DENVER | A new plan for government-run health care that covers everyone is coming from a surprising corner: Colorado, a politically moderate swing state where Republicans and Democrats often share control of state government.
Universal coverage proposals — known as “single-payer” — have failed time and again in the United States. Left-leaning Vermont recently pursued such a system, only to abandon it as too expensive. President Obama’s health care law doesn’t cover everyone and has sparked enormous political backlash.
If the idea hasn’t worked in states that embrace Canadian-style, government-run health care, what are the chances it will fly in a moderate state that has the nation’s toughest restrictions on raising taxes?
It’s a long shot, supporters concede. But they’ve gotten the question onto 2016 ballots and hope that dissatisfaction on both sides with the current federal health law will make Colorado the first state to set up universal health care.
“I think we should take a picture of us throwing a bunch of cash down the toilet, because that’s what we have right now,” said Shelley Cohen of Denver, an advocate who handed out flyers about the plan at a recent meeting in a Denver church fellowship hall. About two dozen people came to hear details.
The plan would work like this: There would be a new, $25 billion-a-year tax taken out of paychecks, similar to how Medicare is funded. That money would then go to an elected board of trustees, which would act as an enormous insurance company and reimburse doctors.
The ColoradoCare tax would raise enough to cover everyone, even people who don’t work or aren’t legally in the country. It’s not exactly a “single-payer” plan, because Medicare and the military health care system would remain intact. But co-payments and deductibles would go away.
And so would most insurers. A brochure explaining the plan touts, “It is assumed that residents and Colorado businesses will choose to discontinue purchasing other insurance coverage.”
The campaign projects ColoradoCare would run annual surpluses of $2 billion, based mostly on trimming administrative costs from insurers and doctors’ offices.
Supporters insist voters are so soured on insurance companies and complicated insurance exchanges that they are ready to try a radical new way of providing health care.
“We will save not millions but billions,” said Jeanne Nicholson, a retired nurse and former Democratic state senator who is touring the state leading workshops on Colorado Care.
Edmund F. Haislmaier, a health policy research fellow at the conservative Heritage Foundation, said he’s skeptical Colorado’s plan will win public support. The price tag is so eye-popping — almost doubling the size of Colorado’s overall budget overnight — that even health-reform fatigue may not carry the campaign, he said.
“You can write the opposition campaign now. ‘Do you want your health care to look like the Post Office or DMV?’ The average person kind of gets that,” Haislmaier said. “When you’re talking about forking over an extra 10 cents a dollar on top of all your taxes, people aren’t going to like it.”
Indeed, a recent campaign to raise Colorado income taxes to shore up the state’s struggling public school system lost badly, despite almost universal acceptance that schools are underfunded. The 2013 schools income tax question would have raised taxes $950 million a year, a fraction of the ColoradoCare tax, but failed nearly 2-to-1.
Even supporters of single-payer health care have questions about ColoradoCare.
At the Denver meeting, one physician asked about the elected board of trustees that would set premiums and decide what to pay doctors for their services.
“This board is absolutely going to control the money, and special interests are going to control the board,” warned Dr. Vince Markovchick, professor emeritus of emergency medicine at the University of Colorado-Denver School of Medicine.
Others asked about abortion services — how could a government-controlled health system pay for them? The question raised the specter of ethical concerns about lots of medical services, from gender transition to fertility treatments to erectile dysfunction medicine. Shouldn’t those services be left to the private sector?
Nicholson said that covered services would be determined by the elected board of trustees. She conceded that a board controlled by insurers “could undermine all our efforts.”
“Even though this is going to be hard and there are going to be challenges, that doesn’t mean we shouldn’t try,” Nicholson concluded.
ColoradoCare supporters say they’ve learned from Vermont’s mistakes — such as trying to take over Medicare, instead of leaving care for people over 65 to the federal government. And the Colorado backers insist they won’t set brute-force price controls on doctors in order to keep costs manageable, which could drive doctors out of business.
“Doctors are leaving now, because they’re at the bottom of the food chain with insurers. Doctors who can afford to retire are retiring,” said Democratic Sen. Irene Aguilar, a physician who is ColoradoCare’s chief supporter in the Legislature.
She didn’t guess how much it would cost to run a campaign to persuade voters to approve ColoradoCare. Win or lose, the question will be an economic boost, she joked.
“This will be a great economic driver for our state because of all the opposition money that’s going to pour into Colorado,” Aguilar said with a grin.