Where there’s a will, there’s a way – but when it comes to the will to reform health care in Colorado, there’s a long way to go.With millions of Americans and almost 800,000 Coloradans lacking health care coverage, citizens, politicians, health care professionals and advocates agree reform is needed, but building a consensus about what comprehensive reform should look seems farther down the road.
With January’s Blue Ribbon Commission report, 2008 was touted as the year health care reform would move into the spotlight. But in this last month of the legislative session, reform is coming in mostly smaller, bit parts.
The largest hurdles to reforming Colorado’s health care system – determining the amount and source of additional funding necessary– won’t be resolved this year.
The most viable fix, according to some health care advocates, could come from Senate Bill 217, which, if passed, would require every uninsured Coloradan to buy private insurance coverage while the state solicits proposals from insurance companies to make low-cost coverage plans available to uninsured residents. The bill also contains a clause that would ask voters for additional funding if necessary.
SB 217, also dubbed the “Centennial care choices” plan, includes language acknowledging the efforts of the state’s Blue Ribbon Commission, but goes on to state plainly, “While comprehensive health care reform is a laudable goal, this state lacks the financial resources to fully solve all the problems facing this state’s health care system.” But, it continues, that doesn’t mean Colorado can’t get started.
“A short term solution for this state is better than no solution at all,” said Rep. Anne McGihon, one of the bill’s sponsors and chair of the Health and Human Services Committee.
Gary VanderArk, a neurosurgeon and patient advocate, said he thinks SB 217 is an important part of health care reform in Colorado and sees the necessary political will this year in the state Legislature and in Gov. Bill Ritter to pass the bill and other reforms.
Ritter spokesman Evan Dreyer said he didn’t know if Ritter has taken a position on SB 217, which was introduced in the state Senate March 28.
“We do have the team that can make this happen,” VanderArk said at a recent discussion on health care and business at the University of Denver that public radio station KCFR 1340 plans to broadcast next week.
About half of the 200 people in the audience applauded this plan, but there were also detractors.
Barry Keene, vice president for Health Care for All Colorado, an advocacy group that objects to SB 217, said it does nothing to curb administrative inefficiencies and puts taxpayer money in the pockets of for-profit companies.
“I don’t believe Senate Bill 217 is a panacea,” Keene said.
Others in attendance said they resented being told they had to purchase health insurance.
The high cost of health care – $30 billion in Colorado last year, according to the Blue Ribbon Commission – is also a point of contention, with some saying excess money is spent on administrative costs while others point to unnecessary procedures.
McGihon said that uninsured and underinsured residents don’t have access to preventive care and wait until they become “the sickest of the sick” to go to emergency rooms, thus putting a greater strain on the state’s entire health care system.
“Universal health care will save money. We don’t have to put more money into the system to cover everybody. There’s more than enough money in the health care system to do that. By having universal coverage we will save money,” VanderArk said.
But Kaiser Permanente President Donna Lynne said duplicated and unnecessary medical procedures as well as a race between health care providers to obtain the newest technology account for a lot of unnecessary medical costs.
“Most people will say everyone ought to have health care … the question is who’s going to pay for this? It’s overly simplistic to say there’s enough money in the system,” Lynne said.
The debate over health care reform also comes down to whether Coloradans view health care as a right or product.
Fabrizio Siracusa, who moved to the United States from Italy, said he spent his first seven years in this country without health insurance because he could barely cover the cost of rent and car payments.
“I hear a lot about health care being treated as a consumer product. I don’t know anybody who goes to the doctor because they want to,” Siracusa said.
But former Gov. Dick Lamm pointed out that a majority of Coloradans are relatively happy with their health insurance.
“Eighty-three percent of us just generally are saying, `We’re satisfied and we don’t want to give up anything.’ So the dynamics of this issue are just awful because there’s got to be some sense of stewardship for our fellow citizens,” Lamm said.
Which makes the political landscape tricky.
“I wouldn’t say that there have been set backs. Clearly health care and the cost of health care are on the minds of Coloradans this legislative session … there has been some agreement that before we take an extremely expensive health care plan to the people of this state we have to do a couple of things,” Dreyer said.
Educating the public about the specifics of the health care crisis tops the list for Dreyer and many health care advocates, as well as addressing the issues that drive the cost and quality of health care.
“This is one of those massive, monumental issues that does not get fixed in a single legislative session or a single bill,” Dreyer said.