By Marshall Snipes, Chair, New Horizon Health Care Council
On November 8th, the election of the next President of the United States, members of Congress and the United States Senate are not the only elections on the ballot of the individual states. In Colorado, voters will decide whether to amend the Constitution of the state of Colorado by voting on Amendment 69 – Colorado’s version of Single Payer. While not widely discussed outside of the state of Colorado, those interested in the future of health care should pay attention. The results of the vote on Amendment 69 will be a barometer for what the citizens of Colorado believe about health care.
Nationally, most people believe the country is still divided as it is on most issues when polled about the Affordable Care Act (“ACA”) or as some call it Obamacare. Recent polling suggests the country may not be as divided as we think. The Kaiser Health Foundation polling shows that even though more people are unfavorable than favorable towards the ACA, the majority of Americans according to a recent Gallup poll conducted in May, 2016 are in favor of replacing the ACA with a federally funded healthcare program providing insurance for all Americans (“Single Payer”). In other words, not all who view the ACA unfavorably are Republicans who want to repeal – many are Democrats who want to replace with a Single Payer system.
By a substantial margin (58% to 37%) the Gallup poll reveals that the electorate is in favor of a Single Payer system. When broken down by Democrats and Republicans the numbers are even more surprising. While 80% of the Republicans want to repeal the ACA, 41% of those same Republicans want to replace the ACA with a Single Payer system. Predictably, the Democrats wanted the ACA to stay (72%) but they also were willing to replace (73%) the ACA with a Single Payer system.
In the meantime in Colorado, Amendment 69 calls for a Single Payer system where the State of Colorado is the payer rather than the federal government for all Coloradans. This distinction may not be important to the electorate. The government pays for health care funded by payroll taxes on the employed. Regardless of the details Amendment 69 is a move to government-controlled health care. Predictably, the debate centers on whether the math adds up. Proponents believe the ultimate cost of the program will save money and provide coverage for everyone. Opponents believe that initially the program will save money but unless the overall cost of healthcare is reduced sizeable deficits will ensue.
Nothing in the Amendment seems to deal with the real issue of artificial demand that leads to lower provider rates to balance the books similar to the financing mechanisms of Medicaid. Those details will presumably be worked out later or taxes will have to increase. In the meantime the voters of Colorado will have the opportunity at the ballot box to opine on Single Payer.
Is Single Payer inevitable? We will have a good idea on November 8th.
Mr. Snipes is the Chair of the New Horizons Health Care Council and former Chair of Integris Health, Inc.