ColoradoCare: You can handle the truth

by Steve Smith

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The current healthcare system has all the hallmarks of an abusive relationship. Well, it’s what we know. Maybe it’ll change. It would be hard to leave.

Consider these symptoms. In most local markets, private hospital providers are able to act as a quasi-monopoly. Absent real market forces, pricing becomes arbitrary, capricious and even whimsical. The uninsured hospital patient is confronted with a bloated sticker price. No visibility. No effective patient bargaining advocate. No explanation. Visa or Master Card?

Private insurance companies then feed from their own monopolistic trough. They price to their own captive market. Their power to negotiate a pricing discount benefits their own bottom line, not the patient. There is zero incentive by them to hold down costs as they are paid on a fixed percentage of the claims they administer.

UnitedHealthcare CEO Stephen Hemsley took home over $62 million in 2014 alone. Shame. That’s far more than friction in the system. That’s strip-mining it.

No wonder many Colorado patients are left naked in the wind. Don’t confuse coverage availability with affordability. Many so-called policies won’t even kick in before a $6,000 deductible. That number might as well be infinity for many patients.

Colorado residents often follow that familiar national pattern: Pray that no medical emergency befalls them, hope to navigate their way through the system, then wait until they finally achieve the eureka moment with the arrival of that Medicare card on their 65th birthday. Facts are facts, and the sad fact is 62 percent of personal bankruptcies are the result of medical expenses. Even more alarming, 78 percent of those had some form of health insurance.

The current health care system is a creature of, by and for the various monied interests. Check it out. Track how the private insurance lobbies worked the Colorado legislature to torpedo a low-cost universal plan. Of course they did. Their very territory was threatened. No lobby for us patients, though. As George Carlin would have said, “It’s a big club and you ain’t in it.”

Maybe it’s time to start a new club. Federal law invites that. Each state is given the opportunity to opt out of the Affordable Care Act (ACA) if it can innovate its own plan that surpasses the goals of the federal system. ColoradoCare aims to do just that. It would establish a true nonprofit co-op to provide a top-grade no-deductible universal healthcare plan for every Colorado resident.

The premium level would be set as a percentage of income. In very general terms that would be 3.33 percent of salary for employees, 6.67 percent salary for the employers, and 10 percent of certain non-exempt income for the self-employed (and non-wage earnings). Weigh that in the context of eliminating your own current all-in (i.e. employer/employee premium, deductible, co-pay) annual cost. As one data point just the premium portion of an average 2015 employer-sponsored PPO plan for an American family of four was $24,671.

Let us welcome a clean debate — clean in the sense it is centered around the interests of the public. Opposition to Amendment 69, which would enable ColoradoCare, will be well-funded, intense and vicious. Consider why. Their special interests — the very ones representing such crushing overhead in today’s system — are threatened.

The referendum this November shall awaken the Beast. The matter goes directly to the people. That’s good. The public would be well served by the ensuing debate. Priorities will be evaluated. Past inertia will be challenged. Truths will be flushed out.
That truth might even lead to Colorado becoming the very model for a bottoms-up national healthcare transformation.

Steve Smith is a Colorado resident on Medicare.

This opinion column does not necessarily reflect the views of Boulder Weekly.

  • Joe Rogers

    One overarching point Steve makes is one of rational pragmatism. Two words, I think, when set together describe Coloradans. We Coloradans have the opportunity in November to pass universal health care built on a system designed by Coloradans for Coloradans. It’s not designed for the insurance companies or large private hospitals or even the physicians. It is not designed for special interests even those special interests who do provide societal value. It is designed for all of us all Coloradans to cover everyone and save us billions.

    The special interests will cry bloody murder but we will be ok. We will be ok because we are a rational pragmatic people. Coloradocare will not be perfect but it will be a hell of a lot better than the current system. When bumps come along the directly elected Coloradocare board will address them rationally and pragmatically and not by special interest profit motives.

    Check out more at coloradocareyes.co

  • Granddaddio

    Excellent article.
    Lets not forget that the Wall street caused the 2008 financial collapse. The same people are managing our health care. Our healthcare is tied to CEO bonuses, stock options, and profit return on investment. Does that sound like healthy healthcare? If yes I got some healthcare credit default swaps to sell ya.
    Lets also be clear. The ColoradoCare tax is a specific and targeted tax that does not go into the general fund. It is not a general tax. Lawmakers do not manage it as they do the general fund. It is specifically set aside for healthcare, nothing else.
    Lets also be clear that in a free-market people know the price as it is disclosed, people shop, and that brings down price. For free markets to work price must be disclosed prior to service.
    I cannot think of a single example of a free market system where price is not disclosed, choices are limited, no one shops, billing is complex, and lacking competitive price disclosure prices far exceed inflation. Free-market?
    Let’s get real about what a free market is. Healthcare is anything but a free market. That is why it cost so darn much.

  • lissmth

    This Dirty Amendment 69 assumes that, somehow, others have the right to command how and where I spend my money. Note to liberals: spend your own money and leave mine alone.

    • Elijah Bleue

      How much is the insurance lobbying paying you? How’s it feel to f**k your fellow man in the a** for profit? Kind of like prostitution, isn’t it.

  • Mshakem

    If this passes seniors will pay 10% of Social Security and 10% of any other income. For example, $40K a year would equal $4000 tax for Amendment 69.

    Self-employed and small businesses pay full 10%. This is NOT an incentive for business growth.

    If you have an IRA, or any other income you claim in a tax year, you can pay 10% of that too.

    Seniors would pay for Medicare as they are paying now, since the proponents of this amendment like to say “there will be no changes to Medicare”. What this really means is that seniors will still pay for Medicare part B ($121 month taken from Social Security) AND the new 10% tax to fund this amendment.

    Right now, many seniors pay $0 a month for a Medicare Advantage plan. That’s $0 a year. With “Amendment 69”, they would pay $4000 a year whether they use the healthcare or not (based on $40K year income).

    Proponents like to say “you can still keep the private insurance you have now…” What they don’t say is that you would be paying 2 times. Once for amendment 69 and again if you want private insurance. Not many can afford to do that, which is probably what the authors of this amendment want anyway.

    Many would pay much more to keep comparable coverage that they have now. And “comparable coverage” is debatable, because we don’t know how Amendment 69 plans will work in reality, because no other state has anything like it. Vermont (I believe) was going to try it, but their governor found it unaffordable.

    And European countries are NOT the healthcare mecca so many amendment 69 supporters make them out to be. They have many problems and taxes go up there not down.

    Do you really think the $25 billion for the 1st year will be enough to keep funding this? Just look at any government program to see which ones have gone down in funding requirements.

    The people who will benefit will be those who don’t work, are in the U.S. illegally and those who come to Colorado because they can get free healthcare, even if they don’t have a job. I don’t mind helping others who are less fortunate, but I don’t like being forced to do something. If I want to give to charity or someone in need, I am more likely to do so if I have enough money to do so, instead of being forced to pay for something I don’t believe in.

    This ColoradoCare is an amendment to the Colorado constitution. If, God forbid, it does pass and then turn out to be a disaster, it will be a nightmare to try to remove it from the Colorado constitution.

    I understand if you don’t like Obamacare, but you should be very skeptical of this as an alternative. We need a change in healthcare, but this is not the answer.

    • Joe Rogers

      Your off. Retirement income is excluded for the first 33,000 for individual and 64,000 for a couple. In your example the person would only be taxed 10% of the 10,000 or $83 a month.

      This is a fact. Your use of data to confuse and deceive is unfortunate and hurts the public discourse.

      For the rest of Coloradans don’t believe us check out coloradocareyes.co for more info

      • Colorado Care Yes is full of deceit. Retired people who have earned Medicare by paying into the system for their entire working lives should be totally exempt from paying for this nightmare. Amendment 69 is an elaborate ruse by which the salaried employee class enriches itself on the backs of the self-employed and retirees with 401(k)s who have saved and invested for decades.

    • Elijah Bleue

      Someone’s been reading the insurance company lobbies talking points.

      And, he’s wrong and lying about the numbers. Pitiful.

  • dogbert

    Premiums set as a percentage of income? Guess that means I save money by not working or by working less. Brilliant idea! Before you go down this road, give a call to the folks in Vermont.

  • EvanRavitz

    Irene Aguilar, who is behind the Colorado Cares ballot initiative, shared this important fact with me:

    http://www.newyorker.com/magazine/2011/01/24/the-hot-spotters#ixzz2JV2YCA4n

    “Two decades ago, for instance, Denmark had more than 150 hospitals for its 5 million people. The country then made changes to strengthen the quality and availabilityary-care services (including payments to encourage physicians to provide e-mail access, off-hours consultation, and nurse managers for complex care). Today, the number of hospitals has shrunk to 71. Within five years, fewer than 40 are expected to be required.”

    We don’t have real Health Care in America, only illness and accident exploitation. So many things doctors and hospitals do to us make us worse, because they consider us profit centers not people.

    • In reality Denmark has replaced hospitals with poorly-staffed and -equipped clinics to cut costs by reducing quality of care. Irene Aguilar should do some research instead of spouting magazine articles.

      • Yortuk Festrunk

        I have a Danish coworker who’s father had a stroke in Denmark. He said that an MD came on the ambulance.

        • There is exactly one ambulance in Denmark with a doctor on board, and it’s in Copenhagen. In general, Danish ambulances are manned by police and fire fighter, as is the case in the US. Here’s the actual research: http://www.ncbi.nlm.nih.gov/pubmed/8455978

          • Yortuk Festrunk

            Ummmm, your citation is from 1993. Do you have something a little more up-to-date LOL?

          • I’ve given you my citation, so now it’s your turn to show me yours.

          • Yortuk Festrunk

            My citation is the anecdote from my Danish friend, who says that that is the norm in Denmark. He is a credible and sober individual, without an agenda.

          • Anecdote vs. peer-reviewed scientific paper. One is 23 years old, but likely to be true when written. The other may be made up and has already been exaggerated by the storyteller.

          • Yesterday a story was circulated around the Internet to the effect that Denmark is set to ban all food that’s not organic certified. It made several blogs and a number of Facebook pages including some run by the Bernie crowd. The story is blatantly false as well as outdated. I don’t believe much of what I read on the Internet unless it’s supported by a reliable source.

  • MarieT123

    As long as the funding source is income, this is a bad idea. Make it a consumption tax and then I’ll consider it. Too many slackers around here who refuse to work or refuse to work full time because then they lose their bennies.

    Like that yoga instructor with the ski son who lives in subsidized housing because she refuses to work full time.

    I do not want to support any more slackers.

    Everybody has to pay or no deal.

    • ernie_oertle

      commenter `Elijah Blerp’ above: How much is the insurance lobbying paying you? How’s it feel to f**k
      your fellow man in the a** for profit? Kind of like prostitution, isn’t
      it.

  • A 10% additional income tax on self-employed people to cover the healthcare costs of salaried employees is unjust. This self-employment tax will hit everyone from investors to Uber drivers and others just getting by in the gig economy, The amendment reads like it was written in crayon by school children. If this monstrosity passes self employed workers will leave the state and so will competent doctors, leaving salaried employees at the mercy of naturopaths and other quack medicine practitioners. My tarot cards say it’s an unfair deal.

  • Joel Faltermeier

    Seems too good to be true – I currently pay over 15% of my GROSS income to healthcare for my family PLUS my employer contributes 15% of my gross. Under the current system that is 30% of my GROSS going to healthcare, and that doesn’t include vision or dental. This proposal says I would only pay 3.33%, and my employer 6.67%? A reduction of 12% for me, plus 8% for my employer (20% total)?

    Sounds wonderful, but too good to be true. How much are the co-pays going to be for non primary/preventative care items? What will be the “maximum out of pocket”? How can we know as voters that this is going to be a good deal when these extremely important factors are not mentioned?

    Let’s assume the maximum out of pocket follows the ACA guidelines, and is about $14,000 for a family. Using this scenario and including the 3.33% cost, assuming my family has a terrible year and reaches this amount, our expenses would far exceed cost of our current plan. How can this amendment be proposed without any specifics on what copays will be, what maximum out o pockets will be, and what the “continued increases” can or will be when they find out there isn’t enough money coming in to pay for this plan?

    I’m all for a feasible plan that will reduce healthcare costs ands provide equal or better service. Paying 30% of gross income in total for healthcare that is barely used is ridiculous, and it only keeps getting costlier. However, it seems completely reasonable to want to understand and know more details on this plan and how much it will really cost, and how it was determined to be feasible to sustain. Or does this follow the same idea of “we have to pass the bill so that you can find out what’s in it”?