Swing state Colorado mulls universal health care proposal

By KRISTEN WYATT

The Associated Press

Published: November 22, 2015 11:12AM
Updated: November 22, 2015 05:13PM

Denver • A new plan for government-run health care that covers everyone is coming from a surprising corner: Colorado, a politically moderate swing state where Republicans and Democrats often share control of state government.

Universal coverage proposals — known as gsingle-payerh — have failed time and again in the United States. Left-leaning Vermont recently pursued such a system, only to abandon it as too expensive. President Obamafs health care law doesnft cover everyone and has sparked enormous political backlash.

If the idea hasnft worked in states that embrace Canadian-style, government-run health care, what are the chances it will fly in a moderate state that has the nationfs toughest restrictions on raising taxes?

Itfs a long shot, supporters concede. But theyfve gotten the question onto 2016 ballots and hope that dissatisfaction on both sides with the current federal health law will make Colorado the first state to set up universal health care.

gI think we should take a picture of us throwing a bunch of cash down the toilet, because thatfs what we have right now,h said Shelley Cohen of Denver, an advocate who handed out flyers about the plan at a recent meeting in a Denver church fellowship hall. About two dozen people came to hear details.

The plan would work like this: There would be a new, $25 billion-a-year tax taken out of paychecks, similar to how Medicare is funded. That money would then go to an elected board of trustees, which would act as an enormous insurance company and reimburse doctors.

The ColoradoCare tax would raise enough to cover everyone, even people who donft work or arenft legally in the country. Itfs not exactly a gsingle-payerh plan, because Medicare and the military health care system would remain intact. But co-payments and deductibles would go away.

And so would most insurers. A brochure explaining the plan touts, gIt is assumed that residents and Colorado businesses will choose to discontinue purchasing other insurance coverage.h

The campaign projects ColoradoCare would run annual surpluses of $2 billion, based mostly on trimming administrative costs from insurers and doctorsf offices.

Supporters insist voters are so soured on insurance companies and complicated insurance exchanges that they are ready to try a radical new way of providing health care.

gWe will save not millions but billions,h said Jeanne Nicholson, a retired nurse and former Democratic state senator who is touring the state leading workshops on Colorado Care.

Edmund F. Haislmaier, a health policy research fellow at the conservative Heritage Foundation, said hefs skeptical Coloradofs plan will win public support. The price tag is so eye-popping — almost doubling the size of Coloradofs overall budget overnight — that even health-reform fatigue may not carry the campaign, he said.

gYou can write the opposition campaign now. eDo you want your health care to look like the Post Office or DMV?f The average person kind of gets that,h Haislmaier said. gWhen youfre talking about forking over an extra 10 cents a dollar on top of all your taxes, people arenft going to like it.h

Indeed, a recent campaign to raise Colorado income taxes to shore up the statefs struggling public school system lost badly, despite almost universal acceptance that schools are underfunded. The 2013 schools income tax question would have raised taxes $950 million a year, a fraction of the ColoradoCare tax, but failed nearly 2-to-1.

Even supporters of single-payer health care have questions about ColoradoCare.

At the Denver meeting, one physician asked about the elected board of trustees that would set premiums and decide what to pay doctors for their services.

gThis board is absolutely going to control the money, and special interests are going to control the board,h warned Dr. Vince Markovchick, professor emeritus of emergency medicine at the University of Colorado-Denver School of Medicine.

Others asked about abortion services — how could a government-controlled health system pay for them? The question raised the specter of ethical concerns about lots of medical services, from gender transition to fertility treatments to erectile dysfunction medicine. Shouldnft those services be left to the private sector?

Nicholson said that covered services would be determined by the elected board of trustees. She conceded that a board controlled by insurers gcould undermine all our efforts.h

gEven though this is going to be hard and there are going to be challenges, that doesnft mean we shouldnft try,h Nicholson concluded.

ColoradoCare supporters say theyfve learned from Vermontfs mistakes — such as trying to take over Medicare, instead of leaving care for people over 65 to the federal government. And the Colorado backers insist they wonft set brute-force price controls on doctors in order to keep costs manageable, which could drive doctors out of business.

gDoctors are leaving now, because theyfre at the bottom of the food chain with insurers. Doctors who can afford to retire are retiring,h said Democratic Sen. Irene Aguilar, a physician who is ColoradoCarefs chief supporter in the Legislature.

She didnft guess how much it would cost to run a campaign to persuade voters to approve ColoradoCare. Win or lose, the question will be an economic boost, she joked.

gThis will be a great economic driver for our state because of all the opposition money thatfs going to pour into Colorado,h Aguilar said with a grin.


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