The United States provides the best health care in the world. Our physicians, hospitals, teaching universities and technological resources are renowned. The Mayo Clinic, Sloan Kettering, UCLA, Seattle’s Fred Hutchinson Center, and many others, are the gold standard for advanced medical care and are the
clinics of choice for those who can afford them . On the other hand, most people agree that our health care delivery system suffers from three indisputable shortcomings; (1) over 40 million people have no insurance coverage, (2) consumers experience unsustainable, often double digit, premiums and health care cost increases, and (3) we spend twice as much for health care as any other similar country, yet we experience less favorable results – we are 29th in life expectancy, and have more instances of chronic disease and higher infant mortality rates.
Health Care in Colorado
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 have heard similar stories during the campaign. We can do better.
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. Statewide, 834,000 Coloradans lack health care. In El Paso County, 124,000 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.
Colorado’s Response and Federal Health Care Reform
Before the federal government enacted health care reform, Colorado took the initiative. Colorado’s Blue Ribbon 208 Commission was created to find better solutions. Its nearly unanimous consensus recommendations were very similar to the just passed federal health care reform proposals.
- Establish a new, regulated insurance marketplace to make health coverage accessible;
- Provide financial assistance to help make coverage affordable;
- Require all individuals to purchase coverage;
- Expand Medicaid eligibility; and
- Include key building blocks to improve the way care is delivered, to improve care and lower cost growth
A recent study shows that implementing national reforms in Colorado can reduce the cost of private insurance by 10-25%, and coupled with Colorado’s Healthcare Affordability Act, can extend coverage to 500,000 uninsured Coloradans. By expanding the number of people in the pools and thereby reducing the amount of uncompensated care to the uninsured, the study projects that we can expect lower premiums. In addition, up to 68,000 Colorado small businesses will be eligible for tax credits, 160 community health centers will receive increased funding and 23,000 new jobs will be created as a result of the strengthening of the economy. (New American Foundation and University of Denver Center for Colorado’s Economic Future)
Challenges Going Forward
The primary goals of health care reform are for expansion of coverage for all care, including optical, dental and behavioral health, and increasing the quality and efficiency in the delivery of care while controlling costs. We should ensure that preventative care and health care screening are available and encouraged by providers as a means of avoiding more costly care latter. Alternative medicine has to be part of the panoply of options available. We must encourage expanded roles for nurse practitioners, physicians’ assistants, midwives and other professionals to provide flexibility in the face of existing provider shortages. Increasing the number of primary care doctors through student loan forgiveness is also recommended as a long term strategy to reduce costs. With the active participation of stakeholders, including employers, insurance companies, consumers and the government, we can call for policies that will promote reforms necessary to accomplish these goals including promoting medical homes, corporate fitness and disease management programs in businesses and rewarding employers and employees who participate, while implementing health information technology and automated records. I support requiring coverage of mammograms, birth control, cancer screenings and preventative health care services as part of basic insurance policies. Most studies recommend that we move away from pay for procedure compensation plans for doctors and establish more patient health oriented and quality outcome systems as well as transparent insurer and provider pricing, and improved end-of-life care. We should encourage and reward patients who adopt healthy lifestyles and schedule regular checkups, by reducing their premiums. It is important for all of us to take individual responsibility for our personal health.
I am committed to addressing the healthcare needs of Colorado by expanding access to comprehensive and affordable health care and improving the delivery of care.