Why I am endorsing ColoradoCare and Amendment 69

Dr William Clancy, Denver PsychologistHere is my personal reasoning for supporting ColoradoCare and Amendment 69, which will be on the ballot here in November. I’m hoping that sharing this could sway a few folks into action on this issue or convince anyone who’s on the fence about whether to vote for it. I’m also hopeful that any clients or colleagues who might oppose my reasoning will not be personally offended.

 

As both a health provider and a consumer I believe we need to be done with private health insurance companies. At MindBodyHealth we accept two types of insurance: one is a private insurer (unnamed so as not to bite a hand that somewhat feeds me) and the other public (Medicare). In every category Medicare is much more reliable, efficient and accessible. People with Colorado employer-sponsored private health insurance pay high premiums, averaging $6251 per individual annually (Kaiser Family Foundation, 2015) and deductibles, averaging $1318 per individual (Kaiser Family Foundation, 2015) prior to receiving any coverage. For those who buy their own insurance like me, those numbers are higher — especially the deductibles, which usually (and perhaps to my detriment) dissuade me and from seeking care in the first place. I would bet most other people who buy their own health insurance would say the same.

 

In my experience, private insurance coverage itself is: complicated; poorly administered by increasingly outsourced personnel; subject to patient co-pays on top of premiums and deductibles; utilizing narrow provider networks; just plain meager where the rubber meets the road. Medicare pays for a uniform percentage of covered services, is regionally administered, and does not operate under a profit motive. Private health insurance companies are beholden to shareholders and make their profit as a function of denying (not providing) coverage. Private insurance revenues offset obscene CEO salaries, bloated administrative bureaucracies, and pricey advertising campaigns. The health insurance industry necessitates and fosters similarly wasteful administrative spending within hospitals and healthcare systems themselves. Generally speaking private health insurance does not provide a lick of actual health care to a single patient, Kaiser Permanente’s not-for-profit setup being the notable exception in our state.

 

The best our federal government could muster in response was the Affordable Care Act. While thankfully doing away with denial of coverage for preexisting conditions, the ACA has made purchasing insurance more complicated and delivery of health care more privatized. The ACA has done nothing to curb premiums. Mine more than doubled last year and under ACA I would pay a $600 fine if I did not enroll. We are getting less while spending more. Despite the ACA codifying their ongoing role in our healthcare system, enough is not enough for the private insurers. Recently some insurers have begun abandoning entire states’ ACA exchanges, cherry-picking the more profitable states for them. Reportedly they are leaving the states who do not have enough “healthy people” signing up for ACA coverage. This throws off their actuarial tables and profit projections and thus turns off investors. Our state is relatively healthy, according to the bean counters, but who knows how much those winds need to shift before we are abandoned, given fewer private-insurance choices, and are further price-gouged ourselves?

 

Private insurance not only price-gouges consumers, but it also reimburses most health providers at a substantially lower rate — 38-48% lower for my clinic despite the fact that we made proper, formal and reasonable requests to be reimbursed equivalent to Medicare rates which usually represent “reasonable and customary” in the health industry. The list of advantages when comparing Medicare to private insurance goes on and on and on. We are shooting ourselves in the foot in order to keep servicing the failed ideology that publicly-run institutions are necessarily deficient/inefficient/too expensive. Or maybe it’s unmitigated worship of corporate culture. Either way the pro-health insurance arguments now come from both major political parties. My guess is that for elected Republicans it is ideological while for elected Democrats it is because the private insurance companies provide sizable campaign contributions and potential state business contracts which also lead to votes. Or at this point maybe it’s both things for both parties.

 

Given my political leanings, however, it is particularly shameful that leading Dems such as Gov. Hickenlooper, former Sen. Bill Ritter, and Sen. Michael Bennet have come out against Amendment 69. This is true even as the 2016 Colorado Democratic Party platform endorsed universal healthcare. Maybe the Hickenlooper-Ritter-Bennet political stance is understandable in a state that has been described as a few blueberries in a bowl of tomato soup. Maybe here it is politically risky to back a ballot measure that would raise state income taxes by 10% (under Amendment 69, two-thirds of that would be paid by employers and one-third by employees for payroll income). But it shouldn’t be difficult to make numerical sense of this even if you’re of the knee-jerk anti-tax crowd. If you compare a personal 3.3% state income tax hike for yourself to what you’re paying for now in premiums, deductibles and co-pays alone, it’s not even close. As a business owner, you can add in the 6.6% your business would be responsible for in covering the tax hike, and it’s still not close to what it costs to provide partial private health insurance for your company’s employees. Currently health benefit costs are 13.5% of payroll for the average U.S. employer.

 

You’ve also got to look at what we would get. We would get more comprehensive care, an expansive provider network, owned by members (Colorado residents) who would elect a board of trustees which can even decide, if the funds are available, to expand into benefit areas traditionally neglected by private health insurance such as dental, vision, hearing and integrative/alternative care. This is improved care at a net savings for the residents of Colorado, and if you’re like me you need net savings yesterday.

 

We are overpaying for private health insurance in what sounds to me like a criminal enterprise. Come to think of it, private health insurance is usually illegal in countries that have universal health coverage! I would hope if we lead the way in providing universal coverage in Colorado, the rest of the U.S. will follow and private health insurance would be defunct if not illegal. If you work for a health insurance company, I would sincerely apologize for you losing your job. But my health costs are not a jobs program — leave health care to the health provider. Either go back to school like I did to become a health provider, or go work in a more socially responsible industry like renewable energy.

 

My experiences as a psychologist in our broken healthcare system don’t end at these comparisons. I have stories to tell, and I intend to include them in a new blog coming soon to a news feed near you.

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