Face The State Staff Report
As a controversial Colorado health care commission prepares to release this week its recommendations to establish health insurance coverage mandates would cost Colorado taxpayers billions of dollars, critics from the panel are providing an alternative blueprint for change.
Tomorrow, Colorado’s Blue Ribbon Commission for Health Care Reform, established in 2006 under Senate Bill 208 and casually referred to as the "208 Commission," is expected to release to legislators a final report that advocates reforms closely mimicking those adopted by the Massachusetts legislature, including a mandate that every resident hold health insurance. The annual price tag has been tentatively set at $1.1 billion.
But not all commissioners agree. In a draft document obtained by Face The State, two dissenting members of the commission express frustration with what they believe was the wrong focus of the commission’s work from the outset.
According to Linda Gorman, an outspoken commissioner and co-author of the dissenting report obtained by FTS, the commission was incapable of cultivating innovative ideas regarding health care. “We should be focusing on access to care—not insurance,” she said. “Insurance is a very expensive and inefficient way to cover costs for low-income people.”
She said commissioners, who first met in late 2006, also struggled with “agreeing on basic facts.” As Face The State has previously reported, projections on the number of uninsured Coloradans swing wildly.
According to the Lewin Group, a national consulting firm hired by the legislature’s Blue Ribbon on Health Care Reform to provide such figures, the number of Colorado residents who didn’t have health insurance for at least a portion of the past year stood at 1.4 million — up nearly a million from a previous Lewin-released figure of 562,800. These two figures, however, are off substantially when compared to the U.S. Census Bureau’s calculation of Colorado’s uninsured at 758,800.
As an alternative to the mandates expected to be released Thursday, Gorman, together with fellow commissioner, Allen Jensen, have proposed a series of recommendations that they say includes substantive reform of government programs, including creating incentives to reduce waste and unneeded administrative and regulatory burdens. According to Gorman, these are the largest sources of cost problems plaguing Colorado’s current system.
Gorman is a strong advocate of “cutting out the middle man,” which she views as the insurance companies who act as third-party “payers”. According to the introduction of her report with Jensen, “When the cost of health care drops, health insurance premiums drop and paying cash for care becomes possible. Paying cash further reduces costs by reducing third party payer overhead, with the result that more people can receive better health care for the same money.”
The commission’s majority recommendations come after the panel rejected 31 other proposals submitted for consideration in 2007. Brian Schwartz, a Boulder-based optical engineer, saw his proposal nixed.
On his Web site, Schwartz writes, “regarding health care reform, Bill Ritter claims to ‘refuse to throw more money at a problem without addressing the root causes of the crisis.’ Unfortunately, the 208 Commission on Health Care Reform does exactly that.”
At a November meeting, the commission passed a rule requiring any commissioner planning to author a dissenting report to vote against the entire package of recommendations. Although Gorman and Jensen voted against the final proposal, Gorman says they do agree with some of the recommendations contained in the set. “Because of this all-or-nothing requirement, people’s views were limited.” A third commissioner, Mark Simon, a disability advocate, is also expected to release his own dissenting report.