13 May 2007

HCAC's take on a Denver hearing

Michele Swenson, an HCAC board member, took notes at the Denver 208 Commission public hearing in Wheatridge, Colo., on Thursday, May 10.

Shamelessly sharing her observations with the world:
There were seven commissioners at the hearing: Carrie Besnette, Bill Lindsey, Arnold Salazar, Julie Greene, Donna Marshall, Joan Weber, and David Downs

Three hours of public comments included a representative of the Colorado Association of Health Underwriters who spoke in favor of mandating individual coverage — without addressing problems of private insurance cost. He mentioned all those people buying ski passes instead of insurance.

The chair of the Progressive 15, a 15-county rural area in northeast Colorado, spoke to the lack of providers and affordable insurance. He mentioned all those people buying food instead of insurance.

Many spoke of the need for primary preventive care. One doctor said primary care is undercapitalized in the United States: Inadequate reimbursement keeps down the numbers of primary care providers.

Bill Sample of the Balanced Choice group (a proposer group whose proposal has been eliminated by the commission) said the Balanced Choice plan had been miscategorized. It serves as a transition plan to single payer, he said. He hoped that the commission would revisit aspects of the plan that they had set aside for reconsideration.

Nathan Wilkes, another single-payer proposer, spoke about his struggle to retain insurance for his family after his son was born three years ago with hemophilia. Wilkes also submitted a single payer proposal that the commission has set aside.

Health Care for All Colorado members testified persuasively. Board member Howie Wolf, M.D., emphasized that insurance does not equal access; that sustainability is vital, and that high deductibles prohibit primary care. The Massachusetts plan is failing, he said, as shown by their falling rates of primary care and immunization. George Swan, a retired hospital administrator, spoke about the thousands of insurance plans, of value streaming, and eliminating the inefficiency of high overhead costs. Brenda VonStar, RN, also spoke about her experience as a provider to underserved populations who can't get needed care. HCAC board member John Valvano told the commission about Tommy Douglas, who brought single-payer-financed, universal healthcare to Canada. A poll recently found him to be the most admired Canadian of the last century. John said we needed to maximize health care dollars and cut unnecessary administrative costs. Health care access should reflect society's values.

Norin Elfton, Dave Bean, Bob Carlston, and Shelly Cohen also gave effective commentaries. Commissioner Donna Marshall asked Dave Bean for a copy of his comments. Dave described our current system as being adversarial. He emphasized that we don't want to have electronic medical records before we have universal access to health care: Otherwise all knowledge shared with insurers will be used against us.

I asked Donna if she was aware that victims of domestic violence have been unable to obtain any kind of insurance.

Barry Keene emailed his comments, asking the commissioners to use the criteria that they had come up with at the expense of so much time. Barry noted that they didn't use that criteria in their first elimination round of proposals.

My emailed comments noted the importance of a health care system of sustainability, with its other implied elements of access to primary preventive health care, controlling inflationary administrative costs and the current practice of cost-shifting. I suggested that the principle of "common good" is vital, because nothing other than true systemic health care reform could so quickly improve the quality of life for everyone, while improving the U.S. economy and freeing people to realize their true creativity.
I turned in my comments at the hearing — calling for quality, universal access, and cost-effectiveness that could ensure sustainability. Single-payer, in other words.

With just a couple exceptions, people seemed to either call for single-payer or call for options that only single-payer is capable of providing.

I'd put the mental healthcare advocates in that category. There were quite a few people speaking to the shameful lack of mental healthcare in this country. We jail people instead of caring for their mental health needs. Now there's a cost-effective plan.

A physician who taught comparative health systems at CU's med school was a disappointment. He told the commissioners that he'd heard people say they wanted everything for everybody — quality and convenience for all — and that was impossible. Therefore, the commissioners were going to have to be courageous in saying that we couldn't have it all. He said that the people of Colorado would also have to be courageous and understand that we can't have it all.

After all, who do Coloradans think they are — French? Canadian? German? Swiss? Israeli? British? Norwegian? Swedish? Belgian? Dutch?

Silly Coloradans. Universal healthcare is only for every other industrialized country in the world. Those people can make it work. We can't.

Do you believe that?

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