Ex-presidents’ blog/ How Should Health Care Services Be Provided in Colorado?

“Common Ground”

Can we meet

On common ground

Are our views so far apart

That there’s no room to be found

Can we speak

Without a sound

Of a world gone quite insane

Can we start settling down

Well

I’ll not play the scene

Where the threats start flying

You’ll not have to scream

Cause we’re not that stupid

Rhythm Corps

 

How Should Health Care Services Be Provided in Colorado?

SCOTT:

There’s a simple answer to this question. Health care services should be provided the same way other services are provided — by providers operating legally and by the choice of the people using the services and paying for them. They should not be provided by force, by third parties, by a “system”, or by government controls.

 

Healthcare services are not a right (something you have inherently) because they have to be provided by someone else and no one should be forced to provide them, directly or indirectly. People should be free to choose what services they want or think they need and how they are going to pay for them as with any other service such as housing, education, or groceries. This includes obtaining such services from people who are willing to provide them voluntarily for free or at a reduced cost, and people should be free to donate to such providers and not be forced to pay for them in taxes with its intervening government waste, inefficiency, and politics.

 

Experience has shown that important and highly individualistic services should not be decided by a “system”, by a third party, by ideology of what’s best for people, or by government using its power and authority. Therefore healthcare services should not be “provided in Colorado”. They should be available in Colorado via a free market for such services including forms of direct payment, insurance, pre-paid groups, and charitable organizations. The worst form of providing such services would be by government monopolies like Single Payer, Universal Healthcare, or Medicare-for-All. Our current situation is as bad as it is due to government interference and controls in the healthcare service market and we will increasingly see people seek out their own way of obtaining the health services they want outside the system similar to how people utilize private education to avoid government schools.

 

 

LAIRD:

First and most important society should provide health services to all. It is in its own interest as people will be healthier in general, suffer from less chronic illness, miss less work days, and save health care costs in the long run. This is particularly true in that health care costs have risen beyond the ability of the average Coloradan to afford. It comes down to we either have many sick people in Colorado or we provide health care to all, just like police service.

There are, I believe, two ways this could be accomplished. The first would be with a continued market based approach for those who could afford it and a public option with or without Medicaid and with continued Medicare.

The second would be with a single payer which would have to be the government. Many people fear this as ‘socialism.’ In reality government has provided health care services for years via Medicare, and efficiently at that. I believe it would be the most efficient means of providing universal health care. There would be huge administrative savings. Compare commercial insurance overhead at 20% or more with Medicare overhead of 3%.

Either way would be fine with me as long as it were universal.

There is the devil in the details problem of paying for it. I am not an economist, so I will not devise a complicated fiscal program. What I will say is that we pay about $30-35 billion per year in Colorado now on insurance, co-pays, deductibles, other out of pocket costs, and taxes. Surely shifting some of that partly to increased taxes to pay for those who cannot pay themselves is reasonable and will save money in better efficiency, reduced overhead, and better population health.

There can be further cost savings by setting up a state wide health care board of physicians that investigates and institutes ways of saving health care dollars. This board would use CIVHC data (the APCD), available now on almost all health care visits in Colorado except for care provided for free or totally out of pocket. The data would be paid for by the state and would afford priceless insights into means of improving health care efficiency and quality.

2 Comments


  1. I think Laird and Scott bring up interesting ideas, but we are at risk of transforming our necessary “safety net” into a lifelong hammock for the sanctimonious and self-entitled. I think the ideal corrective and fair approach will be through enhancing medical economic transparency, but as my response is too long for a comment, I will add it as a new post

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