By Sarah Elmquist Squires

Managing Editor

Better Wyoming’s Nate Martin shared some of the region’s top concerns about health care. Photos by Sarah Elmquist Squires

Cancer, rheumatoid arthritis – even having a baby – in Wyoming means you’re likely to have to spend some serious time in the car, driving to the nearest provider for care. And, if you’re lucky enough to survive the ailment that required many trips across state lines for treatment, you may dread peeking into your mailbox; daunting bills, collectors, threats of garnished wages can await. 

Health care in Fremont County is the most expensive in the state, representatives from Better Wyoming told a roomful of residents last week. And Wyoming is considered the most expensive state in the nation when insurance premiums are measured. 

The dilemma of increased costs and a lack of providers prompted Better Wyoming organizers to launch an informal survey in recent weeks, along with community panels in Cheyenne, Lander, and one coming in Casper, to gauge residents’ ideas about the most pressing problems in the state when it comes to health care. Several dozen interested community members gathered at the Lander Library last week to whittle down a laundry list of concerns, which will later be submitted to state legislators as areas they should work to improve. 

“I continue to grow in my concern about how we survive in the future,” commented Fremont County Commissioner Mike Jones, who recalled a friend who had to drive into Teton County to deliver her baby. “Were in a serious, serious situation in Fremont County.” 

Better Wyoming Statewide Community Organizer Bella Pope (left) and field worker Dakota Metzger led discussions Thursday. 

Attendees worked through a list of queries in small groups to come up with their top concerns about health care in Fremont County, ranging from the high cost of privatized medical care to the lack of maternal care and specialists. Many raised the issue of too few resources for mental health care and substance abuse treatment as particularly dire. That issue – mental health and substance abuse care – rose to the surface as one of the top three issues for the work group, alongside a lack of maternity care and overall affordability of health care in Fremont County. 


About 400 people responded to the Better Wyoming survey, which was circulated on Facebook and generally attracted respondents over 40 years old. Fremont County residents were nearly a quarter of those who filled out the survey, showing a high level of interest in this part of the state in improving health care. 

“We are very accustomed to traveling four-plus hours to find specialists,” one respondent said. “Radiology is unaffordable, we only have one OB/GYN, no inpatient mental health care, and juveniles have to wait six to 12 weeks for substance abuse assessments,” wrote another. 

Just under half of Fremont County respondents said their main concern was a lack of providers in the area, and a quarter pointed to mental health care as their number one issue. Twenty-eight percent said uninsured people are the biggest issue in Wyoming; 23% said rural hospitals were their big concern, and 19% said affordability was the state’s most pressing problem. 

Local voices

“Health is foundational to academic achievement,” Sergio Maldonado Sr. said, explaining that if medical needs are not met early in life, it will have negative consequences for kids lifelong. A number of other health issues impact tribal members at a higher rate, as well, he added. “Diabetes, obesity, lack of general health – those have to be addressed,” he said. “This is a generational dilemma.” 

People are grateful for the resources we do have in Fremont County, but without follow-up care like physical therapy, counseling, and mental health care, many patients feel as though they’re on their own after being discharged from the hospital, explained Debby Thomas. “It’s like you’re alive, but you’re never going to get any better than the day you’re discharged,” she noted. 

Many people pointed to for-profit medical providers as both more expensive, and less likely to provide specialty care in rural areas. “Part of it is that the whole system is not working,” one Fremont County resident shared. Comparing health care in the U.S. to countries with national coverage, “They do have problems, but they put a value on health a lot more than we do in this country … Big pharma and insurance companies have made it so we can’t get [services] because it’s not profitable.” 

When the group was asked to vote to narrow down the list of health care concerns, mental health care and substance abuse treatment rose to the top for many. 

Many people are hesitant to seek help because they don’t want others to know they are struggling with a stigmatized problem, Maldonado shared. “Systems must ensure that total privacy is maintained … That is a huge problem out on the reservation – to the detriment of the community,” he said.

Up next for Better Wyoming is a statewide Zoom meeting on October 5 at 5:30 p.m., when representatives from around the state will share their areas’ biggest concerns with state lawmakers. Check in with our Community Calendar if you’d like to join in.