Government & Politics  November 13, 2015

Is Colorado ready for single-payer?

2016 ballot measure will ask voters to decide

There have been many initiatives around the country to move to a single-payer health-care system. So far, none have been successful. But a single-payer initiative will be on the November 2016 ballot in Colorado and if it passes, could make Colorado the first state in the U.S. to set aside the Affordable Care Act in favor of a Medicare-like system that serves all Coloradans.

Even the Affordable Care Act, or Obamacare as it is known, doesn’t cover everyone in the state, according to T.R. Reid, a health-care author and documentary filmmaker in the state, who also is an advocate for ColoradoCareYes, the grassroots movement that got the single-payer health initiative on next year’s ballot, with 156,107 signatures submitted Oct. 23.

“Obamacare expanded coverage in our country and state but it was never designed to cover everybody,” Reid said. “Obamacare will leave 415,000 Coloradans without health insurance, 30,000 of those are children under the age of 16.”

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But just because they aren’t covered, doesn’t mean they don’t get sick or have accidents or show up in the emergency room, he added. In that sense, their health-care bills are passed on to taxpayers.

ColoradoCareYes believes that any “decent, ethical democracy should provide health care to everyone who needs it,” Reid said. “We think our state should see to it that everybody in Colorado who needs medical care should have access to a doctor. Obamacare doesn’t do it. It is complicated. It is expensive, and it doesn’t get us to universal coverage.”

ColoradoCare adopted a plan that was designed by Denver state Senator Irene Aguilar, who was a physician at Denver Health for 23 years. Her plan would cover everyone in the state from birth to age 65, when Medicare would take over.

Aguilar got involved with this initiative because she was tired of seeing people who couldn’t afford health insurance die or become disabled from preventable diseases. If people with pre-existing conditions such as asthma and diabetes get the preventative help they need upfront, it saves the government money in the end.

“We can control costs by doing aggressive early intervention to minimize hospitalization, and we minimize the people who end up dependent on the federal government because of disability, and premature death would be nice to avoid as well,” Aguilar said.


What it would do

ColoradoCares would levy a 10 percent tax on wages to pay for universal health care.

The Pros:

 All Coloradans would be covered, including 415,000 currently without health insurance.

 Proponents say that individuals would save $1.6 billion and business would save $3.1 billion, with no deductibles and no co-payments.

The Cons:

 Opponents dispute ColoradoCares’ assertion that the system would save money.

 Opponents claim that a universal health-care system would put bureaucrats in charge of health care.

 Critics argue that ColoradoCares would dismantle the state’s health-insurance industry, resulting in a loss of doctors and other health-care professionals.


Under ColoradoCare, everyone would be assessed a 10 percent tax on their wages to cover health-care services. Those who make more, pay more.

“Nobody is getting a free ride,” she said.

Doing this allows the state to offer a richer benefit and eliminates the financial barrier to medically necessary care, Aguilar said.

The ACA did get more people covered by health insurance in the state, but it is expensive. The state does offer a safety net that will pay for people who don’t have insurance but who are critically ill.

“Having worked at Denver Health, people who couldn’t manage their chronic diseases became disabled to the point where they were on Medicaid or Medicare. It is frustrating to me that we could have taken care of them at a much lower cost if they had much earlier access to health care,” she said.

Seniors will stay on Medicare.

“We did that for several reasons,” Reid said. “Medicare has very high approval ratings from people. They don’t want to replace Medicare. And pure politics. When you try to reform health care in America, opponents say they will take away your Medicare. They can’t say that about ColoradoCare because it only goes up to 65, and then they go on Medicare.”

The program will work like Medicare. It will cover everybody, but because there won’t be marketing costs and there will be limited paperwork costs, the promoters of this bill believe it will cost only 4 percent of income for administrative costs, compared with 20 percent on average for private health insurance, he said.

Lower administrative costs mean lower premiums, he said.

Other countries have tried universal health care, including Switzerland, Australia and Canada. Most of those programs began at the state or province level. Canada has had problems with its offering. People wait a long time to get the elective health-care services they need, Reid said. He says that Canada’s biggest problem is that it spends only 9 percent of gross domestic product on health care. The U.S. spends 17.5 percent of GDP on health care. The U.S. has 33 million people who are uninsured.

“I don’t think it is working in Canada, but it can work. If you are acutely ill in Canada, they will treat you,” he said.

Not everyone is enamored of the idea of a single-payer health-care system in Colorado.

Linda Gorman, director of health-care policy at the Independence Institute in Denver, said that “there are far better options out there. This is the worst solution they can think of if you care about patient care at all. It’s a great solution if you are interested in crony capitalism and want to fund a lot of bureaucrats.”

Gorman said that she believes the U.S. health-care system is already very strong and “everyone has access to care through Medicaid. That doesn’t happen when you put government in charge of health care and it decides whether you are valuable enough to have enough money spent on your care.”

She pointed to Canada and Great Britain, where she says people are on waiting lists for years or are denied access to advanced care.

Gorman asserts that the plan will raise taxes on Coloradans by 14.63 percent, which is “higher than any other state.”

Coloradans will have the option of staying on their private insurance and using ColoradoCare as secondary insurance, but Gorman asked what people would do if they got sick in other states while traveling. Private insurance is transferable. Gorman said she did not think ColoradoCare would be.

There have been many initiatives around the country to move to a single-payer health-care system. So far, none have been successful. But a single-payer initiative will be on the November 2016 ballot in Colorado and if it passes, could make Colorado the first state in the U.S. to set aside the Affordable Care Act in favor of a Medicare-like system that serves all Coloradans.

Even the Affordable Care Act, or Obamacare as it is known, doesn’t cover everyone in the state, according to T.R. Reid, a health-care author and documentary filmmaker in the state, who also is…

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