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The EditorsAugust 04, 2016

Colorado is embarking on a bold experiment in direct democracy. Voters this November will decide whether to create a state-run single payer health care system. ColoradoCare would cover 100 percent of residents, including undocumented workers. The cost of the system would be borne by both employers and employees. The proposal is meeting with fierce resistance from insurance companies as well as politicians who worry about the potential costs of the program. Supporters argue that the program would save most residents money by lowering copays and eliminating deductibles.

Though ballot initiatives can sometimes muddle the democratic process (see “Referendum Irresponsibility,” America, 8/1), the ColoradoCare initiative strikes us as a good model of state experimentation. Our current national health care system was modeled on a successful program in Massachusetts. Depending on the results in November, ColoradoCare could inspire other states to experiment with health care delivery. Obamacare allows states to opt out if they provide for a system that gives the same level of care. ColoradoCare promises to offer a higher level of insurance for everyone who lives in the state.

RELATED: Colorado’s Universal Health Care Proposal Is Also a Seismic Expansion of Democracy

ColoradoCare would be paid for by a state income tax of 10 percent, two-thirds of which by law would be covered by employers. Yet freelancers or men or women who stay at home to raise their families would have to pay all of the tax themselves. This places a significant burden on people who cannot find full-time work. But the proposal as a whole is intriguing, especially coming from a state like Colorado, where the reds and blues of electoral politics bump up against each other in unique ways. For decades the idea of a single-payer health care system for all has been by turns glorified and vilified. It would be refreshing to see if it actually works.

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Joseph J Dunn
6 years 9 months ago
This very enthusiastic piece in late 2014 by the Colorado Health Institute http://www.coloradohealthinstitute.org/uploads/downloads/2015_Rate_Analysis_Report_2.pdf. shows a 40-year old male non-smoker in Colorado’s least expensive market region would pay $2,793 per year, for coverage in an ACA “Silver Plan” (covers about 70% of health care costs, and involves deductibles and co-pays to keep premiums down.) The same plan in Colorado’s most expensive region required a premium of $4,297, with same co-pays and deductibles. Note, these quotes are for the second-least-expensive insurer in each region, not for the Colorado HealthOP, a co-op that charged even less, but is now out of business. https://cohealthop.org. See also, also http://www.denverpost.com/2015/10/16/colorado-healthop-shut-down-by-state-regulators-amid-cash-reserve-woes/. So, now comes a new entity, ColoradoCare, a subdivision of the State of Colorado, which proposes to offer all the ACA required coverages at an average cost per Colorado resident of just $2,056 (calculated by taking 10% of total Colorado payroll by the population of Colorado), with NO deductibles. Everyone is covered, including the unemployed. And in the process Coloradans are assured that they will save billions. http://www.coloradocare.org/?nosplash=true. And if you like your primary care provider, you can keep your primary care provider. See also http://www.coloradocare.org/wp-content/uploads/2016/04/amendment-reformatted12.27.15.pdf. Experiments have value, but only if the experimenters review their notes and data, and preserve the integrity of the experiment. As the Colorado Health Institute pointed out in its bulletin above, “The design of insurance plans can change. The price might stay the same, but the provider network could shrink, offering consumers fewer choices for the same price.” That is a special danger in single-payer systems. Let’s wish the Coloradans well, and learn from their ongoing experiments.
Lisa Weber
6 years 9 months ago
An aspect of healthcare that is largely ignored is corruption. Companies have a controlled market where competition is limited but the prices they can charge are not limited. People would be outraged if they knew what was being charged for items used in a hospital and the profit being made on those items. It is not possible to justify a charge of three thousand dollars for a thirty-inch piece of string with a needle on the end - and that is just one example. We need a single-payer system because the government is the only entity big enough to deal with the corruption.
Ernest Martinson
6 years 9 months ago
The use of the state income tax to fund the Colorado single-payer healthcare system would not be healthy for jobs and the economy. But the use of a land tax on the use and abuse of the earth would be healthy for the environment.

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