Jonathan Swift couldn’t have conjured a more sarcastically modest proposal. On Monday, the Colorado Blue Ribbon Commission on Health Care Reform sent out a news release asking “anyone who is interested” to submit a plan to solve the state’s health care crisis.
“Proposals,” the release stated, “must be submitted no later than April 6, 2007.”
The commission’s chairman, Bill Lindsay, understands how silly it sounds to give people a month to draft a fix for one of the state’s most vexing problems. But he says the blue-ribbon panel has been meeting publicly since November.
Though it didn’t formally publish guidelines for proposals until Feb. 22, Lindsay said, the players who will shape Colorado’s most important public policy in decades have been all over this since last year. That’s when the state legislature established the commission.
“It’s a tight timeline and challenging,” admitted Wade Buchanan, president of the Bell Policy Center, which consults with several groups submitting proposals. “But it’s not like people are starting from scratch today.”
The universal health coverage the governor and the legislature promised to all Coloradans by 2010 seems likely to require more government-driven health care programs.
Expect at least one call for single-payer health insurance. Expect at least one call for a phased expansion of Medicaid paired with a parallel program that increases health coverage to the working poor. Expect at least one private market-based program.
Lindsay said he has encouraged the private health insurance industry to present a plan. But with less than a month to go, the state’s universal health care plan seems destined to be shaped by groups such as the Colorado Coalition for the Medically Underserved, Health Care for All Colorado, the Colorado Consumer Health Initiative and the Colorado Community Health Network.
Blue-ribbon commissioner Linda Gorman of the conservative Independence Institute claims that the process guarantees a government-heavy approach.
“The focus is on the uninsured,” Gorman complained of the plans she’s heard of. “That’s a pretty terrible way to design a health care system.”
Guys like Mark Earnest, a physician who serves as vice president of the Coalition for the Medically Underserved, thinks it’s just fine. Colorado’s 770,000 uninsured citizens forced politicians to finally address an imploding market-driven system.
“Financing is the bugaboo,” Earnest said of proposals that will emerge in the coming month.
Cost estimates for the much-touted Massachusetts universal health coverage program have turned out to be artificially low, critics claim.
At the same time, administrative overhead in the U.S.’s current private health care system has reached a point where government-mandated care might deliver more actual medical treatment for the same dollars.
By the time the blue-ribbon commission offers its recommendations to the General Assembly on Nov. 30, 2007, Lindsay promises to have identified a lead proposal and passed along as many as four alternatives for legislators’ consideration.
He and his 23 fellow commissioners “reserve the right” to “cobble together” the best ideas they get and add some of their own. Meanwhile, the commission has set up a conflict of interest policy to keep members from profiting.
“Clearly, we’d love to give people more time (for proposals),” Lindsay said.
Just as clearly, they can’t if the commission is going to make a first cut and submit several plans to a private consultant for 90 days worth of economic analyses and still meet its legislated deadlines.
In the end, the commission, then the legislature and the governor must establish a balance between costs and care. That tricky equation turns on whether folks think medical treatment is more a human right or a business endeavor.
However tight the time frame, the distinction will determine what happens to health care in Colorado.
Jim Spencer’s column appears Monday, Wednesday and Friday. Reach him at 303-954-1771, jspencer@denverpost.com or blogs.denverpost.com/spencer.
