AURORA — At a health-reform town hall gathering this weekend that brought together six members of the Colorado delegation to the nation’s capital, Democrats, including Sens. Mark Udall and Michael Bennet, said that health care costs would continue to skyrocket unless insurance companies were subject to anti-trust regulation and to competition from a national non-profit government-insurance option.
At the event, sponsored by 9News and held here Saturday, Rep. Jared Polis of the 2nd Congressional District said he thought opposition to the public insurance option was due in part to misrepresentation. It has been reductively pinned to the term “single payer,” he said.
“The single-payer system is a bit of a false stalking horse,” Polis said. “This isn’t foreign to the United states.” The government is the sole or “single” payer in Medicaid. Under that plan all bills go to the government and the government pays them. But that’s not what the reform legislation is proposing. Here the main purpose is to provide competition and drive down prices, especially if everyone is being asked to participate.
“We’re telling people as part of this proposal, there’s a mandate. It is unfair to say that you have to get insurance and by the way we are throwing you into bed with the sharks.”
Polis said the public option would save $120 million over ten years.
Rep. Diana DeGette of the 1st Congressional District agreed.
“Part of the reason we need reform is to get everybody involved in health care. But it doesn’t do any good to do that if health care premiums continue to go up and [people] can not afford to pay their health insurance premiums.”
DeGette said that Democratic congressional leaders feel that “a robust public option within the insurance exchange will provide cost-saving competition.”
Rep. Mike Coffman of the 6th Congressional District, the sole Republican on the panel, agreed the goal should be cutting costs through competition. He told the audience of about 500 that the free market was a better solution.
“The American people are being presented with a false choice, to say that the only solution is a government-controlled health care plan. It is government that doesn’t allow competition in the private sector.”
Coffman said lawmakers should be looking to lower barriers for insurance industry private sector competition and said that regulations preventing individuals from buying insurance across state lines should be eliminated.
DeGette agreed again. She said the House bill would break down those regulations by setting up an insurance exchange in which citizens could purchase plans available across the nation. She pointed out, however, that regulations weren’t the cause of today’s skyrocketing health costs and minimal consumer options. She noted that insurance companies and baseball were the only tow industries not regulated by antitrust laws. In towns throughout the country, she said, insurance companies ran virtual monopolies.
Coffman conceded that the insurance industry should not be excluded from anti-trust laws. But he insisted that legislators acknowledge that government “broke the system” and so should help lift barriers to increased free enterprise.
The Democrats disagreed on funding mechanisms.
Polis bucked the senior member of the Colorado delegation.
“The worst way to pay for [health reform] is the way that’s in the House version, in my opinion.” Polis said. “This is putting the burden on LLCs and all the small businesses in the state that are profitable… I would hope that that is not part of the final version.”
Polis said he would prefer to fund health reform through savings within the system and by closing loopholes for offshore corporations. Short of that, he felt that the Senate bill provided the next-best method to funding.
The Senate finance bill finds its largest amount of money in an excise tax of 40 percent on health insurance plans provided by employers that exceed $8,000 for individuals and $21,000 for families.
Rep. Ed Perlmutter of the 7th Congressional District said he would prefer to fund the plan partly through a tax on stock trades. “We helped Wall Street. Now Wall Street can help Main Street!” he exclaimed.
Perlmutter laid out a plan to tax every thousand dollars in stock trades $2.50. His actions would reinstate a tax that was discontinued in 1966.
Rick Dakin, CEO of Coalfire Systems, a Louisville cyber-security firm, told the panel that as a result of state-imposed regulations, he had been forced to move “his flag” to Seattle. He explained he has had to send jobs out of state because even though he’s using the same health care provider, he’s charged 20 percent less in Washington state. He asked the panel to make it possible for him to bring his jobs home to Colorado.
Polis explained that insurance exchanges would provide small businesses with the power to bargain the way large businesses do now. The exchanges would also enable small business owners like Davis to purchase plans from an insurance pool.
Davis told The Colorado Independent he was happy with both Republican and Democratic responses to his concerns. He said it sounded like the hurdles to purchasing health-care across state lines would fall no matter which plan was adopted in the end, so long as some reform plan was in fact adopted.
“I don’t care if it is [market] competition, whether it is the government option, I’m not really tied to these things. What I am tied to is if I have one carrier who has price-fixing ability over me, that pisses me off.
“And each one of [these lawmakers] says ‘I will not let a bill go forward that doesn’t cause competition’” Davis said. “I almost don’t care which option. I just don’t like the option I have now.
Doctor Jandel Allen-Davis, vice president of government and external relations for Kaiser Permanente, asked the panel what types of payment reform would be included in any of the current legislation moving through Congress. She explained that payment reform such as providing physicians salaries instead of paying per volume of work is key in Kaiser’s successful containment of costs.
Udall responded that there are a number of elements to the bill which move the industry away from a pay-for-service approach and toward a patient-centered approach. The government would penalize those in Medicare who have high infection rates or readmission rates.
DeGette added that reform legislation is aimed at creating a system that would provide better information on procedures and effectiveness. She said that the House bill provided a system to collect, assess and provide that kind of data to care givers. The final system would set up a list of procedural recomendations that caregivers could follow.
Allen-Davis told The Colorado Independent that while she was satisfied with the answers the panel had given, she thought changes needed to reform the system can not really be legislated or even regulated.
“The nods that they’re giving to prevention, wellness and delivery system reform are really not going far enough… It is really up to us, the people who provide the care, to have the courage to figure this out.”