Editorial: ColoradoCare too risky, but boost tobacco tax
We think guaranteed health care for everyone, supported by taxes, is a good idea for the United States, just as public education is a worthy public benefit and investment that fuels our economy. Philosophically and morally, it’s easy to make a case that caring for each other and ensuring that our neighbors don’t go broke when they get sick is at least as important as smooth roads.
Like everything — Every. Single. Thing. — that President Barack Obama has done, the version of national health care attached to his name is embroiled in partisan controversy that prevents progress.
The Affordable Care Act’s attempt at a market-driven public-private system, similar to a plan first suggested by the conservative Heritage Foundation, may have been too complex to have succeeded even if Republicans hadn’t done all they could to choke it to death.
In any case, Obamacare is a mess today, with unaffordable premiums in many cases (particularly in western Colorado) and insurers dropping out of state exchanges.
It needs to be revised in a way that preserves coverage for people with pre-existing conditions, young people starting out and for the 20 million Americans now covered who used to be without health insurance.
Whether the next president and Congress can do that is doubtful in our hyperpartisan world, but the ACA’s several problems are instructive as Coloradans fill out their ballot this fall and decide on Amendment 69, a universal state health plan known as ColoradoCare.
Simply put, the ACA’s troubles show that ColoradoCare is too risky with far too many uncertainties for the state to take a chance on the idea. The shortcomings of Obamacare show why Colorado, lacking the resources and scale of the federal government, should absolutely not strike out on its own to fix one of the nation’s most vexing and complex problems.
It’s one thing to experiment with legal marijuana, but quite another to make the state a laboratory for a system on which our financial health and our very lives depend.
ColoradoCare supporters would like us to believe it’s a simple system. A 10 percent added income tax, generally paid two-thirds paid by employers and one-third by employees, will raise $25 billion, cover Coloradans’ health-care costs and eliminate the need for premiums and deductibles. So supporters say.
But nothing having to do with health care is simple, and much remains unclear, such as whether or how residents would be covered if they need medical care out of state. Some immediate risks are known:
• Some Medicare recipients apparently would pay for health care twice — once for Medicare and again on income above $24,000 for ColoradoCare.
• Small business owners, farmers and ranchers, and the self-employed apparently would pay the full 10 percent additional tax.
• Abortion rights supporters believe that, as a state bureaucracy, ColoradoCare could not pay for abortions.
• Of critical importance, we cannot estimate with certainty the liabilities of the system and whether unanticipated demand and costs would force the elected board overseeing ColoradoCare to raise taxes even more, limit coverage or ration care.
Nor can we know how it would affect the state’s population. Some people think businesses and high earners would leave; others think the plan would attract new residents.
That’s no small uncertainty. Colorado’s population is already sure to grow, a significant source of strain for the state’s transportation infrastructure and amazing outdoor amenities. With ColoradoCare, that growth also could strain a health care system with no certainty the state would have enough providers or enough money to care for our growing population.
Finally, any massive policy will have unforeseen consequences. Given that ColoradoCare will be embedded in the state constitution, it will be difficult for lawmakers or voters to fix those certain pitfalls.
We think supporters’ hearts are absolutely in the right place, but, as Vermont learned, health care is too big, too costly and too risky a system for a state to try to fix alone.
On another health-related issue on the ballot, a $1.75-per-pack increase in Colorado’s cigarette tax should pass.
Opposition, financed almost entirely by Altria Group, the parent of tobacco giant Phillip Morris, has $17 million to fight the proposal.
Why? Because Big Tobacco knows that raising the cost of its products will cause some people to quit and reduce the number of new customers (meaning adolescents) for their poisonous, addictive products.
It’s proven that higher taxes on tobacco products reduce use.
We also know that the best way to reduce health-care costs is to prevent disease rather than treating sickness after it has taken hold.
Inhibiting tobacco use prevents disease and death, and saves money.
Arguments against the amendment — that cigarette smuggling from lower-tax states will increase or that the precise use is not sufficiently spelled out for the estimated $315 million a year raised by the tax — are subterfuge. The money is earmarked for smoking cessation, research of tobacco-related health issues and other health-related services, including to help homeless military veterans.
This is an easy yes.
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