Healthcare - We Can Do Better

We have all heard the stories from friends or relatives – the working mom who can’t afford insurance and forgoes prenatal care, the laid off worker who loses health insurance and can’t afford to pay for a child’s dialysis, the homemaker who finds a lump but lacks the money to visit a doctor. I hear similar stories on the campaign trail. We can do better. Our healthcare system is spiraling downward. We are the wealthiest country in the world and spend twice as much per capita as any other country. Nevertheless, we are the least satisfied with our healthcare, and we are 29th in life expectancy.

Heatlhcare in Colorado:

Our current system doesn’t work very well for consumers. Health insurance is increasingly hard to get – fewer employers are offering coverage, and individual plans are often unaffordable. Pre-existing conditions disqualify people who need care the most. In El Paso County alone, 116,000 of our neighbors are uninsured.

Our current system doesn’t work very well for providers, either. Too much of their time is spent obtaining authorizations and collecting payments. Due to excessive paperwork and low reimbursement rates, very few providers accept new Medicare or Medicaid patients. Hospital emergency rooms are increasingly providing primary care, both for the uninsured and for those who have insurance but can’t get a timely appointment with their doctors.

Our current system is expensive, and taxpayers already fund substantial amounts of care. Almost half of all medical costs are paid by the government through Medicaid, Medicare, SCHIP, and other programs. The system is further subsidized by giving businesses tax deductions for employee premium expenses. Among private insurance providers, overhead costs consume 25-30% of the healthcare dollar.

Colorado's Response:

Because the federal government has defaulted on its responsibility to deal with healthcare, many states, including Colorado, are taking the initiative. Colorado’s Blue Ribbon 208 Commission was created to find better solutions. They recommended expanding access to government programs, requiring employers and private insurers to offer coverage, and providing a sliding scale subsidy for low-income families. The challenge is funding. The Governor has pledged not to request a tax increase this year, and I support this pledge. It is inappropriate to ask taxpayers to fund a broken and costly system without major reforms and improvements.

Reform Considerations:

I believe healthcare coverage must be comprehensive, affordable, and accessible.

• Comprehensive coverage should include physical, mental, and dental health, as well as eye care. It should include preventive, chronic, and catastrophic care.
• Affordable coverage means that families’ total out of pocket expenses (premiums, deductibles, and co-pays) would be a manageable portion of household income.
• Accessible coverage means that it is guaranteed to be available to all residents regardless of age, sex, health status, or pre-existing conditions.

Large group plans with many subscribers spread the risk and are the most effective way of providing comprehensive and affordable care. For this reason, a single payer system deserves our serious consideration.

While considering comprehensive reform, I suggest the following steps to improve the existing system:

• Allow tax deductions for physicians who provide unreimbursed care for those who are under-insured or un-insured.
• Promote conversion to electronic record systems to facilitate coordinated care and reduce costly medical errors.
• Encourage expanded roles for nurse practitioners, physicians’ assistants, midwives and other professionals to provide flexibility in the face of existing provider shortages.
• Reward patients who adopt a healthy lifestyle and get regular physical exams by lowering their premiums.

I am committed to addressing the healthcare needs of Colorado
by expanding access to comprehensive and affordable healthcare.