New Democrat Bulletin - April 2008
KEEPING HEALTH CARE AFFORDABLE
At a time when policymakers are seeking ways to improve the quality of health care, while making it less expensive, there is a proposal in the legislature that could increase health care costs for consumers. That is especially unhelpful when those costs are rising twice as fast as workers' wages.
SB 164, by allowing injured patients to sue doctors for more money, would significantly increase medical malpractice insurance rates. Capping jury awards and other similar reforms have helped to keep such premiums approximately 10 to 15 percent lower, according to the Congressional Budget Office.
Higher health care costs make it even more difficult to get everyone insured and harder to improve access to care, especially in rural areas. It could also result in more doctors practicing “defensive medicine,” conducting unnecessary procedures and avoiding riskier practices like emergency care, obstetrics and surgery. As quoted in The Denver Post, "physicians will look at more and more ways to cover their butts," according to Sen. and New Democrat Caucus Chair Bob Hagedorn (D-Aurora).
Legislators should not mess with a good thing. The American Medical Association identifies Colorado as one of only eight states in the country with a sound medical liability system.
The Colorado Community Health Network, which represents clinics that provide comprehensive primary health care to nearly 400,000 low-income Coloradans every year, is opposed to injecting more litigation costs into the system. In a letter to legislators, Polly Anderson of the Network wrote “with more than 790,000 uninsured Coloradans, we cannot afford to make medical care even more expensive. We urge you to vote ‘NO’ on SB 164.”
Reforming health care is already hard enough. This is no time to make it even more difficult.
BETTER HEALTH CARE
Sen. Hagedorn (D-Aurora) and a bipartisan group of other legislators are leading the charge to give health care reform a very-needed shot in the arm. The proposal, named "Centennial Choices," recognizes that everyone - individuals, doctors, hospitals, health insurance plans, businesses and government - must come to the table and work for a health insurance system that covers everybody.
Every Coloradan should have access to a menu of coverage options that meet their budget and health care needs. Too many low-income individuals, children, and employees of small businesses do not.
Along those lines, Centennial Choices directs the state to request private insurance companies to come up with low-cost plans. The state would then evaluate and endorse these "value benefit plans" (VBPs) and help make them available to all Coloradans.
Every person would be required to take individual responsibility and have health insurance. That is only fair since the uninsured raise the costs of the entire system. Financial assistance for a VBP would be provided to those who do not qualify for Medicaid but still cannot afford private insurance.
More immediately, Hagedorn and his fellow Democrats are also focusing on how to get health insurance to more children. SB 160 and the current proposed budget make 50,000 more kids eligible for the state's very successful Child Health Plan Plus (CHP+) program.
On another front, a lengthy, detailed application process for both CHP+ and Medicaid programs makes signing up kids challenging. For example, some children do not get enrolled because their parents do not provide the required paycheck stubs for the entire previous month.
Such paperwork requirements should not be necessary in the Information Age when that data are already kept by the state. Sen. Betty Boyd (D-Lakewood) and Rep. Mike Merrifield (D-Colorado Springs) have a bill that would allow CHP+ and Medicaid to verify a family's income through the state Department of Labor and Employment.
Better yet, the state could build on this idea and do what Maryland is now considering - taking and using information from state income tax forms to identify which eligible children are uninsured and discuss with their parents the available health insurance options. Parents would check a box on the form indicating whether their children are insured or experienced recent lapses in coverage.
The health care crisis has reached such depths that both short-term and long-term strategies are necessary. Thankfully, Democratic legislators have shown they are up to this most important challenge.
“NEW” NO-FAULT MAKES NO CENTS
After years of escalating auto insurance premiums, the Colorado legislature in 2003 switched from a “no-fault” system that required purchase of what was then the third most expensive medical benefits package in the country to one that lets consumers pick and choose the coverage that makes the most sense for them. Under the old system, Colorado motorists were required to purchase coverage that often was not needed, wanted or affordable. The large majority of drivers who already had health insurance were effectively - and most times unnecessarily - required by law to pay for still another medical policy.
Not surprisingly, empowering consumers with coverage choices, combined with intensified competition from 51 new car insurance companies that have entered the market since the end of no-fault, have turned double-digit rate increases into double-digit rate decreases. According to a study prepared for the Governor’s Office released earlier this year, the average premium in the state has decreased 35 percent, $322 less per car per year. Once ranked ninth in the nation for having the costliest auto insurance rates, Colorado has dramatically dropped to 21st - in the short span of just six years.
Under no-fault, an estimated one-fourth of all state drivers violated the law by not carrying auto insurance. Today’s lower costs, combined with tougher enforcement, have reduced that number to 11 percent (while the national rate during that time actually rose). Increasing the portion of motorists in the system will be another force that helps decrease rates for everyone else.
The new system also seems to be boosting customer satisfaction. Despite an 18 percent increase in the number of registered cars, consumer complaints have actually dropped by 63 percent between 2002 and 2006.
Of course, drivers will still need compensation for their medical expenses from accidents. However, compared to the old auto insurance system, health coverage has been much better at covering that care while more effectively controlling its costs.
Today’s more streamlined auto insurance system, along with the ever-rising cost of emergency medical care, has yielded one unfortunate result. Many trauma care providers, especially in rural Colorado, are hurting financially. That is the major factor behind why some want to bring back the costlier system.
But that is like using a sledge hammer to kill a fly. Instead, lawmakers should consider a more targeted strategy - providing subsidies to those trauma centers that need the help.
At the end of the day, Colorado motorists are much better off now than they were prior to 2003. They know a good deal when they see it.