Thursday, December 7, 2017

Colorado Care May Soon Rise On Its 2016 "Ashes"

Image may contain: text
Comparison of Colorado Care provisions with those of the failed plan in Vermont. This post deals with a number of reasons why the former "went down in flames".

My wife, Janice - with dozens of others - had worked ferociously to get the Colorado Care health plan passed in the state in the 2016 election cycle. Alas, there was simply too much opposition arrayed against, especially the sheer volume of "free speech"...errr,  the money.  The Colorado Care team and activists had amassed some  $800,000 to support their campaign but were confronting the Koch brothers' deep pockets which easily had ten times more to spend.  No surprise the Kochs' ads- seen much more frequently (and laden with propaganda) won out.

But according to T.R. Reid - one of he spokespersons and lead voices for the bill, there is no reason that it can't come back on the ballot in 2020, provided some tweaks are made.

Universal health care advocate T.R. Reid jokes that he's a bad campaign chair. - COURTESY COLORADO CARE YES
T.R. Reid - a long time advocate for a universal health care bill believes Colorado Care can be resurrected with the right tweaks.

In a recent interview with The Colorado Springs Independent, Reid made it clear what went wrong and now the next iteration of the bill could be improved. This is essential also in a hostile environment to any kind of social safety nets and with the Republicans on the warpath to tear down Obamacare by detaching its mandate. This despite a remarkable 55 percent approval rating in an April Gallup poll, and currently with a historically impressive 50 percent approval rating according to Gallup.

What happened? Millions of people - including Trump voters- realized they could finally obtain the affordable care they need, even with preexisting conditions. 

This elicits the question of why Americans have been chronically leery of enabling or allowing the government to run a health care system?  In fact, the reasoning is inchoate and absurd. As Reid put it in his interview:

"If government doesn't get between you and your doctor, then United Health Care in Minnetonka, Minnesota, gets between you and your doctor and dictates which doctor you can see, Public health payment plans are just more efficient and work better."


"Just about everybody on it will tell you Medicare is the best insurance they ever had,  You know, I worked for the Washington Post company, and it's a very generous company, very generous, and it took really good care of us in terms of health insurance and Medicare's better than the insurance I had with the Washington Post."

I can vouch for that, completely. As I already noted in a post last month,  the CMS Summary sheets for the procedures carried out this past year totaled more than $60,000. This was for the 3D staging biopsy and cryotherapy cancer treatment at UCHealth.  The ultrasound guidance part of the cryo treatment alone came in at $16,000 and the anesthesia just for that treatment, not including the 3D biopsy anesthesia, was $3,149..

If I'd  had to operate under a $20,000 per annum GOP voucher plan, I'd have ended up shelling out nearly $40,000 out of pocket for the uncovered procedures.  None of that even would even had included the cost for wife's hip replacement surgery, including 7 days in rehab.

So, as T.R. pointed out in his Indy interview it is "silly" for people to bitch about government health care when one of the most successful ever designed has prevented more seniors from impoverishment than in the nasty early days.  That was pre-1966 when oldsters had to either hope a son or daughter would take care of them, or they had to beg on the streets for help.

But, of course, viewed as (GASP!) "socialized medicine"  that's why the Repukes are determined to destroy it now - when their tax plan comes a cropper with exploding deficits, as it surely will.

So what went wrong with Colorado Care, apart from the fact supporters lost the money as speech game to the Kochs?  T.R. Reid provided several plausible reasons:

-  People were quite willing to help a sick kid or neighbor, so hypothetically backed the plan However, the rubber hit the road when they read the fine print and grasped they'd have to help pay for it

- Seniors especially were against it as even though they'd have to pay there was no benefit at all for them. So why support it when they already had Medicare?

Janice and I discussed this very issue last year when we both attended a meeting downtown and after a presentation, one older lady on Medicare Advantage insisted there was no reason at all for her to vote for such a bill Not one which dinged her while providing  no further benefit.

But as we noted, it was precisely this "what's in it for me" mindset that's preventing the country from moving forward on a universal health plan.  By contrast, Europeans  - like our Czech friends Martin and Gabby, e.g.
Image may contain: 2 people, people standing and indoor
are quite happy to pay higher taxes because they understand "we are all in this together".  As Gabriella told us while we dined out in Prague in 2015,: "You can't take the money with you, so why not spend it on better health for you and your fellow citizens. It is win-win."  This sensible philosophy also carried over into their daily lives, in which they valued time much more than extra money to work more hours. 

As Gabby put it: "Here in Europe the companies cannot work us to death or to the point of insanity like they do people in your country. That's why we can travel our continent for weeks at a time. Your countrymen would probably feel they have to check their cell phones or emails every day or twice or more a day!"

Back to the reasons for Colorado Care's downfall, T.R. also pointed to the wording on the ballot. The resolution began as follows: "Shall we raise taxes $25 billion in order to ..."   In he words of Reid:

"A lot of people thought we lost the minute that became the language of the ballot. You know, people were just not going to spend $25 billion. And the answer to that was, well we're spending over $30 billion on health insurance now to out-of-state insurance companies. But we never had the money to make that point."

Which is why a much more extensive grassroots education effort is needed.

What about future strategies for  resurrection? Reid's ideas are as follows, in his own words:

"I think there are two possible routes. One is put in legislation to the [state] Legislature to try to advance the cause. And, in that regard, we have written what's called the Colorado Patient's Bill of Rights. I think it's nine proposed bills. And they are bills like the Choose Your Doctor Act, and that says any health care plan sold in Colorado has to let the patient choose the doctor. As you know, currently, insurance companies have these narrow networks where they dictate the hospital and the doctor you can go to. So we're going to put in legislation that says they all have to do what Medicare does, which is cover all doctors, any licensed practitioner. That's one bill. Another is the Why Pay More Act, and that says whenever a hospital or a doctor bills you for a procedure, the bill has to show you what Medicare would have paid for the same procedure. And presumably then people will respond and say, "Why am I paying $36,000 for a hip [replacement] when Medicare pays $1,900 for the same procedure?"

... Different legislators have offered to put in those bills, and here's the thing: They're all gonna lose. Because the hospitals or the doctors will fight them and they'll lose. But that kind of makes our point, that the Legislature is not the place to get this done because it's owned by insurance companies and for-profit hospital companies and drug companies.

... The second plan is to come back on the ballot in 2020. And if we did that there's two crucial points about that idea [usually called the 2020 plan]. One is that the plan would be vastly simpler. Our last plan was quite complicated, we had a 35-page booklet explaining it, you know just about everybody could find something in it they didn't like, so I think next time we will make it much, much simpler. Maybe, for example, one proposal is for a two-sentence ballot initiative. First sentence is: Anyone who needs medical care in Colorado shall have access to a doctor. And the second one is: The Legislature is mandated to effectuate this guarantee by Jan. 1 of, you know, whenever."

The Indy: Where would the funding come from in this scenario?

T.R. again:

'That would be up to the Legislature, but presumably, it would come from a tax just like ours.But if the people vote for this concept, then everybody should have health insurance. The Legislature has to enact it. I mean, it doesn't solve all the problems — then the Legislature has to go back to the voters and say, "Will you pay for this?" But at least then we have the opportunity to say um, a) the people want this, they voted for it, and b) it's cheaper ..."

Indy: What year?

"In 2020, and the plan is, 10 states put the same measure on the ballot in the same year, and they would be Oregon, Washington, Colorado, New York wants to do it, Ohio and Michigan have talked about it, maybe California. And the theory is then, if it's on in 10 states, this will dissipate the insurance companies' money. You know, they'll fight it in New York and California at great expense, and maybe that would let Colorado or Oregon or Washington slip past, because they wouldn't be able to fight it everywhere ... Almost every state has a group of people who are working for universal health care ... and they've decided the way we're going to get there is state by state. Washington, D.C., can't do it."

One point of Reid's needs to be underscored: Don't look to the gridlocked Beltway for any help on affordable health care. It may well be up to state versions of universal or single payer health care to win the day. Provided the respective citizens agree with Gabby's take that "we're all in this together" as opposed to the individualist path of "every one for him or herself".

No comments: