A year from now, Colorado voters will decide if they want to adopt a universal health insurance system to replace Obamacare.
The ballot initiative proposes a single-payer system that would take the form of a publicly funded cooperative. Instead of health insurance companies, the co-op would pay for every citizen’s healthcare. And instead of premiums, co-pays, and deductibles, Coloradans would pay more taxes to fund it.
Of course, voters are predictably divided over whether single-payer is the answer to a broken system or the evil creep of socialism.
The grassroots group ColoradoCareYES gathered 158,831 signatures supporting an overhaul of the state’s healthcare system. Last week the secretary of state’s office confirmed the group had surpassed the 90,000 verifiable names needed to put the measure on the November 2016 ballot.
What Supporters Say
Here’s how it would work, according to supporters.
Every resident would have lifelong healthcare coverage. The program would be a cooperative operating in the interest of the residents and would be independent of government agencies and partisan politics.
It would be fiscally responsible and affordable as a coordinated system and is expected to reduce administrative costs. According to the measure’s advocates, health insurance companies spend about 30 cents of every premium dollar on overhead costs; the new system would bring that down to 4 cents.
Citizens would be free to choose their own doctors. The funding would come from a payroll tax, with employers contributing the same way they do to Social Security and FICA.
According to the Kaiser Family Foundation, 11 percent of Coloradans are presently uninsured.
Irene Aguilar, a doctor and a state senator, has been working on the issue for years. An earlier proposal died in the legislature in the face of insurance industry objections. This time ColoradoCareYes has taken the issue out of legislators’ hands and put it directly to voters.
T.R. Reid, author of “The Healing of America,” is a spokesman for ColoradoCareYes who sees the plan as a way to solve several problems. If the initiative passes, it becomes part of the state’s Constitution and therefore is difficult to change or adapt. To Reid, that is one of its selling points.
“We don’t want the legislature anywhere near this,” Reid said in an interview with Healthline.
He cited problems in Vermont, where a similar measure passed, only to be scrapped three years later for lack of funding.
“They [Vermont politicians] larded it up and the price got too high,” Reid said. “Politicians can’t mess around with this.”
He isn’t worried about the tax burden either. “The insurance companies raise their rates at double or triple the rate of inflation,” he said. “We priced this out. We won’t need to raise taxes.”
He sees Colorado as leading the nation toward a system of universal coverage “This should have been done years ago,” he said.
In an opinion piece in the Denver Post, Reid explained how “the new plan will save billions in administrative costs. Private insurers now fritter away 20 percent of premium revenues on paperwork, marketing, salaries, etc. And that’s legal under Obamacare.”
What Opponents Say
As soon as the initiative qualified for the ballot, opponents warned that the proposal could be economically devastating or a nightmare to implement.
“A single-payer system would destroy our industry. I don't think there's any question about it,” Byron McCurdy, board president of the Colorado State Association of Health Underwriters, told the Denver Post.
The insurance industry organization itself, however, has not issued an official statement. According to Tammy Niederman, legislative chair for the organization, a lot of research has to be done first.
In an interview with Healthline, Niederman explained that at this time of year members are busy helping people with open enrollment issues.
She said the initiative would eliminate four programs in Colorado: workers compensation, Medicaid, the Children’s Basic Health program, and the Colorado Health Benefit Exchange.
“We’ve spent a lot to set that [the exchange] up. It’s still in its infancy. The idea that we’d scrap it in favor of a new system leaves me speechless,” Niederman said.
The Colorado Hospital Association has taken no position yet. Neither has the University of Colorado health system.
The Colorado Medical Society does not have a position on this issue yet, but its president, Dr. Mike Volz, issued a preliminary statement late last week. He cited the society’s long history in trying to improve access to healthcare.
“As for support or opposition for ColoradoCareYes by Colorado Medical Society, I think you will see a range of passionate views, not on coverage where are all in general agreement, but rather on the ColoradoCareYes approach as opposed to our current private-public systems of coverage. We will be polling all of our members at some point on this subject.”
The Colorado Association of Commerce & Industry has spoken out against the initiative.
“Amendment 69 would undoubtedly be the most massive, expensive change in Colorado state government in recent decades,” said Dan Pilcher, CACI executive vice president, “and the effects on the Colorado economy would be huge because it would eliminate the entire health insurance industry, costing tens of thousands of private sector jobs, while creating a giant ColoradoCare bureaucracy.”
Citizens Weighing In
While many organizations have not picked sides yet, individuals have no such inhibition.
In a recent issue of the Denver Post, readers spoke up. Diane Merrill of Colorado Springs was one of them.
“Many of the headaches of the current system were brought on by the lack of a single-payer option being included as part of the Affordable Care Act in the first place,” Merrill wrote. “Seems like single-payer (see Medicare) would reduce the complexities of getting affordable coverage and would reduce costs, stress, and confusion for everyone because the insurance companies would no longer be calling the shots and putting profit before patient care.”
Rob Piggott of Denver disagreed.
“Reid says that ColoradoCare won’t ‘fritter away’ revenue on administrative costs, keeping those expenses down to 4 percent,” Piggott wrote. “That lack of administrative expense will curtail the bean counters, which for insurance include the actuaries, underwriters, and adjusters who can give some reasonable measure of risk and protection against fraud. Any form of insurance that cannot accurately measure risk is going to ‘fritter’ itself into oblivion.”