place to try and get healthcare professionals to set up in rural communities, but what we’ve learned is that simply incentivizing people by either offering loan reimbursement or sign-on bonuses is; a) usually not enough to fill the demand and b) it doesn’t keep people there — they might go for a year or two to get their sign-on bonus, but often leave shortly thereafter.

What we really need to do is start acculturating healthcare students while they’re in training by having them do rotations in rural settings — that’s what we’ve done in the School of Nursing. We’ve sent some of our nurse practitioner students to rural and frontier settings to actually do their clinical hours there and get a feel for what it’s like to really practice and live in that area.

A lot has happened in healthcare since January — some of it very unexpected.

We just saw a measles outbreak nationwide, including cases here in Colorado. Through the work I do in public health, we’re very concerned about the evolving recommendations for immunizations and vaccines that have been coming out recently.

There’s a lot of conflicting information coming out from the federal government right now, which can often play into people’s suspicion and caution surrounding healthcare in general.

When we see this type of chaos, it leaves patients and providers confused and unsure of how to move forward.

Also, many of us in healthcare are very concerned about the funding cuts that are coming in 2026, many of which will disproportionately harm rural facilities — rolling back healthcare coverage for people who use the insurance marketplace and undocumented immigrants. We are going to see the impacts of that in the coming years when folks are coming into the ER in absolute distress because they were unable to access or were afraid to access care prior to then.

I think that the healthcare providers coming out of college programs now, whether they’re physicians, nurses, whatever, are coming out much better informed and much better trained than in previous generations.

Additionally, some of our younger, Gen Z healthcare providers are not afraid to advocate for themselves and to advocate for their profession and their patients. They’re much better able to hold those boundaries than many in my generation. We had the mindset of, in many ways, “shut up and put up.” We ended up paying the price with a lot of unsafe situations and burnout.

I also think that the students we’re seeing now are much more tolerant and non-judgmental, largely because they’re just a more diverse generation that is better prepared for taking care of diverse populations.

And science is always improving too. We see survival rates with things now that didn’t exist 10 or 20 years ago. Even in my lifetime as a nurse, we’re seeing much better outcomes in terms of our treatment options for a lot of diseases.

“That’s one of the things about this country; unless we face a catastrophic need, we’ll argue with each other endlessly. Therefore, it may take reaching a crisis point to see some significant change in our healthcare system.”-Larry Leaming, DHA, LFACHE

An Administrative Perspective

Quotes from Larry Leaming, DHA, LFACHE, adjunct instructor for the Master of Business Administration program in the Monfort College of Business.

The evolution of our healthcare system has been ongoing since its inception and continues to change today. Initially, health systems and hospitals focused primarily on caring for patients. Over time, organizations and major employers created health insurance systems to help cover the costs of care and significantly improve access to quality healthcare services.

Over the years, the government has become increasingly involved in healthcare by implementing programs such as Medicare and Medicaid, which primarily serve elderly individuals and low-income families. Commercial health insurance companies also offered their services to those who wanted to purchase insurance coverage and spread the risk among a larger population.

Originally, healthcare was not very expensive, all things considered. However, today it has become extremely costly.

Healthcare professionals continually seek innovative ways to improve the quality of care for individuals and, equally importantly, to provide care to underserved members of our society.

One problem is that insurance costs have risen so high that the cost of health insurance is pushing people out of the system altogether.

This often leads people to forgo health insurance or delay medical care until a severe problem arises. Alternatively, they may purchase insurance policies that only cover major emergencies because that’s all they can afford. In those cases, when a catastrophic issue arises, it can be financially devastating.

That’s honestly very frustrating. You’d think a wealthy country like the United States could find a way to offer better healthcare coverage for its people without bankrupting either the population or the nation itself.

One aspect of the course I teach here at UNC is exploring healthcare systems in other countries. We examine nations like Canada, Germany, France and others, which provide examples of countries that have managed to offer more comprehensive coverage to their populations. That coverage usually comes with a significant tax burden to fund it — something Americans generally prefer not to consider — or some residents of those countries can face delays and barriers to accessing healthcare.

Building a more universal healthcare system is much easier in smaller countries with smaller populations. However, in this country, numerous competing interests exist, and we tend to avoid interfering with free enterprise, so we hesitate to impose mandates.

There are many profit motives involved, not only in information systems but also in the health insurance industry and the healthcare sector.

The healthcare industry makes up a big part of our national gross domestic product — we’re talking about trillions of dollars. All those independent interests, combined with the ingrained desire for free enterprise in our country, make it very challenging to create something more affordable and universally available.

It’s ultimately an issue of aggregation. We’re seeing large health insurance companies merging and acquiring significant portions of territory across the country. They have grown to wield substantial power when negotiating contracts with healthcare providers and hospitals, especially small rural ones.

In a smaller rural hospital, if a health insurance company comes in and says, “We’re going to redo our contract,” and that contract ends up causing a loss in revenue for the hospital, there’s not much that a small hospital can do. It’s take it or leave it, in many ways.

As a result, many rural and smaller hospitals are joining larger healthcare systems, such as UCHealth, Banner Health and CommonSpirit, to gain more bargaining power when negotiating with insurers, medical suppliers and information system providers who might not otherwise engage with them.

There are several advantages to hospitals being part of a larger system, including improved employee health coverage, enhanced opportunities for providing specialized care and greater flexibility in transferring personnel between hospitals. There are also some downsides.

One disadvantage is the loss of some autonomy. When part of a healthcare system, an individual hospital cannot make decisions independently. For instance, it may not have the freedom to choose which services to offer or not offer in its local community; strategic decisions are often made at the system level.

One of the significant concerns in rural healthcare is that when large systems take over, some specialty services currently available in smaller communities may be eliminated. Instead, these services might be consolidated and offered only at larger, more centralized facilities.

I always hold onto hope. Over the years, we’ve witnessed various developments that enhance access to healthcare. One significant example is legislation that mandates hospitals treat patients with emergent conditions, regardless of their insurance status or ability to pay. In fact, hospitals are not allowed to inquire about a patient’s insurance before screening and providing emergent treatment to stabilize the condition.

Healthcare systems and the quality of care have improved markedly over time. Technology plays a significant role in this — including video monitoring, telehealth services and diagnostic innovations.

The issue is that it’s quite costly to find a system that offers better coverage for everyone, especially for those who currently lack access.

There’s a lot of discussion, but few solutions are emerging. I see a lot of fighting between political parties, and it may simply be a result of how this country is structured — or maybe it’s because we’re so focused on freedom and free enterprise that we’re hesitant to intervene with the for-profit industries responsible for much of the healthcare costs.

That’s one of the things about this country; unless we face a catastrophic need, we’ll argue with each other endlessly. Therefore, it may take reaching a crisis point to see some significant change in our healthcare system.

It all sounds frustrating when considering the future healthcare landscape. However, I believe those challenges motivate healthcare leaders like me to dedicate time and effort to training the next generation of healthcare leadership. Because if progress is going to be made and change is going to occur, it will be driven by young people in the classroom today.

“Number one, we know there’s a physician shortage in both Colorado and across the nation. We’re working to fill that gap.”-David Ross, D.O.

From an Osteopathic Medicine Perspective

Quotes from David Ross, D.O., associate dean of Clinical Education and Graduate Medical Education for UNC’s proposed College of Osteopathic Medicine.

The impacts are huge — both community-wide and outside of the Greeley-Weld County area.

Number one, we know there’s a physician shortage in both Colorado and across the nation. We’re working to fill that gap.

Specifically, [UNC’s proposed College of Osteopathic Medicine] won’t see our first class graduate until 2030, but we already know some of the impacts those students are going to have, and they’re going to be highly beneficial.

There are shortages of healthcare professionals in both rural and urban communities as well, and I hope our students will be able to graduate and offer their services in both areas.

Not only are students able to build professional relationships and connections during their residency programs, but the hospitals they work with, both here in Greeley and those further away, directly and immediately benefit from their presence — they’re able to go out and start having an impact even before they graduate.

From the availability of future physicians to supplement the healthcare workforce to the economic boons the school itself brings to an area, programs like ours are a vital part of the community.

The thing that people think and worry about the most in rural communities is likely healthcare access — are there people in those areas for patients to get seen? It goes back to those health profession shortage areas.

And another factor that can impede access to healthcare is transportation. The bulk of healthcare available in rural areas is primary care. If a patient in a rural area needs access to specialty services, odds are they’ll end up needing to drive quite a ways to get it.

Traveling specialists and telehealth services can help alleviate some of these issues, but they’re still limited in how much of an impact they can have.

Finally, a big concern for rural areas is funding. In these areas, physicians and other advanced practice providers often rely on Medicaid dollars to exist. There’s always a question of whether or not that funding will be sufficient to attract a specialist to move to rural areas.

In an underserved area, if a patient needs specialty care — having their gallbladder removed, for instance — they’ll need to see a surgeon. If the funding for that specialty care isn’t great for rural areas, the nearest surgeon might be quite far away.

It’s our hope to expose our students to working in rural environments, give them positive mentorship experiences there and show them some of the advantages that exist when it comes to working in an underserved community — increased procedural experience, the ability to make a genuine impact in a community and hopefully, feeling welcomed by that community as well.

Currently, as there always has been, there’s a lot going on in healthcare.

In some practices, we’re seeing a loss of autonomy as healthcare is corporatized to some degree. Somewhere around 60% to 70% of physicians nowadays are employed by a large healthcare entity or group as opposed to an independent organization.

With this comes a tendency to feel like you’re a cog in a machine and that you don’t have as much control over things like your schedule, what you’re doing and maybe even your practice itself.

There are many flaws with our current healthcare system — some of the things we’ve talked about as they relate to rural communities and the challenges facing physicians in general are among them.

We’ve also talked about funding issues. Some hospitals, mainly in rural areas, can be officially designated as “critical access hospitals” that receive additional funding to make up for some of the economic challenges they face. But that’s never a certainty and it’s always under assault, in a way, as we talk about things like budget cuts from the federal government.

Private insurance can be expensive and many patients can’t afford the premiums. Further, sometimes private insurance reimbursement for healthcare costs may be delayed, and some things may be denied. These factors can further reduce patient access to care.

If funding changes significantly, some hospitals are forced to close. So, there’s always that concern, especially in rural areas.

There are a few factors that I imagine will have a big impact on the future of medical education and practice.

Artificial intelligence (AI) is chief among them. I don’t know how extensive the impact will be, but I wonder if we might see positions like radiologists — someone who reads x-rays, CT scans, ultrasounds and things like that — get replaced by some sort of AI bot who can read those things automatically. I imagine AI will have an impact on medical education as well.

Medicine is certainly not for everybody. I encourage students to think it through carefully before applying to medical school — it helps if they’ve been able to shadow medical professionals before and get an idea of what the life and workload is like. There are some wonderful advantages to this line of work, but there are also some realities that people need to know about.

That said, I can’t help but be optimistic for both the future of healthcare and the physicians to come. I do think things will get better.

You can absolutely make a difference in people’s lives as a physician. And so, I’m both optimistic and excited about the opening of the [proposed College of Osteopathic Medicine] as a part of the network that will produce the future healthcare professionals who will go on to make those differences in the lives of many.

“When we’re talking about things like Medicaid and billing things to Medicare, we’re seeing drastic impacts. All these changes … are having real, substantial impacts on people and families everywhere. “-Caitlin Raaz, Ph.D.

A Speech/Language Perspective

Quotes from Caitlin Raaz, Ph.D., associate professor of Communication Sciences and Disorders in the College of Natural and Health Sciences.

Speaking for speech pathologists, an issue I hear about time and again is caseload size.

In some school districts, the average number of cases for a speech pathologist at a given time is around 40 — which might seem like a lot. But then you have other districts where people have upwards of 130 cases at a time. That’s just not sustainable.

And it’s a symptom of personnel shortages in many ways. When a speech pathologist in a school district is expected to see 70, 80, 90 kids every week, complete with paperwork and administrative duties, people are more and more likely to burn out. When that happens, the shortages get even worse and the issues just compound.

There’s a huge shortage of speech pathologists everywhere, and many other professionals in the health field for that matter. Rural communities are being hit the hardest by that shortage.

Something like over 75% of Colorado’s rural communities are designated as areas experiencing a healthcare shortage. That means they’re lacking many areas of healthcare.

So what happens is families end up having to drive well out of their way to clinics like the one we have here at UNC because they have no other options – sure, there’s some access to telehealth services, but wanting in-person services is not uncommon. This leads to families on wait lists for care or worse, not receiving care at all.

Another critical issue that isn’t discussed as much is how speech-language pathology professionals, along with those in a lot of other allied health professions, are predominantly white and monolingual. Because our rural communities tend to have a lot of Spanish-speaking families, we aren’t able to provide them the level of care they deserve due to that language barrier.

They say, “those who care about rural health are the people in rural communities.” So we’re trying to train trusted community members to deliver that critical information, as well as to recruit students from those communities who are then much more likely to go back to live and work in these rural areas.

Programs like ours have a very important role to play, especially when it comes to addressing some of the challenges that come from being in a more rural area like Greeley.

If we don’t continue to train students on how to address some of those speech and language issues, then it’s just going to be a waterfall effect, with more and more kids needing help, and fewer and fewer speech pathologists to help them.

In many ways, we have a big responsibility to work with the surrounding rural communities and support them in whatever way we can. So as far as education goes, we’re really trying to work with those communities to get the word out.

That said, we’re seeing a lot of families and a lot of parents who are — right now especially — very hesitant to enroll in state-funded early intervention services or even give information to anyone from a university, because they don’t know who we are or if they should trust us.

So it’s on us to evaluate and figure out how we can be the most helpful and supportive to those communities.

Right now, I feel like everything is a mess.

We’re hearing about Medicaid cuts and an increase of people who aren’t going to be covered, and therefore won’t get any services, as well as people with certain disabilities and certain conditions who won’t be covered either.

It’s frustrating, because a lot of times, it just feels like, “what can we do? How can we help?”

We’re also dealing with a lot of funding issues, especially for rural programs. We’ve had to completely change the way we approach funding applications. The Speech Language Pathology and Audiology Clinic is a no-charge, donation-based clinic, thankfully, so we’re seeing a little leeway there.

But when we’re talking about things like Medicaid and billing things to Medicare, we’re seeing drastic impacts. All these changes to funding and coverage are having real, substantial impacts on people and families everywhere.

Personally, my work focuses on helping children. So when I hear about funding potentially being cut for things like Head Start programs, it really worries me. If we aren’t able to address the health and well-being needs of children at an early age, those problems are going to become much worse and harder to address later on.

Ideally, I would like to see more incentives for people going into these hard-to-fill positions so that we can address some shortages.

In addition to that increased funding, I would like to see more support for school-based speech pathologists to help them figure out how to manage the massive number of caseloads.

At the end of the day, I’m hoping things stop feeling like such a roller coaster and that we can achieve some sense of stability soon.

The thing that gives me the most hope is the students themselves. Even hearing things directly from my students like, “this is what I want to do. I really want to help and this is how I want to do it,” fills me with such hope. There’s a positive future coming at the hands of these young, passionate people.

Topic

Health

College

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