Health-care reform facing acute pains
Colorado voters will say yay or nay to socialized health care in November’s election. Amendment 69, aka ColoradoCare, plans to provide complete health care for all citizens with no deductibles while reducing costs. The program could work.
A note on words: George Orwell would nix the term “single payer” to avoid bleaching the language. It is good advice.
It is no secret that U.S. health care is plagued by psychopathic costs. They take a quarter of a median Colorado family’s income. It is the primary reason for the deepening national debt, according to the unusually credible Congressional Budget Office.
Singapore has higher average income than the U.S. It also has a state-of-the-art health-care system that does an excellent job at a 75 percent discount to U.S. prices. Clearly, Americans are being hornswoggled.
Amendment 69 will raise a new tax equal to 10 percent of incomes, doubling the state budget, but — cross your fingers — reducing overall health-care costs.
In theory, theory and practice are the same. It is only in practice that they differ.
Colorado’s new health bureaucracy is planned as a consumer cooperative. Supporters expect that will wall out the special interests. That is Twinkie thinking. People who know the co-op world know a big co-op is just another big organization that tunes the little people out and the big players in.
Private insurance will not be banned. However, the poor and most middle-class people will not have the extra cash to escape. It is financial repression of the have-lesses. Like public schools.
Ever hopeful, Colorado Democrats’ platform supports Amendment 69. The American left has pined like a heart-broken schoolboy for socialized health care for a century.
Now it is within reach, yet the state’s Democrats are hopelessly fractured on the issue. Gov. Hickenlooper, former Gov. Ritter, Sen. Michael Bennet, the abortion-rights group NARAL and Progress Now are all pointing their thumbs down. The Democratic Party is even coaching candidates to speak out against Amendment 69.
Ski country Democratic state legislators Millie Hammer, Kerry Donovan and Diane Mitsch Bush did not respond to requests for a statement of position. Republican Bob Rankin did, and stands against the plan.
So why the internal fight?
Here’s one possibility. An Obamacare episode mimics a scene from the movie “Monty Python and the Holy Grail.” As two pro-Obama books covering health care reform point out, after briefly skirmishing with the health lobby’s killer rabbit over cost control, the party leadership shouted, “Run away! Run away!” and did so.
It is possible some Democrats do not have the courage to take on the health care industry, while others do.
Another possibility: Anti-69 Dems may think the plan will fail. Blowing the big bucks necessary to fire up ColoradoCare could ruin Democrats in Colorado for a generation.
Could Amendment 69 actually work? Vermont pulled the plug on a similar plan in 2014. Prelaunch analysis showed an unacceptable risk of spooking the state’s economy under the added tax load.
Fears are not frivolous. Government’s record on big projects is heavily salted with failure. Social Security is legitimately criticized for stealing milk from babies. Public education is a source of unending unhappiness. Anti-poverty programs are weak on making people self-sufficient. The tax code is widely recognized as a financial cluster bomb.
Yet, despite deep pools of bureaucratic malfeasance, the Veterans Administration seems to be reasonably effective at delivering health care. A recent Rand Corp. analysis says that VA health care quality on average exceeds non-VA care. Who would have thunk it?
In 2014, the Congressional Budget Office cautiously reported that while comparing costs is squishy, VA health care costs were between 20 percent and 30 percent below non-VA costs 18 years ago, though that may not still be true.
Both sets of data are as soft as melted ice cream. Nonetheless the VA model is worth exploring. So, open the VA to all paying customers and see if it can deliver.
Meanwhile it would be negligent to ignore Singapore’s remarkable health care success. It has a simple, three-part design.
First, it subsidizes the poor. Second, it requires everyone to save big for health care. People then spend their own money. So they shop it hard, a natural talent of American households.
Third, there is a layer of insurance to cover the most expensive health problems that blow out the top of the health saving accounts. Quality is great. Costs are rock bottom. Individuals have control.
Amendment 69 is an all-or-nothing gamble on a mountainous, loosely designed program run by newbies handling money for which they have no personal responsibility.
Financially, it could end like the last flight of space shuttle Challenger.
Government is foolish to bar experiments with the widest array of arrangements. Thumbs down on Amendment 69. Thumbs up on direct citizen choice and direct consumer control.
Reach Vince Emmer, a financial consultant in Gypsum, at firstname.lastname@example.org.
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