U.S. Senate
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(D) J. Hickenlooper*
(R) Somebody
80%
20%
Governor
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(D) Michael Bennet
(D) Phil Weiser
60%↑
50%↓
Att. General
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(D) M. Dougherty
(D) Jena Griswold
(D) David Seligman
40%
40%
30%
Sec. of State
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(D) A. Gonzalez
(D) J. Danielson
(R) Sheri Davis
50%
40%
30%
State Treasurer
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(D) Brianna Titone
(D) Jeff Bridges
(R) Kevin Grantham
40%
40%
30%
CO-01 (Denver)
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(D) Diana DeGette*
(R) Somebody
90%
2%
CO-02 (Boulder-ish)
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(D) Joe Neguse*
(R) Somebody
90%
2%
CO-03 (West & Southern CO)
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(R) Jeff Hurd*
(D) Somebody
80%
40%
CO-04 (Northeast-ish Colorado)
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(R) Lauren Boebert*
(D) Trisha Calvarese
(D) Eileen Laubacher
90%
20%
20%
CO-05 (Colorado Springs)
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(R) Jeff Crank*
(D) Somebody
80%
20%
CO-06 (Aurora)
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(D) Jason Crow*
(R) Somebody
90%
10%
CO-07 (Jefferson County)
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(D) B. Pettersen*
(R) Somebody
90%
10%
CO-08 (Northern Colo.)
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(R) Gabe Evans*
(D) Manny Rutinel
(D) Yadira Caraveo
45%↓
40%↑
30%
State Senate Majority
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DEMOCRATS
REPUBLICANS
80%
20%
State House Majority
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DEMOCRATS
REPUBLICANS
95%
5%
March 31, 2008 07:20 PM UTC
47 Comments
The Ritter “Colorado Promise” has only delivered a patchwork of fee increases to avoid the voters.
Michael Scott is an armchair critic who doesn’t have a clue about what’s really going on.
How easily you forget that Ritter has made health care reform possible, something the R’s stone walled for years. His office has been working with the Democrats and Republicans in the legislature to craft good health care reform policy for Coloradans taking into consideration the findings from the 208 Health Care Commission, which will be signed into law by Ritter.
Just last week, Senator Hagedorn (D), Sen. Penry (R), Senator Johnson (R), Rep. Massey (R), Rep. McGihon (D) and Rep. Roberts (R), in response to the Blue Ribbon Health Care commission recommendations, introduced the “Centennial Care Choices,” plan.
So, in our system, the legislature crafts the laws and the Executive Branch signs them into law. See how that works?
Oh Michael, why don’t you find a good cause like combatting rabbies to occupy your time since represenative government seems to be too much for you to comprehend
The increase in premiums is in large part fueled by escalating healthcare costs. What does Rep. Carroll want state regulators to do-play King Canute and demand that those costs simply roll themselves back? The increases are not simply part of a vast healthcare conspiracy among insurers, doctors, hospitals, and HMO’s/PPO’s, but are driven by, among other things, the increasing sophistication/cost of even routine treatments, the aging of the population, the indifference of large segments of our population to exercise/healthy eating, and to our shared national belief that we’re all entitled to triple-A quality healthcare, even if we can’t afford it.
We need reform-but I’d guess that we’ll never get the single-payer national system that would both reduce overall system costs and cover the presently uninsured. We’ll just muddle along with piecemeal measures, some of which will have no effect, some of which will help, and some of which will just further screw up and already screwed-up system.
I’d guess that Rep. Carroll’s proposal will fall into the third category.
First, no one is arguing that insurers are the only problem. Our health care system is complex and many factors are contributing to spiraling costs.
Second, you are correct about the role of technology in increasing costs. It is certainly a large factor. The issue though is that while technology costs are increasing insurance companies are reducing the rates they pay doctors and increasing the fees from consumers. The insurance company is not charging higher fees to consumers in reaction to increased costs. They are doing their best to avoid paying those costs.
Third, in regards to your point about exercise and healthy eating – Colorado is the fittest state in the nation and pays the 7th highest health insurance premiums. That certainly suggests that our current rates are completely disconnected from the health of the population.
Fourth, who is arguing for triple-A health care? The health care reformers on the left are concerned with setting a baseline quality of care that everyone can have access to.
When you throw around the complaint that multi-billion health insurers and oil companies make billions in profits, you show your anti-business bias and your ignorance of business and economics.
If you’re going to throw flames, throw some that will burn.
Morgan Carroll obviously didn’t live through the Nixonian price controls of the ’70s and doesn’t realize the devastating impact of the Reagan era Medicare price controls (prospective pricing, DRGs). She seems to be as fanatic as Jim Dobson and as clueless.
Or, are you just pulling them out of your ass, as usual?
When United Health can pay its CEO several BILLION dollars in a year, yeah, it’s no wonder their profits are so low.
Boo hoo, I cry for him. Meanwhile, the bureaucrat over at Medicare perhaps made $200K.
I believe the dems have coordinated this strategy and the gov has been a player.
but isn’t seen as the leader (not sure that is the right way to say it).
I agree the Dems have coordinated strategy on this, but twice now, health care and transportation, the Gov has come out both guns blazing, only to dial back policy proposals later.
The Gov has fulfilled his higher education funding promises by refiguring the way energy impact monies are distributed in the state. Some groups were going to the ballot on this issue anyway.
The Gov has done well with his new energy economy as well, but with high corn prices and the trend already moving towards renewable energy, the Gov needs to share credit on this one too.
It seems Gov Ritter’s grand plans hit the realities of fiscal constraint and the Legislature picked up the reins to move the issues forward a step or two. Whether that is their strategy or not, I can only guess.
Good job by Morgan Carroll. Yes, it is piecemeal H-Dog but I think it’s a step in the right direction.
This type of healthcare consumer gouging is just taxation in another form. Right out of your pocket in the form of higher premiums and denial of coverage and into the pocket of the healthcare bureaucracy. Profits over people, what a concept.
Now, similar to the scare tactics on behalf of the oil and gas industry, will we see right-wing state reps cry wolf that the health insurers will pack up and flee the state in droves ?
I think so.
It’s “take the reins” – as in taking the reins of a horse – not “take the reigns.”
Watching the Colorado house and senate primaries this year, it is becoming obvious that you can’t win the Democratic Party nomination unless you make a commitment to Single Payer. Health care reform in general and Single Payer specifically are huge issues to the grassroots of the Democratic Party.
Things are more tentative in swing districts, where Democrats are still timid about offering more than lip-service to single-payer. The second tipping point will come when the Democratic Party higher-ups realize that health care reform is a winning issue in swing-districts and in state-wide elections.
In defense of the CDP and Governor Ritter, Colorado is facing a number of critical budget issues, and you can’t go for tax increases on all of them at once.
But, if Ritter continues to stonewall on health care he won’t be seen as a leader when he is up for reelection in 2010.
Who is proposing single-payer? Not Obama or Hillary. Are specific state legislators calling for single-payer in Colorado? Not that I know of but please provide links if you have some, I’d be interested in reading that.
As for health care reform being a winning issue, they’ve known this for a long time. Health care reform as a central focus of a campaign is not new. It was a central focus of Ritter’s campaign – hence the criticism.
As for 2010 – that is sort of the point, time has pretty much run up this session, 2010 is an election year so no major reforms will be proposed then. 2009 is it, except now we have a budget short-fall that makes it fiscally imprudent and politically untenable to move on health care.
His numbers are high enough that it would take an absolute disaster to keep him from being re-elected. Perhaps they are just biding their time until the 2nd term? That seems pretty irresponsible to me. I can’t believe that they are consciously doing that. So we’re left to wonder why there has been so little movement on health care… and transportation… and education reform…
It’s that damn fear of leading…. and fear of the Insurance Company PR machine!
Everybody keeps hoping somebody else, like the Feds, will save their butts.
The Democratic Party Platform explicitly endorses Single Payer. I don’t have all the nuanced positions for all the candidates (that would be a good project for someone); Jared Polis is one example of a candidate who makes a strong commitment to Single Payer. HD-8 and HD-6 are other examples where the candidates have explicitly taken a Single Payer stance.
Solution? The leaders will follow only when the people lead. Obama, Clinton, Ritter, Romanoff, etc., need pressure from below. Maybe it will take a new generation of “more and better democrats”.
But, we live in interesting times. Nationwide (less in Colorado), the Republican Party has lost 18% of its popular support according to the recent Pew polling. That is huge! I’m afraid our Democratic leaders are still a bit psychologically damaged from all the abuse they suffered over the years.
You’re exactly right about the people needing to lead, ParkHill. I get annoyed when elected officials don’t take leadership, but I also realize that we’re the ones who have to make it happen. They are not our leaders; they are our representatives. They work for us. And since we are the boss, it’s our responsibility when things don’t get done.
You don’t become a leader by being elected; you become a leader by leading.
Not all – or even many – of our elected officials are leaders.
…allegedly said, “You must excuse me. I have to catch up with my people, I am their leader.”
True or not, something for politicians to remember.
Any politician pushing single-payer health insurance is simply making a grab for tremendous political power. If the government is the single payer, the politicians in charge of the government have life or death power over patients and pocket book power over providers and their suppliers.
It’s just amazing that politicians are so eager to screw up our health care markets just to serve a few uninsured American citizens and millions of self-insured freeloaders and illegal immigrants.
Where’s the integrity?
Why in every country that has single payer is there NO movement to move to the American Profiteer model?
National health care plans where everyone is covered are a huge, popular success everywhere they are implemented. Look at health statistics from countries with universal health care. The US comes out worse.
Talk to people from Canada, England, France, Germany, etc. They think we are insane.
Rich snowbirds from Canada who buy houses in the US keep a residence back North so they don’t lose their health insurance.
Nobody wants to go on the US private insurance system.
Where’s the integrity of a greedy corporation refusing a procedure resulting in the death of a patient ?
Charged with coming up with Health Care reform, the 208 Commission expended a lot of energy avoiding real reform. You can make adjustments around the edges, but you just don’t get significant cost savings if you ignore the big, fat, insurance elephant in the room, i.e. the 30% going to profits and administration.
Look at the Lewin Group analyses of the plans studied by the 208 Commission, which deal specifically with Colorado: http://www.colorado.gov/208commission/ (Menu “Evaluation” is the detailed report). The CHSP Single Payer plan saves $1.4B over present expenditures. The other plans raise costs up to $1.1B.
I don’t think people realize that CHSP Single Payer plan doesn’t just extend junk insurance to the uninusured, it also increases access to health care by the underinsured. So, it is doubly interesting that Single Payer saves money while actually increasing health care coverage.
Here are the increase health care expenditures proposed by the CHSP plan:
– $939M Acute care utilization for newly insured
– $ 70M Acute care utilization for currently insured
– $765M Change in long term care utilization
Keep in mind a large part of the health insurance administration cost will remain if we go single payer. We can’t just say everybody gets everything, that would also break the bank.
Medicare/Medicaid (single payer) spend 5% on admin.
Doctors office spend 10% on admin.
Insurance companies spend 15-20% on admin.
Doctors office administrative overhead would include extra staff to deal with filing insurance claims.
Consumer overhead includes all the hours you spend comparing benefits plans and trying to figure out why something got denied.
Insurance company overhead includes profits (that’s what they are in it for), $100 Million salaries for executives, entire office buildings full of staff who handle insurance denials and claims “management” (i.e. denials).
Two hospitals, two payment systems. Each very similar to the other.
In Seattle, they have 210 employees dealing with insurance and payments. That’s ONE hospital.
In Vancouver……………. five.
There is only one logical conclusion what we need to do in America. Hey, aren’t the cons all for efficiencies?
The Socialist Republic of Washington has over-regulated the insurance industry. Too many mandates. Small businesses cant afford to cover employees and self-employed pay more in health insurance than they do on their mortgage. Of course, that’s the intention; create so many mandates and regulations that people have no other choice than to welcome socialized health care.
Yeah, Washington is SOOOOO socialist…. I have tears in my eyes, I’m laughing so hard…
You understand I was talking about Washington State, home of Jim McDermott.
I lived there for 8 years and remember the big breaks the state house gave businesses there, like the $3 billion in corporate welfare for Boeing so they’d build the 787 Dreamliner there. That’s what’s so funny about your comment. That, plus most of eastern Washington might as well be Kansas as far as political outlook is concerned.
Large companies negotiate cheap insurance, thus “cost shifting” onto small companies that get a much worse deal.
Insurance is fair only when “everybody is in and nobody out”, both in terms of contributions and benefits.
Most of the single payer insurance plans have private providers, i.e. doctors. Even Medicare is privately delivered. The single payer portion is about the social benefit of pooling everybody. That is social, but not socialism.
It is, right?
BTW, if you haven’t noticed, three dozen advanced countries have welcomed “socialized health care.” None have gone back to that wonderful capitalistic American model.
This can be seen in the difference in overhead between private and public care organizations. While some of that administration will remain, much of that redundancy, profit, and other overhead would be cut out in a socialized system (and to a lesser extent in a single-payer public-private partnership system).
Rep. Carroll’s bill is only one of many steps that need to be taken if we want to overhaul health care without going the full single payer route.
The bottom line is that we probably can’t squeeze much below 5% in terms of Overhead and Administration. But, that means we would save about 25% when compared with 30% due to using an inefficient private insurance system.
If Health Care takes 12-15% of our GDP going to Health Care, then we are looking at very large numbers.
Your other argument is that people might use too much health care…. Like go to the doctor too much? Like if they are sick they actually get more treatment they need? Compared with what, the present system? where if you break a leg you have to see if your insurance company will “allow you to see an out-of-network doctor”, or if you use the closest ambulance, you pay out of pocket because you didn’t use the approved first-responder.
So you prefer a system where your insurance company is the one making the decision about whether you really need a knee replacement, or chemo for your cancer.
Personally, I think treatment decisions should be made by the patient and the doctor based on standard, scientific protocols. Everybody gets the same ability to obtain primary care or emergency or surgical treatment.
It is obvious that the state is not ready to vote for a single-payer system, even though it would save the state a collective $1b+.
Given that, this bill and a host of others would at least help. I propose:
If we want to go further than that, I suggest a national transition to non-profit healthcare with strong oversight on executive salaries as a more palatable step toward single-payer. Some kind of national buy-out would be in order for outstanding stock shares.
Thoughts? Legislators interested in talking for next year?
Really great post Phoenix. Great ideas, all of which are really common sense and will improve our health care crisis.
I hope some of the policy makers are listening.
I don’t know who’s senate or house districts you are in but you should make a phone call and get a meeting.
Also, we do need to increase medicare and medicaid reimbursements. Asking doctors to eat the cost is unfair. Aside from that problem, a majority of doctors and an overwhelming majority of primary-care (i.e. family docs) are in favor of Single Payer.
True, insurance companies are masters at transferring expensive patients out of their pools, but as the transition to Single Payer will take time, we need to put stringent regulations on private insurance.
Competition Option.
We could also allow anyone to buy into an improved Medicare or Medicaid. That doesn’t address all the overhead problems, but it would effectively create a decent minimum benefits plan.
One of the biggest problems with government-run solutions is that legislation never seems to get the cost part right. You legislate for a set cost, then every once in a while you “fix it” (see mining and logging fees, United States). Somewhere, out there, there has to be a solution that keeps up with the times.
I think allowing people to sign on for Medicare / Medicaid is somewhere down the line, but it’s a good transitional option, or one to consider if the insurance industry can’t get a grip on itself.
how would someone who believes in the free market feel about these proposals? For instance, the fixed service rates and statewide rates – I have been taught that “price fixing” is actually bad for the economy since it interferes with supply and demand. Or do we not believe in that anymore?
Can you explain how that would not be the result?
Price fixing is working with your competitor to set prices. Fixed pricing means what you see is what you get. I do not propose as an initial step to set all insurer’s rates to the same fixed price. Let them compete in an open market by advertising their prices openly.
The incentives are all messed up, leading to an immoral and illogical (from a social standpoint) business model. We need insurance for several reasons:
(1) Everybody gets sick, but we don’t know when, so we want this taken care of by prepaid medical treatment,
(2) Sometimes we get REALLY sick or randomly injured, and we need insurance to cover those possibilities, even if we never need it. Yes, nice, young people get cancer, sometimes.
(3) We want people (individuals) incentivized to get frequent primary care, because it avoids costlier long-term problems like heart attacks,
(4) A disease like the flu is really a social problem, not a private one. Even though the individual gets sick, we want everyone (yes, including illegal immigrants) to get vaccinations and flu shots so they don’t pass it around to everyone else.
When you permit private industry to get involved, you get all kinds of distortions.
Why let someone make money on something that is really a simple, actuarial problem. It’s like privatizing social Security: bringing in a private player doesn’t offer anything except additional overhead and middle-man fees.
At his blog, Steve Balboni has a wonderful quote about the insanity of the system:
Private Health Insurance makes money by collecting more premiums but delivering less service. It’s immoral, really: you make more money the better you are at removing expensive patients from your pool, and pushing them onto somebody else, like the taxpayer, maybe.
Making people healthier is a long-term proposal, and most people change jobs and insurance within three or five years, so there is no incentive for Insurance companies to offer primary care; it never improves their bottom line.
Vertical, long-term institutions, like the VA have the incentive and the outlook to truly service the health care needs of their community. The VA is a rare example of a truly socialized medical system in the US, and the outcomes are excellent.
There was a time when the VA was poorly funded, and you got some horror stories. That’s the same story with Canadian system. When the Conservatives came to power, they defunded the medical system… sort of like Republicans who hate government proving by their own incompetence that government doesn’t work.
The FEMA response to Katrina was intentional.
…we would have been much better served by the Colorado Promise doing the hard work to come up with a sensible plan that provided good coverage to everyone.
Yes it would have been a boatload of work to figure out what such a plan should be. But how do we solve this if no one will try.
And yes, it would be almost as much work to get it passed. But again, you don’t fix a totally dysfunctional system by tweaking the edges.
Disappointing…
There are legislators who support a single payer system. It cannot be passed and implemented unless voters will support a dedicated revenue stream (i.e. a tax). Achieving that requires a concerted campaign to enact the program.
Employers have to begin to really examine whether it makes sense to be in the business of assuring access to health care. Do they provide education, fire and police protection? If we view health care as a matter of public welfare, employers shouldn’t be saddled with this obligation. While the “business community” is generally conservative and suspicious of change, if they really examined the benefits of a single payer system, they would be leading the charge for change. After all, they could hire and expand their workforce without worrying about the cost of health care. Workers could come and go according to their skills and life time goals rather than the health care coverage offered by their employers or their need for continued group rates.
To begin a serious discussion of the single payer option, the public has to overcome its inherent distrust of government. The public has to really understand that private, for-profit insurance companies are structured to deny them the care they believe they are paying for. We have to see health care as an essential governmental benefit – if taxes should be spent on libraries and golf courses shouldn’t health care be on the list also?
Finally, we need to acknowledge that the public is already paying for over 40% of the health care delivered in the U.S. Colorado funds health care for children and the poor through Medicaid and CHP+ with general fund dollars. The current solution to the uninsured seems to be to slowly increase the number of people whose health care the public is subsidizing. Wouldn’t it make more sense to be forthright about this and create a dedicated funding source for health care into which we all pay and from which we all benefit? As it is, we’re all paying but most aren’t benefiting. And because we do provide health care as a matter of basic human decency, we fund it from the same pot of money from which education and all other governmental services are funded.
It is time to stop tinkering with an inefficient and inequitable system. But your elected representatives can’t do it without popular support.
Yes – please get me out of the health insurance business. We would have staffed up sooner when first starting if not for wanting to put off when we had to go get insurance.
Support is not enough. Legislators must be able to explain, educate and lead on this issue. We must take the time and effort to build the political will to accomplish Single payer.
He introduced legislation (HB 1327) that would have increased competition by allowing people to buy insurance from out of state. Can anyone explain why that was a BAD idea?
And what about HB 1020 which this legislature passed – which increases health care costs by upping the amount individuals can be awarded for non-economic damages? Can anyone explain why that was a GOOD idea, when we are aiming to drive down the costs of medical care?
The original caps were not tied to inflation.
What if car insurance payouts were capped at the price of a car in 1988?
I have a problem with caps in general, but at the very least they should be tied to inflation.
Here’s a nice article about the impact of caps from TIME in a Colorado case.
http://www.time.com/time/magaz…
Here’s my favorite quote
CA passed a caps legislation in the late 1970’s for medical insurance. Rates just kept going up as they had before.
Nothing changed until Prop 10..4? When the citizens got a place on the state insurance commission, and insurers had to open their books, well golly be, rates dropped.