BY FREDA MIKLINGOVERNMENTAL REPORTER
In a meeting of the Common Sense Policy Roundtable (CSPR) held at the Warwick Hotel in Denver’s North Capitol Hill neighborhood on March 9, a lively discussion of the state of health insurance and the proposed public option raised many questions and provided few answers. CSPR President and CEO Kristin Strohm introduced the program.
Lauren Laron, executive director of the Governor’s Office of State Planning and Budgeting opened the program with a report that the 2020 budget process went relatively smoothly and resulted in a 2.7 percent overall increase from 2019.
Next, Chris Brown, CSPR director of policy and research, presented data on the question of, “What drives health insurance premium increases?” He said that costs related to care have gone up more than five times as much as the increase in (profit) margins by hospitals. As revenues decrease, due to government-set rates of payment, as proposed by the Colorado Option bill, more costs will be shifted to less-regulated payors and markets.
On the panel for the program were state Rep. Dylan Roberts, the sponsor of HB20-1349, Colorado Affordable Health Care Option, Bill Lindsay, longtime health care insurance and employee benefits broker/consultant who also headed up four commissions on health care issues for the State of Colorado, and Richard Rush, FSA, a health actuary with over 30 years of experience, who co-authored a study with Chris Brown on the issue of the public option. Joey Bunch, senior correspondent deputy managing editor of Colorado Politics, moderated the discussion.
In answer to the question, “Are we being gouged by the hospitals?”, Lindsay talked about the “gigantic health systems” in Colorado that now have “quasi monopoly power” and have engaged in “predatory policies.” He emphasized that those that are tax-exempt use their excess revenues to expand their footprint around the state and purchase physician practices, noting that 60 percent of doctors in Colorado are now employees of hospital systems. He also pointed to the fact that hospitals are sometimes built just for competitive reasons in areas where there are already enough beds to serve the population. (Colorado eliminated its certificate of need law over 20 years ago).
Roberts explained that his interest in this subject arose because of the district that he represents. It has been well-publicized that many residents of Colorado’s mountain communities face extremely high premiums and often only a single choice of carrier for individual health insurance plans. He pointed out that “the Colorado option is not a bill that’s intended to fix all the problems that we have,” that it is intended for those who cannot afford any other product that is available in the individual market. “We understand that most people like their employer-based insurance and we are not doing anything to touch that in this bill.” He explained that his goal is to “try to increase competition in the counties that I represent (Eagle and Routt) and many other counties.” If the bill passes, Roberts anticipates it would impact five to ten percent of the state health insurance market. HB20-1349 was introduced March 5. It passed out of the House Committee on Heath and Insurance on March 11, with the first six of what will likely be many amendments to the original text, to the House Appropriations Committee.
Lindsay gave Roberts credit “for taking on this tough issue,” but expressed objection to “the State of Colorado interfering in a contract between two willing participants, an insurance company and a hospital, and setting the prices,” as a fundamental public policy. He also objected to the requirement that insurance companies sell in markets not chosen by them. Lindsay said that overall fault with the current situation lies with employers, because they “don’t buy health care like they everything else, like steel, electricity, and legal services. They don’t buy based on cost and they don’t buy based on quality.” He continued, “They want to give employees choice, as if there’s a value in choice,” pointing out that choice doesn’t help employees determine where they can get the best care for their particular condition.
Paul Archer, President of Automated Business Products, addressed the panel, saying that there is no free market, no accountability, and no transparency in health care. He disagreed strongly that employees and employers like their employer-based health insurance, citing “rising premiums, rising out-of-pocket costs, and limited choice.” Archer criticized the Affordable Care Act (ACA), saying it has increased costs and increased access only through Medicaid. He credited the ACA with getting more people in the system (93 percent of Coloradans have health insurance) by requiring coverage of pre-existing conditions.
The discussion drew a highly distinguished group of listeners, including J J Ament, CEO of Metro Denver Economic Development Corporation, Henry Sobanet, CFO of the Colorado State University System, Heidi Ganahl, University of Colorado Regent, Dr. Reginald Washington, chief medical officer of P/SL Medical Center and The Rocky Mountain Hospital for Children, Ben Stein, former deputy state treasurer and former CFO at the Colorado Department of Transportation, and Jennifer Churchfield, former president of the Cherry Creek School Board.
2018 All Rights Reserved. Villager Publishing |