The Final Four
Just as we learn that health insurance premiums in Colorado have increased by 11% for the third straight year (followed by a 22% increase in 2002), the blue ribbon commission has narrowed down it’s options to four proposals. What are they aiming for? I would say the most important factor, even above efficiency, is a plan that is moderate and politically viable.
In order of their proposal number, the final four selections are…
Better Health Care for Colorado, from the Service Employees International Union (proposal #2). This plan puts a cap on premiums for people who don’t make a certain amount of money. It then creates a high-risk insurance pool to lower the premiums of people who might be uninsurable because of pre-existing health conditions. This ensures a more complex system of health insurance premiums based on income with various amounts of subsidisation.
Solutions for a Healthy Colorado (proposal #5), from the Colorado State Association of Health Underwriters. This proposal would require all Coloradoans to have health insurance, it would increase Medicaid reimbursement rates, and have a “Core Benefit Plan” that all carriers would offer with guarantee issue and modified community rating. This is the plan I support because it has the best mix of efficiency and political reality built into it.
A Plan for Covering Coloradans (proposal #12), from the Committee for Colorado Health Solutions. This plan requires all Colorado residents to have health insurance, it will require employers to contribute to employee coverage or else pay a “reasonable assessment”. Then it would create a purchasing pool that will replace existing individual, small-group and large-group markets. There would be subsidies for all Coloradans at or below 400 percent of poverty level.
Colorado Health Services Program (proposal #16), from the Health Care for All Colorado Coalition. This plan creates a single, publicly funded program for the financing, deliver and administration of health care. The program will govern and administer the program like a public utility, and establish a health trust insulated from the general state budget.
When the 24 members voted on their favorite plans, proposal #12 got the most votes and is thought to be the most “moderate” proposal of the original 31. It’s likely that the final plan won’t be one of these exact plans though. The members may take some of the best points of each plan and combine them into a “Super Health Plan for Colorado”.
Well, this is all very interesting, but it seems to me that each of the “final 4″ proposals only suggest ways that the State can pay for the cost of health care – none of them makes a practical recommendation that would reduce the cost of health care. IMO, that is a losing strategy.
Health insurance premiums are high because the cost of health care is high. Health insurance premiums are rising because the cost of health care is rising. The solution to health care cost problems will not – not – be found in some insurance scheme. I think the thought leaders in our country are behaving rather like the fellow looking for his lost watch under the street lamp, where there is light, instead of over there, in the dark, where he felt it slip from his wrist. OK, the health care cost problem is immensely difficult, and so people avoid facing it. However, it does not go away when it is ignored, as the experience of the past 40+ years amply illustrates.
It seems to me that the ideas that have reached the “finals” will have the principal effect of pouring more money, thru the insurance pipeline, into a broken system that has proved that it cannot control its own costs. I think this can have only be one result – still higher costs.
Well spoken, and true. However, I think proposal #5 focuses on the goal of covering the uninsured the best. “Most” of those uninsured don’t have coverage because they don’t make enough money or because they have pre-existing conditions that prevent them from getting individual coverage and can’t afford guaranteed issue coverage.
They’re getting subsidized already. This program will just make it a more efficient way of doing it, through tax dollars that everyone pays instead of shifting costs to only those that have insurance.
As for the problem of people making enough money to afford health insurance but still not having it, now they’re required to have it.
Aug 7th, 2007 at 6:58 pm
[...] after the State of Colorado contracted with Lewin Group to review the 208 commissions proposals on the future of health care in Colorado, Lewin Group was bought out by United Health Group (UHG). UHG is the largest provider of [...]