Colorado may become the first state to establish a universal health care system in the U.S. In July, the Secretary of State certified a proposed initiative for the 2016 ballot that would create a universal cooperative plan called ColoradoCare. They have to collect 99,000 valid signatures by October 16 (they are planning to get 120,000).
This is the project of the Colorado Foundation for Universal Health Care and its campaign arm, ColoradoCareYES.
The board chair of the foundation, Denver journalist and filmmaker T.R. Reid, has traveled the world and compared the “crazy quilt” U.S. health care system with those of other developed countries in three films for PBS and a best-selling book, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care.
Reid says: “All of the world’s industrial democracies provide highquality health care for everybody — all of them, that is, except the world’s richest country, the USA. Obamacare has significantly expanded coverage — but it falls well short of the goal. If Obamacare works perfectly, according to the Congressional Budget Office, it will still leave 31 million people uninsured in 2020 — including some 400,000 in Colorado.”
The ColoradoCare plan is based upon a proposal by State Senator and physician Dr. Irene Aguilar. She was prompted to work towards a state-wide initiative after hearing numerous complaints about the Affordable Care Act (ACA or Obamacare). She says that under the ACA, premiums are too high, some people can’t afford health insurance even with the subsidies and copays, co-insurance and deductibles can be prohibitive for people with chronic diseases.
Under ACA, insurance companies are creating “narrow networks” of doctors to limit patient choice. Under ColoradoCare, you could go to any doctor, hospital, chiropractor, physical therapist (etc.). The patient will choose the doctor and hospital, not an insurance company.
The private, for-profit insurance industry would no longer be a middle man. That would save an enormous amount of money. Our current multipayer non-system with 400-plus insurers is incredibly wasteful. The Institute of Medicine estimates that on a national basis, 27 percent of health care expenditures ($765 billion in 2012) are unnecessary and avoidable. Private health insurers spend billions on paperwork, bright and shiny marketing, stupendous executive salaries, etc. A recent study showed that between 1970 and 2010, the number of U.S. physicians has increased about 200 percent while the number of administrators has increased about 3,300 percent. Administrative complexity continues to grow with the private insurance-based ACA.
A study of the ColoradoCare plan by economist Gerald Friedman of the University of Massachusetts at Amherst concluded that ColoradoCare would decrease the total cost of health care by $4.4 billion by eliminating administrative waste.
Under ColoradoCare, all billing from health care providers would go directly to ColoradoCare and it would be paid for through a tax. Employees would contribute 3.33 percent of gross income and employers would contribute 6.67 percent of payroll. There would be no premiums, no deductibles. There would be no co-pays for most preventive and primary care, and those co-pays would be waived if they cause financial hardship.
It would be cheaper for employers as well as employees. Reid says currently, employees spend 6 to 10 percent of gross income on health care and businesses (according to the U.S. Chamber of Commerce) pay 10 percent of payroll.
ColoradoCare would operate using the cooperative business model. It would be owned by and accountable to the residents of Colorado. An elected Board of Trustees would hire and oversee the professional staff. The board would have 21 elected representatives from seven districts in the state. While it would be a political subdivision of the state, it wouldn’t fall under the legislature, governor or any administrative department or agency.
There are many cooperatives in the United States such as credit unions (which, as a group, topped one trillion dollars in assets in 2012), Recreational Equipment, Inc. or REI (with 17 million members), Group Health Cooperative in Seattle (a large insurer and health care provider since 1947), the winning Green Bay Packers football team (owned by the residents of Green Bay), and Rural Electric Cooperatives (which increased the number of rural homes with electricity from 10 percent in the 1930s to 90 percent in the 1950s).
Every Coloradan would have comprehensive health care — including mental health and some vision and dental — at all times without any exceptions.
ColoradoCare is possible due to the “state opt-out” Section 1332 clause of ACA which allows a state to create its own system if it is as good as the ACA. That will be easy.
We were ahead of every other state when we legalized marijuana. Let’s do the same with universal health care and join the civilized world.Find out more at www.ColoradoCareYES.co.
This opinion column does not necessarily reflect the views of Boulder Weekly.