Colorado HB 1273 And Single Payer Health Insurance
Colorado House Bill 1273, the Colorado Guaranteed Health Care Act, is scheduled for a hearing in the Business Affairs and Labor Committee on Wednesday. The bill, sponsored by Rep. John Kefalas, a Democrat from Fort Collins, is expected to meet with quite a bit of resistance, and may not get past the committee hearing this week. It calls for sweeping reform and would be an expensive endeavor in a year of tight budgets. There are lots of ideas for health care reform in Colorado right now. HB 1273 proposes to cover all Coloradans. This is in contrast to HB 1293, introduced last month, which would expand current state programs to offer health insurance to at least 100,000 currently uninsured Coloradans.
In reading through the text of HB 1273, I’m curious as to why the bill aims to establish single payer health insurance, but also maintain separation from the Colorado government. The bill proposes creating a “Colorado Health Care Authority” that would be a
body corporate and a political subdivision of the state, that shall not be an agency of state government, and that shall not be subject to administrative direction or control by any department, commission, board, bureau, or agency of the state.
I can see the validity of both sides of the prevailing arguments about health care reform. Maintaining private health insurance on one side, and single-payer, government run health care on the other side. But I can’t see the logistics of a program that aims to provide universal health care to everyone in Colorado, in a single-payer system, without government involvement. Perhaps HB 1273 is trying to address the concerns that people have when “government-run health care” is mentioned. I think that the public fears about government involvement in health care have diminished over the years, but there is still a widespread distrust of having the government actively running our health care delivery system. And by having the Colorado Health Care Authority be a separate entity from the Colorado government, perhaps it would appeal to more people. But I think it’s going to come up against the cold hard reality of finances. Without government administration, either on a state or federal level, I don’t think that any sort of single payer health care system can be successful. We can either have private health insurance (with government regulation but private administration), or we can have single-payer health insurance (like Medicare and Medicaid), but single payer health insurance without government administration seems like having one’s cake and eating it too.
I’m glad to see that the Colorado legislature is addressing health care reform. House bills 1273 and 1293 both generate discussion about what we can do to provide health insurance to the 800,000 people in Colorado who are without health insurance. I’m curious to see what the Committee response is to HB 1273 this week. I’m doubtful that it will get much traction in its current form, but perhaps it will add to the dialog that is going on at the capital, and ideas will be generated that will lead to solutions for uninsured Coloradans.
For more information on HB09-1273, please see http://healthcareforallcolorado.org/?p=60
The aim is to provide health care for everyone–not health insurance. That’s an important distinction. We believe–and the Lewin analysis of the 2008 Commission proposals showed–that there is more than enough money spent on health care in the state right now to cover every Coloradan. However, we need to spend it differently.
With regard to the issue that Louise raises about the involvement of the government, the simple idea is that many would prefer not to have the government running our health care system. We envision a public nonprofit or something like that running the authority. We’d like to have smart health care providers and business people–experts–design the system.
Please note that the plan that will develop under HB1273 has to come back to the legislature for approval, so if it seems like the plan is not fully formed at this point in time, that’s because it’s not.
Finally, for an important endorsement of the bill by a business newspaper, see: http://www.ncbr.com/article.asp?id=97568
Cheers,
Tom Russell
Vice President, Health Care for All Colorado
trussell@healthcareforallcolorado.org
It is time for a change in the health care industry. Too many people are living without health insurance and and going into debt trying to pay off past medical bills. We shouldn’t be thinking about how much money seeing a doctor is going to costand instead think about getting better.
The bill as written is nothing more than a de-facto takeover of the delivery of all health care provided to Colorado residents and is probably designed as it is in an attempt to get around TABOR. There is no language that allows for self-insuring, based on my brief review. And, as far as the government not running it, all of the directors would be appointed by the legislature, and funding would be a public / quasi-public arrangement. It is a single payor system which will lead to either ballooning costs, the rationing of healthcare, and/or the establish of premiums and costs that will offer no savings and exorbitant and uncompetitive cost increases in the future. This is a boondoggle that only Democrats would sign on to. This is no solution – it’s a politically inspired “blank check” to redistribute income, and it won’t work.
The comment regarding people going into debt to pay for health care expenses is simplistic. I’ve been benefits professional for almost 20 years and have never seen this happen. First of all, most people in that situation don’t have any insurance to start with, and secondly, many people don’t have even a month’s gross wages in savings – so naturally they end up in debt to pay out-of-pocket expenses. I’ve seen dozens of highly expensive illnesses, many which ended in death, and I’ve never once had this scenario occur. It is, generally, a canard and it’s used to scare people. I’m notifying my clients to contact their representatives about this – people still do not want the government, even in this guise, involved in the delivery and complete financing of health care.
Of course people go into huge debt to pay co-insurance. I got cancer when I was 42, 14 years ago. I had savings-spent to pay co-pays on surgery. I had a 401K-spent to pay co-pays on chemo therapy. My husband had a 401K-spent to pay premiums, co-pays on chemo and food, when both of us lost our jobs in 2001. Equity in our house-borrowed against to pay for co-insurance on chemo ($5,000 per year, every year since 2001) credit card debt, again, money to go toward premiums and co-insurance.
in 1995, when first dx with cancer, our net worth, -15,000.
now, age 56 and 54, our net worth is -107,000 We live in a 800 sq. ft. home.
The government has no money, only that that we provide. How do you plan to pay for this so called free insurance. We already have free health provided by emergancy rooms. If you are in prison you get free health, if you are an addict you get free health, if you have HIV, you get free health, currently in Colorado if you have an income less then $30,000 you can get free health. Are you trying to make us a Communist Country?
We do not need more free stuff, or did you not know that there is no free lunch, someone is paying for it. US THE TAX PAYER.
Anita Hathaway, Denver , Colorado 80237
I have submitted my thoughts on this FREE HEALTH BILL #1273
Nothing is free, it will cost the tax payer, over what we are paying now for the FREE HEALTH we now provide. Please, we do not need nay more FREE stuff. Why can’t the representatives that were elected to represent the tax payer are now turning on the people that pay there wage?
Anita Hathaway Denver, Co. 80237
Ms. Hathaway,
No one has said that this is a free health bill. That is an error or misconception on your part.
You are correct, though, that we already pay for health care for people who are uninsured or underinsured through a variety of cost-shifting mechanisms.
If HB1273 passes and a health care system is created, then instead of paying a health insurance premium, you would still make a payment into the system. But, because the overhead would be lower, payments would likely be lower in a new system than in the existing one.
You would save money.
But again, the system would be not be free. I am not sure where that idea comes from.
Tom Russell
Tom:
Would the payments into the system be used for other state expenses, or would there be a “lock box” into which these payments would stay?
Don Levit
Don,
You betcha. That’s part of the reason that we don’t want this to be government-run. The Authority would set up a trust fund into which health care money would go. If the system is run as an entity separate from the state–a public nonprofit, perhaps–then the state could not raid health care funds in order to pay for various other projects. That’s a key component of the whole idea. Thanks for asking about it.
Tom Russell
There is no language that allows for self-insuring, based on my brief review. And, as far as the government not running it, all of the directors would be appointed by the legislature, and funding would be a public / quasi-public arrangement.
Hi Tom…
Can you please shed a little more light on how this new entity will provide lower costs than our current private system?
You mention “overhead” being lower, but I assume the entity will still be making an attempt to keep quality high, which would mean hiring good employees and investing in decent facilities. Typically, a new entity like this would be expected to have higher overhead, than a company that has been around for years working at becoming more efficient, in order to compete and stay in business. I know with my own provider, if they don’t stay competitive from year to year, as well as providing good service, I look at taking my business elsewhere. That’s a pretty powerful incentive for them to keep looking for ways to reduce their overhead. Do you think a non-profit start-up will really have that same incentive and ability? It’ll be a first.
So… I can only imagine that maybe you’re referring to lower costs based on forfeited profits (which is not technically “overhead”). But, since profits generally represent a return on investment to obtain financing, and I assume this new entity will need to be financed, who is expected to make that financing risk with no return? The taxpayer? Because I feel like our govt has been forcing us to invest in companies with no return quite a bit lately. And that IS absolutely a cost to the taxpayer, if that is the intention.
And in any case, even if savings from eliminating slim profit margins is what you’re offering, I have doubts that those will constitute enough of a price drop to convince many of the uninsured to start paying for their healthcare. Pull up any healthcare company stock on yahoo finance and check their last income statement. Humana (the 1st one I pull up) shows $29 billion in revenue, and profits of only $650 million… about 2%. No one is going to decide to start paying for healthcare based on 2% savings on their premium. Especially considering the likelihood that that 2% will probably be more than offset by higher costs of inefficiency, since they are a start-up, non-profit, govt sponsored/formed entity.
Unless there is some other easy overhead reduction that this new entity is aware of, that private industry hasn’t been able to find over years of searching for how to make more money, the only way I can see for this to be “cheaper” would be to subsidize the business with govt funds. Hence the recurring concern about cost to the taxpayer. And the recurring statement that “nothing is free.”
What am I missing?
Please explain to us where this significant savings comes from.
Thanks,
Todd
Tom…
I’d really like to hear a response on my above concerns. Which continue to grow in regards to this bill.
I’ve continued to research and found info regarding payments to this system planned on a “progressive sliding scale”. That really disturbs me. I can only assume that savings for some will be generated from higher payments from others. I’d be curious to see how those numbers pencil out. For those of us in the middle income range, that currently pay going market rates for our insurance (and are content to accept that cost for the benefit we receive), I can only assume we will be forced to leave our insurance companies and end up with this single-payer” system… and most likely be PAYING MORE, since we will be covering much of the cost of the currently uninsured. Since they would otherwise continue to keep opting out if they don’t get much cheaper pricing. How else can this math work?
I’ve hear that donations and grants may help…. but do any of us really believe those will be sufficient? Especially now that the President is attempting to reduce deductions on charitable donations.
It really scares me that no one has truly worked the math on this, since the math doesn’t seem to add up. I mean… can we really expect to pay for an additional 100,000 insurance customers, while keeping our rates as low as current, with no taxpayer subsidies? Based on what? The efficiency of this new govt mandated program? How often do we see that sort of efficiency from govt?
I’m afraid this bill hasn’t been thought through enough… and your above comment:
“Please note that the plan that will develop under HB1273 has to come back to the legislature for approval, so if it seems like the plan is not fully formed at this point in time, that’s because it’s not.”
doesn’t make me feel any better. Why attempt to pass anything before it’s been fully thought out. Please do us citizens this favor. We deserve to have all details considered before being passed into law.
We look forward to your response.
Thanks,
Todd