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Posted: March 10, 2011

No to a Colorado Heath Care Authority

It would mean jobs lost

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Editor's note: This is an edited version of the recent testimony from Dan Anglin, CACI Governmental Affairs Representative, against Senate Bill 168, sponsored by Sen. Irene Aguilar, D-Denver. The bill would set up the Colorado Health Care Authority to design a health care cooperative. The authority would recommend a universal health care system that could be run by the cooperative, and the proposal would be put to a statewide vote.

I am here today to oppose SB-168. The CACI HealthCare Council carefully considered this bill and determined that it is designed to create a single-payer system of health benefits that will put the delivery of health-care within the confines of a governmental authority.

By creating a governmental health-care authority that is charged with providing health benefits for all Coloradans, SB-168 displaces the private health-insurance industry that directly employs over 20,000 people in our state.

Data indicates that for every health-insurance job, there are two-to-three other occupations that are directly related, which means that passing SB 168 could mean more than 60,000 jobs lost in Colorado. 

The bill recognizes that jobs will be lost if this measure is passed by requiring the authority to determine measures to provide retraining, and to determine measures to provide extended unemployment insurance benefits for those who are displaced by the establishment of the cooperative. 

We are talking about claims processors, fraud investigators, information-technology professionals, actuaries, benefits managers, phone-bank workers, collections agents, administrators, assistants, and anyone directly employed by an insurance carrier. 

In addition, this bill would put pharmaceutical benefits-management companies out of business as well as brokers, agents, and anyone else who works in the health-insurance industry. 

As we all know, Colorado's Unemployment Insurance (UI) Trust Fund is insolvent. It is unclear how the state will be able to manage the burden of over 60,000 new UI claims when Colorado is already borrowing money from the Federal Government to cover those unfortunate Coloradans whose jobs have already been lost to the recession. How can we afford to put an entire industry out of business? 

Single-payer models are not innovative. Competition drives innovation. Private health-insurance carriers are well ahead of such single-payer models as Medicare and Medicaid in:

· Predictive modeling tools to proactively identify high-risk individuals and then outreach to help improve their quality of life and reduce cost,

· Disease management and wellness programs, and

· Certification for high-performing physicians, for example. 

By putting providers under the umbrella of the state, hospitals, clinics, surgery centers, emergency rooms, urgent care centers and medical centers will become the financial burden of the taxpayer. Private health-care that is managed by private businesses will become a thing of the past. 

The legislative declaration of this bill states that the PPACA is insufficient to cover the care of those without insurance. CACI, as well as all of the other major business organizations in Colorado, have been working with the sponsors of the bill that will create the Colorado health insurance exchange, a measure that promotes competition within private health-industries to provide access to care for over 300,000 people currently uninsured in our state. 

The exchange is not an effort to put private industry into the hands of the government. It is an effort to enroll those who would qualify for Medicaid under the new Federal guidelines into that program and to create cost-savings for individuals and small businesses by combining the risk of the individual market and the small-group market, to provide people with access to quality, affordable care. 

SB-168 would decimate those herculean efforts by the business community, the health-care industry, consumers, and elected officials to provide health-care that builds Colorado's economy while making our residents healthier. 

Additionally, the bill has a conditional fiscal note of $1.2 million just to create the authority and the administrative burdens that are associated with the creation of a new quasi-governmental agency. 

In closing, the concept of a single-payer system is designed to put the government in the business of providing health benefits. This bill will put too many people out of a job, put too much of a financial burden on taxpayers and will put a government agency in charge of your health-care decisions. 

Additionally, the financing of this authority would center on mandatory payroll contributions, income-tax assessments, and an income-based premium. 

Please reject this job-killing, government-takeover of the fastest growing sector of our economy.

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Readers Respond

Now you're sounding like Nancy Pelosi with her famous idiotic statement: We have to pass it so we can see what's in it>" It's amazing to me that anyone would try to find out a solution with "legislation.' It's simple, when Jerry Sonnenberg and Greg Brophy tell me it's worth looking at, I'll consider it. I supported BOTH of them a LOT and I trust them. I trust few of the "front range" crew. You have to get our support before you'll get ANYTHING done and so far it's the same old government story. I find it difficult to waste even this much time on it. Come up with a BI PARTISAN plan that my rep's can support and I'll consider supporting it. I DO talk to a LOT of people each and every day. By john wray on 2011 03 24
John - You keep saying Obamacare is bad. I keep saying Colorado can do better by independently designing our own system. You don't want anything to do with government-controlled health care. I see that SB11-168 seeks to remove a lot of the government control of our health system by keeping our health care dollars in an independent protected trust and not part of the state's General Budget. You keep saying rural doctors won't participate in Obamacare. I keep saying we need SB11-168 to see how we can design a system that supports those docs and builds more private health resources in underserved areas like rural Colorado. You complain about direct-jobs programs through government. I say we need to reduce health insurance expense burden so that capitalism can grow its own jobs across all industries with the savings. It turns out we are not so different after all. The difference comes down to what we decide to focus on: the problems we know or the solutions we can create. By Nathan Wilkes on 2011 03 24
IF the "independent commission" was comprised of small business people, I'd be glad to consider it, but if it has ANYTHING to do with the government controlling it, then I don't want ANYTHING to do with it. when you can tell me how well our government has done with ss and medicare, I'll listen to you, but of course you can't. EVERYTHING the government has done with money is broke. Unless we get away from that we have NO chance of improving the situation. The road to hell is paved with good intentions and I'm sure you know that, but you seem to ignore my point about rural health care being destroyed. The DOCTORS won't do it. I have MANY doctor friends and NONE of them intend to participate. Most rural doctors are wonderful people who care about their patients as opposed to the metro situation. The already have to pay two extra staff people to process medicare and medicaid and know what a govt program will do. To a person, they intend to retire if forced to participate. that's the law of unintended consequences that liberals just can't get grasp of. It goes on and on and gets worse at every step. It's kind of like the governors "ground up" jobs program (that I am on) that acts like the government can create a job. The ONLY job they can create is a government job which takes ANOTHER ONE OR MORE out of the private theater. this simply will NOT work the way it's set up and I will be eternally grateful that liberals don't have a majority to get it throught the legislature now. By john wray on 2011 03 24
John - I still haven't heard any specifics from you regarding your opposition to SB11-168, other than a ACA-directed opposition to anything you decide to label "government." I'm guessing that means you don't accept Social Security or use Medicare. Please correct me if I am wrong. Do you have any real specific issues with Colorado seeking an independent, innovative alternative to federal health care reform? Also, calling a fact an opinion (and vice-versa) doesn't magically make it one. Real critical thinkers will see through your "sweeping generalizations" argument, as I haven't posted anything I can't document and prove. I understand your frustration with government, but that is why SB11-168 is much better than what we have now or will have under the ACA. It seeks to return the power to the people. The ACA only gives more power to the big-business private insurers, who reciprocate through campaign contributions to the government power brokers in both parties. My personal doubts about the ACA are due to the fact that special big-business interests (health insurance companies) wrote it. In that regard, I agree that government is indeed broken. We have more local power and control at the state level, though -- more responsive to people, communities, and real small businesses. One state will figure things out and fix it first. It would be great if that state were Colorado. By Nathan Wilkes on 2011 03 24
I'm sorry, but I guess I'm always stunned that ANYONE can believe that our government can get anything right. Small business can and only they. If I could join my nationwide organizations plans, I could cut my costs by 1/3, but that competition is barred. The sweeping generalizations by Nathan are OPINIONS and ONLY OPINIONS that have NOT been proven and that have little chance of being proven. By john wray on 2011 03 24
there's an old adage about government that any "cost estimate" for a governemt program should be tripled. You just don't get that. This bill is a government program and is doomed to fail, especially without COMPLETE bi partisan support which it will never get because of the current climate in government. There is NO more give and take and until our conservative rookies get more say, there's no chance for sensible compromises. This is a waste of time. How about obama care's TOTAL "miscalculations" and the already HUGE hc increases for small businesses. In fact a large number of companies have pulled out of rural areas so the "choices" that have been promised will never materialize. Rural care is doomed under obamacare AND this poorly put together state joke of a hc program. By john wray on 2011 03 24
Starbucks had long admitted that health insurance costs for their company was more than what they spend on coffee beans. Starbucks CEO, Howard Schulz, recently said "we have faced double-digit increases for almost five consecutive years with no end in sight." This was before the ACA. He recognized that the MANDATE to purchase costly PRIVATE insurance is harmful to small businesses. This is exactly why we need to explore the opportunity in SB11-168. The Cooperative would present a plan that would show lower costs to small business. The Cooperative is an attempt to "start over" as you suggest, as the plan presented would offer Colorado an independent option for self-destiny that is not reliant upon the ACA. We are Colorado and we can do it better. We just need SB11-168 to give us accurate information first. Without that, we have to follow the lead of the federal government. Simply trying to undo any reform at all would mean status quo -- continued double-digit increases, more people losing coverage, and a faster unraveling of the health insurance system. I don't know where you get your NFIB numbers, but the ones I see in quotes from NFIB executives suggest that premium increases could be around 20%. Still ridiculously high, but nowhere close to your 40-65% suggestion. I would appreciate a reference, as I tried in vain to find one to support your argument. My personal experience is that I've had about a 10% increase most recently, where previous years were routinely 20-35%. The lack of cost control in the ACA will eventually be its undoing. Universal participation is one method to help contain costs, but the individual mandate as written is not sufficient enough. All it does is guarantee taxpayer and workers will be funneling billions more dollars to health insurers. SB11-168 would let Colorado evaluate the system as a whole -- tackling access issues and cost control simultaneously and in a real and tangible way. Bipartisanship is not necessarily the panacea you might expect. As a case in point, consider the Exchange bill that was just introduced this week. It has bipartisan co-authorship. However, it lacks any cost control mechanisms. As it stands now, the Exchange is forbidden from helping reduce costs of plans in the Exchange through what is known as "active purchasing." This was one of the key recommendations of the NAIC. The provision was stripped by Republicans at the request of insurer-dominated business groups. So, we end up with something ostensibly "bipartisan" but it fails to address the runaway cost inflation that ultimately hurts both your business and mine. I think you would find SB11-168 to be a good idea if you took an honest look at it, rather than assuming incorrectly that it is some kind of extension of "Obamacare." There is a lot as independent business owners we actually agree on. Several Republicans I talked to at the Capitol yesterday expressed interest when they saw it as a way to truly address cost control and create a better climate for business. Plus, SB11-168 allowing Colorado to chart its own destiny in health care -- with smaller government involvement -- was seen as a major plus. The only Republican bill proposed thus far would require that we get into bed with some other random state, such as Tennessee, (through "interstate compacts") and jointly develop health care reform. So we would have to deal with TWO state governments AND additional inter-relational government boards to get anything done. Sounds like pretty dumb big-government to me. By Nathan Wilkes on 2011 03 24
btw, the CEO of Starbucks who was an avid supporter of obama care has now seen the light. He finally figured out that it would increase costs in a huge way. NFIB estimates that small business increases will be between 40 and 65%. Mine is 40% THIS YEAR because of obamacare so I guess I should consider myself lucky. Colorado HAS to start over and get a BI PARTISAN approach to this or the state, like this nation, will be horribly split for a very long time. By john wray on 2011 03 24
Ivan, there's direct pay and indirect pay; yours is indirect. You couldn't be MORE obvious in you presentation of a failed and misdirected bill. You don't really have a clue, imho, about the real effects of this bill and you've ignored EVERY single fact that I've presented you. You are a lobbyist period, no matter what your "pay" is or isn't By john wray on 2011 03 16
John and Bill, I take umbrage with what you have said about me. My identity is not a secret, however, I am not paid. I volunteer as Senator Aguilar's Health Policy Advisor. SB 168 was written incorporating the concerns of a wide range of people and economic considerations, and I believe it is unfair to call it communist. It has been designed with the interests of consumers, providers, and employers in mind. I am providing information on blogs because that is one forum for people to learn, and I think it is unfair to call that harassment. My information is usually footnoted, and I make every effort to make sure it is accurate. I do care about people who cannot receive health care, and I believe that it is wrong that we pay so much more for a system that keeps so many without health care when we could cooperate as a community, pay less, and have everyone have health care. Many societies do this all over the world without having communism. That is the motivation of most of the people in Health Care for All Colorado and Denver Health and Hospitals where many of the uninsured and underinsured are cared for. If I were CACI or NFIB, I would not support SB 168 because it would be disruptive to the organization to have the health insurers' businesses become obsolete because of a better system that benefited the other members. I would not want the disruption and internal conflict. As a businessman and in discussions with many other business people, there is a great desire to look for solutions that remove business from responsibility for health care. I believe that when examined closely, realistically, and fairly, most people will find SB 168 to be a great step forward for consumers, providers and employers. By Ivan J. Miller on 2011 03 16

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