Opinion: Beyond Obamacare: The new paradigms

By Ivan J. Miller and Barry Karlin

Ivan J. Miller and Barry Karlin

Ivan J. Miller and Barry Karlin

We recently honored Martin Luther King Jr. as a great civil rights leader. Those of us in public health also remember his statement: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

We also have a dream: that Colorado can lead the way toward true health reform, so that no one suffers from preventable disease or medical bankruptcy.

Very few people love the Affordable Care Act (ACA or “Obamacare”). Yes, it has many admirable features. Young people under 26 can remain on their parents’ policies. Denial of coverage due to pre-existing conditions is no longer allowed. We can no longer be told that our coverage has been canceled due to minor undisclosed health issues. Emphasis has been placed on health promotion and disease prevention. More poor children are covered under Medicaid.

In spite of such benefits, even when fully implemented, it is estimated that 400,000 of our fellow Coloradans will remain uncovered. Equally important, we can expect costs to continue to rise at an even greater rate for families and businesses. The average family premium has already exceeded $15,000 a year. The increased administrative complexities for medical providers and employers are maddening.

However, the ACA includes an important, paradigm-changing provision. President Obama has supported state innovation through the ACA and he said, “If states can come up with even better ways of covering more people at the same quality and cost, this law allows them to do that, too.”

Vermont is moving toward a state-operated universal health care system. Coloradans are free to develop their own health care system reflecting our own special needs and traditions. We, as Coloradans, can do it ourselves.

One approach is to create a non-governmental health care system under the direct control of Coloradans. Colorado State Sen. Irene Aguilar has proposed a Colorado Health Care Cooperative, which would provide all residents access to full physical and mental health services, as well as care for dental and vision needs. It would be run by a regionally elected board of directors. (See: www.couniveralhealth.org.) Everyone would be covered regardless of employment status, and no one would be denied coverage. Throughout the world, other countries do so and at half the cost of the U.S. system.

“If France can do it, the U.S. can do it,” journalist and author T.R. Reid told an audience at a recent forum on health reform at the University of Colorado in Boulder. “I think a few innovative states are going to find ways to provide coverage to everybody. If Colorado could do it, we could become a national leader.”

The panel included Reid, author of Healing of America and filmmaker of Frontline’s “Sick Around the World;” Sen. Irene Aguilar, D-Denver, a physician who is also chair of the Senate’s Health and Human Services Committee; and Eric Whitney, health reporter with Colorado Public Radio and National Public Radio.

More than 100 people filled the Hale Science classroom, including Senate Majority Leader Rollie Heath, D-Boulder, Rep. Michael Foote, D-Lafayette, Rep. Jonathan Singer, D-Longmont, and former Colorado Secretary of State Mary Estill Buchanan, a self-described moderate Republican.

“You can be both fiscally conservative and focus on what brings good outcomes and keeps people healthy,” Aguilar said.

The cooperative, she said, will focus on prevention.

“If we help you control your blood pressure, it’s a lot more affordable than if we have to take care of you because you’ve had a life-threatening stroke.

“At the end of the day, everyone will sacrifice everything they own for their life. And once they’ve sacrificed everything they owned, then they qualify for Medicaid,” she said. “And then who pays?”

Dr. Gerald Friedman last year analyzed the economic impact of the cooperative and estimated per capita annual savings of over $,1000 in 2016 and nearly $4,000 per person in 2024. Employers could provide full health care coverage and the medical portion of workers compensation for 6 percent of payroll, about half of what they now pay. These estimates are in line with 16 analyses of similar health care system changes.

The cooperative proposal rests on two paradigm shifts in health care reform. Although advocates for universal health care and health care reform have long focused their efforts on national change, the ACA supports a growing movement for state-led reform. Second, many expect better health care for more people to cost more. The cooperative would save money through management efficiencies, cost significantly less, and improve health care for all Coloradans.

Instead of asking for more money from employers and consumers for a system that is still problematic, both groups could spend less for a well functioning high-quality universal health care system.

It is time to look at change.

We urge you, as a health care consumer, to find out what your options are and become involved in the quest for state-led change: Visit www.couniversalhealth.org and www.cooperatecolorado.org. Please click here to see a video of the forum.

Ivan J. Miller, Ph.D., is a Boulder psychologist and president of the Colorado Foundation for Universal Health Care. Barry Karlin is a doctor of public health and assistant professor of public health at CU.


Opinions expressed in Health News Colorado represent the views of the individual authors.

Print Friendly

Leave a Reply