Once again, Colo. needs universal health insurance

Since time immemorial, Colorado’s government has been appointing special committees and task forces to look into various statewide problems. Generally, these efforts end in a familiar fashion: The commission reports that the problem can be solved — if the legislature can come up with a few billion dollars to fund the solution.

But a task force that issued a report to the legislature on Tuesday broke with that standard pattern in a startling way.

The state’s Health Care Cost Analysis Task Force, of which I was a member, told the lawmakers that we could provide health coverage to every resident, and thus improve overall population health and increase employment, and still spend billions less than we are spending now on health care.

That is, Colorado could fix a significant problem and save money at the same time.

The bi-partisan Health Care Task Force was created by the legislature in 2019 to deal with a paradox in Colorado’s health care system: generally, health care works well in the state, but there are many Coloradans who simply can’t get the care they need if they are sick or injured.

The Commonwealth Fund, which carries out comparative studies, rates Colorado as the 6th healthiest state in the union (Hawaii came in first), and the healthiest of all the Rocky Mountain states. Millions of Coloradans receive excellent care in worldclass facilities. And yet, some 357,000 Coloradans have no health insurance; hundreds of thousands more are “under-insured,” which means they face deductibles and co-pays so high they can’t afford to go the doctor.

And Coloradans who get care are paying dearly for it. For standard hospital procedures like maternity, hernia repair, knee replacement, etc., Commonwealth found that fees in Colorado are higher than in 40 other states – higher than New York, California, Illinois, etc.

The Health Care Task Force was directed to study different ways to provide affordable health insurance to everybody in Colorado. It retained a team of experts at the Colorado School of Public Health, led by Profs. Beth Mcmanus and Gregory Tung.

These scholars modeled two different approaches to universal coverage: One was a “mixed” system, in which some people get private insurance — through an employer, or any of the individual plans on the market in Colorado — and there’s a public insurance plan for those without private coverage.

The other model was a single public insurance plan that covers everybody. (In both models, people over 65 would be covered by Medicare, the federal insurance plan for seniors.)

The experts’ report said that both systems of universal coverage would “improve overall health” and “likely” produce “an increase in overall employment.” Universal coverage would also “likely decrease medical bankruptcies” and would “likely decrease medical financial hardship in Colorado.”

Comparing the two models, they reported that a “mixed” system of private and public health insurance would be cumbersome to administer and cost slightly more than Coloradans are paying now for medical care. In contrast, a single insurance plan for everybody would “yield significant health care savings.”

They found that Colorado’s current health care system costs us a total of $38.3 billion annually in medical bills and insurance premiums — and still leaves hundreds of thousands without insurance. The “mixed” system of universal coverage would cost $38.6 billion to $39.34 billion, depending on how much doctors and hospitals would be paid.

The single universal system would cost $34.62 billion to $37.78 billion.

That is, even at the highest projected level of medical fees, the single system would save us hundreds of millions of dollars each year. If the single insurance system used its market power to reduce those high hospital bills we pay, the savings would be in the billions.

Colorado legislators in both parties have told us that they want to improve population health and increase employment. And they want to reduce the amount Coloradans must shell out for medical care and insurance premiums each year.

The report they’ve just received from the Health Care Cost Analysis Task Force says we could achieve all those goals, if the legislature would create a public health insurance plan covering everybody. That would increase coverage and reduce costs more than the modified “public option” plan the legislature passed this year.

So the question looms: Will our legislature act on this expert advice from its task force?