A common front is needed for single-payer insurance advocates
Even as the Colorado Legislature works to put the final touches on the Colorado Insurance Exchanges required by Obamacare, critics are pushing on two fronts for a single-payer system, instead.
Sen. Irene Aguilar, D-Denver, has introduced a bill to create a Colorado Health Care Cooperative to provide a single-payer system instead of the exchanges established under Obamacare.
Meantime, Health Care for All Colorado, is reviving its effort from 2008 to build grass-roots support for a ballot initiative supporting single-payer medical insurance.
A single-payer system is “characterized by universal and comprehensive coverage. Single-payer health care is similar to the health services provided by Medicare in the U.S. The government pays for care that is delivered in the private ... sector. Doctors are in private practice and are paid on a fee-for-service basis from government funds,” according to Medicine.net. Unlike socialized medicine, under a single-payer system, the government neither owns nor manages medical practices or hospitals, which remain private.
Aguilar’s bill cleared the Senate Health and Human Services Committee last Friday. It calls for the Legislature to put a measure on the ballot allowing voters to choose a single-payer system. It would not become effective until 2016.
Although these two single-payer advocates disagree on tactics, they see the need for a more comprehensive plan than the state is offering.
As critics have pointed out, although the Colorado Insurance Exchanges developed under Obamacare will be an improvement over the present dysfunctional medical insurance system, they will not cover all residents of the state.
As Nathan Wilkes told the Denver Post, “the exchange will direct federal subsidies to individuals and small groups, but ... there’s still a long way to go” to cover gaps.
“Many of the new insurance plans sold under the exchange will reflect the private trend of sky-high deductibles and large co-pays for consumers,” Wilkes added. The 31 cents of each health care dollar in the private insurance market that goes for overhead could be saved, he argued.
Wilkes makes a persuasive case because he has a foot in each camp. He serves on the board of directors of the Colorado Insurance Exchanges, while also working with HCAC on an initiative to gather signatures to take the single-payer issue directly to the voters.
“Access to health care is a human right, it’s not something that should be bought and sold as a commodity,” said Donna Smith, executive director of Health Care for All Colorado.
Under the system proposed by HCAC, employees would pay into a trust fund based on income and net worth. Federal funds for Medicare and Medicaid also would go into the fund, contributing billions of dollars annually. All health care payments would come from a single Colorado trust fund.
Aguilar’s bill would establish a non-profit “cooperative” to which employees would contribute three percent of their salary and employers would contribute six percent. It would also add a nine percent income tax increase.
The cooperative would collect premiums, administer benefits and pay providers for health care services as insurance companies do.
It is hard to say which bill has the harder way to go to make the ballot. Aguilar’s bill must get a super-majority in both houses, then win the state referendum to become law.
Just to petition on to the ballot, HCAC would need to collect at least 86,000 valid signatures, requiring at least 100,000 to allow a margin of safety. Without very substantial resources, this is a difficult goal to achieve.
While Sen. Aguilar and the HCAC activists seem to be competing against each other to achieve very similar ends, conservatives are busily doing their work of undermining support for single-payer insurance.
The Denver Post quoted libertarian Independence Institute’s health care analyst Linda Gorman, who claims single-payer systems are “are unbelievably expensive for what you get.”
She also said, “They eliminate treatment and physician choice, make everyone wait for care, degrade the infrastructure needed to diagnose and cure disease and result in widespread denial of care to those who are seriously ill.”
Although these charges have been exposed as untrue repeatedly, they continue to be repeated.
To respond effectively, single-payer advocates should bridge their internal divide and present a common front against conservative-supported, profit-driven health care in Colorado.