State Sen. Irene Aguilar wants Coloradans to imagine a day when 80 percent of them see their health care costs drop.
She says the wildly different health care system she envisions can make that happen 鈥� largely by eliminating much of what health insurance companies do, and by purchasing everyone鈥檚 medications in bulk.
The Denver doctor and Democrat is proposing that Colorado throw out the impending reforms know as Obamacare 鈥� which is permitted if the state comes up with a better plan. This week to ask Colorado voters to create a universal health care system for the state.
鈥淚 want the public to understand the United States spends more money on health care than any other industrialized country in the world,鈥� Aguilar said. By cutting the 28 percent of spending that is wasted, her plan will cover every resident who鈥檚 lived in the state at least a year.
Her plan is radically different from health care as we know it. No more paying for insurance premiums when one is without income or a job. No more sorting through confusing policies trying to figure out which one to choose. No more bills where the hospital is covered but some doctors are not. No more insurance companies with hundreds of different billing systems driving doctor and hospital staffs crazy, denying claims, and driving up the cost of care.
(editor's note: Disclosure, Dr. Marc Ringel was a former commentary contributor to KUNC on health issues), a Weld County physician, supports Aguilar鈥檚 plan and describes the high cost of that mess of insurance paperwork in a doctor鈥檚 office.
鈥淥ur overhead is 20 percent to maintain this complicated, complicated system鈥� for insurance billing, Ringel said. There are at least as many people in the front of most doctors鈥� offices doing paperwork as in the back providing care to patients, he said.
鈥淵ou can get rid of the incredible waste in our system,鈥� by cutting out the middleman, agrees Ivan Miller, a psychologist and president of the Colorado Foundation for Universal Health Care. The group supports Aguilar鈥檚 plan and did an economic analysis of it.
The proposal has yet to be thoroughly vetted by opponents 鈥� who could be legion given the number of people who might lose their jobs and businesses.
Specifically, Aguilar鈥檚 bill would ask voters to create a statewide health insurance co-op, owned by all Coloradans, which would replace health insurance companies. It would offer one wide-ranging policy for all residents. It would be funded by a tax, which would replace the insurance premiums that companies and people now pay.
By slashing the 31 percent of Colorado health expenditures that now go to administration 鈥� most of it caused by insurance companies 鈥� Miller expects the cost of health care to drop by $880 per person the first year.
鈥淲e know that it would save billions of dollars,鈥� said Lyn Gullette, a psychologist and executive director of Co-operate Colorado, the organization set up to advance the project. 鈥淲e expect some business will want to move to Colorado because costs are lower.鈥�
Employers currently spent 11.8 percent of their payroll on staff health insurance and worker鈥檚 compensation, Aguilar said. 鈥淥ur plan would ask them to pay 6 percent,鈥� she said.
Employees would pay 3 percent of their incomes. For the average Colorado family with an income of $52,000 that would be $1,500 鈥� far less than many are spending now, Aguilar said.
People with non-salary income would pay 9 percent on up to $450,000 in income, Miller explained. That might be steep for a successful single person or the wealthy. But for a family of four with an income of $100,000 it would amount to $9,000 a year 鈥� well below the $15,000 cost of a typical insurance policy today.
To succeed, Aguilar has to win a statewide ballot approving her plan. Such a campaign could be expected to prompt deep-pocketed insurance companies to spend millions in opposition, and to stir conservative outrage over a new tax.
Sen. Kevin Lundberg, R-Berthoud, says he objects to the general concept.
鈥淲hen the patient and the doctor don鈥檛 have to consider what will this cost, they choose things that cost too much,鈥� Lundberg said. 鈥淎nd the overall system gets overburdened, we find we can鈥檛 afford it and the only final solution is rationing of care.鈥�
But Aguilar is an unusual legislator. Last year, she won 9-0 approval in committee and eventual bipartisan passage of her bill that stopped hospitals from charging their highest prices to their poorest, uninsured customers. She altered the bill until she had support from both Republicans and hospitals.
Even the insurance companies are taking a gentle approach for now. Ben Price, executive director of the , praised Aguilar鈥檚 attempts at improving the system. 鈥淭he health care system is broken 鈥� She鈥檚 trying to solve it. She really is,鈥� he said.
Price said that instead of worrying about Aguilar鈥檚 proposal, insurers are focused on implementing the health reforms already approved 鈥� the and the state鈥檚 new online system for buying health insurance that will be operating by this fall.
If Aguilar鈥檚 proposal becomes reality 鈥� no sooner that 2016 鈥� 鈥渋t would be difficult for the carriers to operate in the state,鈥� Price said. But still, 鈥渨e don鈥檛 want to see any of the carriers that are in the state leave, because right now we are the fourth-most competitive state in the country, and that鈥檚 a good thing,鈥� Price said.
The bill doesn鈥檛 actually ban insurance companies, and some would continue. Kaiser Permanente, for example, is already also a health care provider. Others companies could shift their business models toward management.
The Colorado Medical Society, representing the state鈥檚 doctors, said it is 鈥渕onitoring the bill closely鈥� and communicating with the senator.
The economic study predicts Aguilar鈥檚 proposal will save $1.2 billion in the first year by purchasing all medications used in the state in bulk. Costs would be cut further by consolidating all medical records on a smartcard carried by each resident.
Miller likened the current health care system to a state where people are allowed to drive only on the highways built by their own highway provider.
鈥淭he state would be covered with asphalt鈥� and the cost would be enormous, he said. Aguilar鈥檚 proposal is similar to a single publicly funded system of highways, he said.
Aguilar doesn鈥檛 know if she鈥檒l find a single Republican co-sponsor, but said, 鈥淚鈥檓 hopeful for a vote or two鈥� from among GOP legislators to agree to put the question to the voters. She is hoping to get the proposal on the ballot this fall.
鈥淏ut I know that frequently, things that are very dramatically different take a few years to make them happen,鈥� she said. 鈥淪o if not (this year), this will get me one step closer than I would be without it.鈥�
