[HealthCareForAllColorado] Report on the Health Care Summit

[Carolyn L Taylor]

>     Northern Colorado Business Report's Sixth Annual Health Care Summit 
>                        Tuesday, June 26, 2007   7:30 am - 1:15 pm
> 
Notes on the event by Carolyn Taylor
> First of all, we are happy to announce that HCAC's and PNHP's Dr. Glenn
> Pearson was recognized as a Health Care Hero for his selfless efforts to
> ensure access to health care for all. 
> He is a driving force behind the grassroots movement for single-payer here
> in Northern Colorado.  Congratulations, Glenn!  
This is a report on the three panels, a white paper and the keynote address.
The meeting was very well planned and well attended - 90 attendees.  
Thank you to the NCBR for putting on this annual event to study one of the
most pressing issues of out time - how to get health care to everyone.  

> First panel:  Discussion of CO Healthcare-related Legislation
> Panelists:  State Rep. Kevin Lundberg HD 49, State Rep. John Kefalas HD
> 52, Monica Griego and Kelly Shanahan, both of CO Consumer Health
> Initiative, Ginny Brown, Well City, moderator
> 
> Three bills, which were signed into law this year, were discussed:
> HB 1355, with a phased-in implementation period, removes health status and
> claims history barriers from small group insurance market. Before this
> bill, if an individual who had employer coverage experienced costly health
> problems, the entire workplace could have a rating increase called "rate
> up."
> SB 36 includes "six biologically based mental disorders" in mandatory
> health insurance coverage:  PTSD, ADD, ADHD, substance abuse, depression
> disorder.  
> SB211 Health Care for Children creates an advisory committee. 
> 
> Kefalas voted in favor of all three bills because he believes positive
> effects would be expanding the risk pool, lowering costs for employers and
> eliminating rate banding. (Colorado had a rate band system where small
> firms paid about 10% more for the same benefit plan as larger firms.)
> Mental illnesses cause job absenteeism and job terminations; costing
> businesses to replace workers. Government can make it easier to run a
> business and provide for employees. The role of government would be to
> bring administrative costs down, with the delivery of health care from the
> private sector.  Medicare works well with much less administrative costs.
> Cutting use of ERs would be cost effective. Health care reform must bring
> universal access. Reform can ensure affordability when wellness and
> prevention are emphasized.  He said that it is a question of values when
> there are 785,000 uninsured in Colorado, including 180,000 children. 
> 
> Lundberg voted against all three bills because he believes they take away
> some pricing options. In 2003 the legislature implemented rate banding to
> create a more competitive environment for insurance companies. He believes
> mandates on insurance coverage packages drive up costs for businesses. He
> asked, "What is the role of government in this arena - to force everyone
> into that mold or not?" He expressed concern about Government Doctors,
> "perverse government controls" and "onerous proposals." He believes
> government should act as a referee.  He believes SCHIP plus Medicaid gives
> basic coverage for those most in need.  
> When the 208 Commission was mentioned, he responded, "Trust us - we're
> from the government - we'll look after you!  This year the Colorado
> government is in command and control mode."  He wants to keep "free market
> sensibility." 
> 
> Griego said that CO has one of the highest insurance premium rates.  From
> 2000-2006 there was an 82% rise in health care premiums, while median
> earnings rose by 15%.  Despite having the 7th highest per capita income in
> the nation, Colorado has a higher than average number of uninsured
> residents.  
> 
> Question: Because of these bills, insurance companies will drop out of CO.
> 
> Griego reported that in 2003 there were 81 small group insurance carriers
> in CO.
> They were already dropping out, down to 12 in 2006.  
> 
> Second Panel: Health Care Cost Drivers and Solutions-
> Panelists: Mark Wallace,MD, Dir., Weld County Public Health Director, 208
> Commission member; Marty Bachman, PhD,RN, Director of Nursing, FRCC; Sue
> Carparelli, CO Center for Nursing Excellence;  Virginia Englert, moderator
> Health care costs are projected to double by 2015.  Some causes are
> obesity, diabetes, cancer, depression, stress, tobacco, etc.  Solutions
> are prevention, timely immunizations, pre-natal care, food choices,
> wellness conversations, communities and schools inspiring healthy
> lifestyles, health behaviors incentives/disincentives. 
> 
> Third Panel: The Great Single-Payer Debate - 
> Need of a Patch, or Major Surgery Required? -Linda Mahan, moderator.  
> Cory Carroll, MD,  Fort Collins family practice, speaking in favor of
> single-payer 
> State Sen. Shawn Mitchell (Broomfield) speaking against.  
> Carroll:  Single payer is an organized health-financing program. We have
> other social programs organized this way such as police, libraries, public
> schools, fire departments and mail service.  
> He gave a brief history of health care funding from the 1930s to present,
> citing that FDR (1935) and Truman (1948) attempted to install a universal
> system, which the AMA actively fought, while other nations proceeded with
> universal care. In 1965 AMA came out strongly against Medicaid and
> Medicare. The free market system grew and those who could not pay did not
> get care.  
> 1986 - EMTALA   Emergency Medical Treatment and Active Labor Act -
> emergency rooms must be open to all
> 2000 - U.S. national health care expenditures were 1.3 trillion dollars.
> 2000-2006 - Health care premiums rose 87%.  Why?  
> 1. Insurance companies administration experienced a 2600% rise.  
> 2. Health care insurance companies maximized shareholder profits,
> maximized company worth and maximized executive payroll, 
> 3. But failed in several areas: failed to control costs, failed to be
> efficient, failed to increase access, failed to improve quality, and
> failed to improve health.
> It's very important to look at the TREND, which is toward 
> more uninsured than the current 47,000,000 people.
> US health care spending per capita is twice the spending in other
> countries.
> Ten Reasons Why Business Should Support Single-Payer: 10. eliminate
> liability insurance and worker comp costs, 9. eliminate cost and headaches
> dealing with insurance cos., 
> 8. eliminate conflict and unhappiness with employees, 7. attract better
> employees, 6. curb bankruptcies and free up money for consumer spending, 
> 5. reduce your costs,4. eliminate retiree costs , 3. eliminate unfair
> competition from employers who don't provide coverage , 
> 2. reduce absenteeism and produce healthier workforce, 1. eliminate
> barriers to planning .
> Covering everyone in a single risk pool is the right and moral thing to
> do.  
> 
> Mitchell: Government should have some level of modesty in efforts to help
> people.  A "crisis" - compared to what?   We need a better safety net,
> like those in place for providing food for the poor. 
> Reasons for escalating health care costs:  
> 1. We are treating a lot more people with new therapies.
> 2. Health care is a high priority item, as is going to college. Colleges
> can charge a lot of money because college is something people want.  
> 3. Medicaid and Medicare make US health care 50% publicly funded.
> 4. Red tape and bureaucracy. 
>  I believe other countries are moving back to free-market system. These
> countries have waiting lists of a year or two, creating a greater risk to
> die.  If you're seriously sick... you're shafted.
> The number of uninsured in Colorado, 770,000... there's debate over that
> number because 50% of that group will have "turned over." 200% of Federal
> Poverty Level (FPL) is $38,000/family of 4. This family will have cable
> TV, cell phones, and more than one car. They roll the dice against buying
> insurance. This creates a free rider problem. These are the long-term,
> hard-core uninsured. A state run system equals waiting lines and
> bureaucracy.  
> Question:  How would we take care of the huge profits generated by our
> for-profit system?  
> Carroll: Currently, health care dollars of $300 billion/year are tied up
> in administrative overhead. We could redistribute the money across the
> board, and deliver health care instead of administrating against it.
> Mitchell:  Health Savings Accounts should be set up.  Routine health care
> should be taken care of and paid for by individuals similar to paying for
> oil changes in their cars, not expecting car insurance companies to cover
> that.  
> 
> Question:  Jonas Salk, a very important figure in health care, had no
> desire to get rich.  Why the record profits for the insurance companies?
> Mitchell:  We all can't be Mother Teresa.  Profit seeking is good.
> Viability of the insurance companies depends upon young people buying
> insurance.  
> Carroll:  Fortune 500 median profits from 1996-2004 were single digit
> (3%-5%), while drug companies and health care insurance companies profits
> were sky high (15%-18%). This is not sustainable.
> The government regulates all other aspects of health care, except the
> insurance companies.  
> 
> Question about Social Security and Medicare systems.
> Mitchell:  Current entitlement programs already are squeezing us.
> Carroll:  We must prioritize and ration intelligently.  We can't sustain
> unreasonable end-of-life costs while children are diagnosed with
> illnesses.   Other countries know that they can't give everything.  
> 
> Question: What about our long-term economy?  
> Carroll:  Health care profits are hurting us as an economy.  GM adds
> another $1500 to the price of a car to pay health care costs, compared to
> Toyota's $200 per car cost.  We are spending two times more than other
> countries for health care, yet not getting the value. There is a more
> intelligent way to do this.  
> 
> Question: Lasik eye surgery used to be very expensive, but now prices have
> come down and people buy this service on their own. I want to get both
> public and private bureaucracy out of the way and have individuals pay for
> their health care on their own. Then medical prices will fall.  
> Carroll:  People can't pay for some medical procedures on their own
> (cancers or a terrible auto accident). What do we do when people don't
> make the right choices? The biggest risk pool can provide care for all.
> Single-payer would provide regional delivery of care. 
> Mitchell:  Our system is distorted by the tax code and by employers paying
> for insurance.
>  
> Comment to Sen. Mitchell:  Only 8% of Canadians said they'd prefer the
> U.S. system to Canada's.  In Britain, the poorest quintile is healthier
> than the richest quintile of Americans.  I'd like to suggest that you are
> really a single-payer supporter because of a few things you said, the
> first being that you voted against 1355 because you thought it diminished
> the risk pool - you understood that everyone needed to be paying in.
> Single-payer is the biggest risk pool of all.  You said that young people
> should be paying into the system and that safety nets are too expensive.
> Conservatives in other countries are all for universal healthcare.  I
> thought that you would see this as a conservative value.  
> 
> Question:  I wonder about early care and end of life care. My brother, in
> his thirties, has Crohn's disease and is bleeding to death.  Would
> single-payer help my brother?
> Carroll:  Your brother could look to Cover Colorado, a state
> not-for-profit, which charges 1.4% over the average of regular insurance
> rates.  
> Where do we spend the money -- on an 85 year old on Medicare, who has an
> aneurysm and cancer, or a 35 year old with a life-threatening disease and
> no insurance ?  
> 
> 
> White Paper by Martin Shields reported on the health care sector's role,
> viability and future in Larimer County.
> 
> 
> Keynote speech by Steve Summer pointed out statistics that the state of
> Colorado will need to address before it gets on the road to health care
> reform.
> He had us think about some statistics that make Colorado appear to have
> misplaced priorities. Colorado is ranked 47th in Medicaid per capita
> expenditure, while Colorado median household income is ranked 11th place.
> We show "bottom of the rung" commitment to provide health care. There is a
> 6% limit in state budget for health care. 
> 19.7% of Colorado's children have no health insurance.  17.2% of
> Colorado's total population has no health insurance. 50% of those
> uninsured have income too high for Medicaid, have no employer or are too
> well paid for help from other agencies.
> 
> Summer's Three Predicates (after which health care reform can follow):
> 1. Improve the process - make the system work better by emphasizing
> patient safety and electronic transactions.
> 2. Commit to reduce levels of uninsured by reauthorizing SCHIP and making
> use of Medicaid and SCHIP.
> 3. Eliminate Colorado's constitutional restraints. Health care reform will
> require more money investment.
> 
Other Health Care Heroes (as best I could get them):  Pam Brock, Glenn----,
Project Smile, Michelle Fangman, Jennifer Cobb, Rick Sutton and Maggie
Bassinger         END 
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