The Blue Ribbon Commission for Health Care Reform, Senate Bill 208-2006, could be a major step in reforming the existing health care system. It was passed with solid bi-partisan support and signed by the governor in June. The Blue Ribbon Commission’s members are representative of consumers, purchasers, care providers and insurance providers. Its task is to comprehensively examine Colorado healthcare. The Commission will solicit reform proposals, select several proposals to be analyzed by an independent expert organization, hold public hearings throughout the state, and make recommendations to the General Assembly by November 2007.
The Commission is, however, only a first step. Commissions come and go; they gain little attention, and their reports frequently gather dust on library shelves. The general public is rarely aware of their existence. Without public support they are dominated by major players with interests to protect, and nothing much is changed. To achieve meaningful reform, the Commission needs the support of an informed and active public.
A recent study of sixteen states by Community Catalyst, funded by the W. K. Kellogg Foundation, points to the importance of building public support. It finds that successful health care reform is linked to effective public advocacy. In states such as Illinois and Massachusetts, where consumer advocates were organized and active, they were able to expand health care access to hundreds of thousands of previously uninsured. The health care reforms were the result of several years’ work by consumer health advocates.
If health care reform is to truly reflect the needs and values of Colorado residents, the public must be informed and able to influence the Commission and the General Assembly. Opinion polls indicate that when it comes to significant health care reform, the general public is ahead of the politicians and vested interests‑‑and even many health advocates. An informed and active public can offset the opposition from powerful interest groups that may have to change the way that they do business.
The success of consumer advocacy efforts requires working inside and outside politics. It needs broad based coalitions of advocacy groups and organizing activities at the grassroots level. Local organizations and individual activists can provide the community contacts necessary to reach the public. Organizations with different political orientations will need to cooperate on a common goal of achieving effective and affordable health care.
Every sector of the health care system has its own problems and its reasons for seeking to change the system. Nearly one-in-five (770,000) Colorado residents are uninsured. Those who have insurance are often underinsured--only one serious illness or job loss away from bankruptcy. Medical expenses contribute to at least half the personal bankruptcies in the nation. Co-pays, deductibles, and prescription drug costs are all rising. Employers find it increasingly difficult to provide insurance; there has been a 6.4% decline in employer sponsored insurance in Colorado in just the last two years. Consequently, the number on Medicaid has increased, even though Colorado in 2004 ranked in the bottom fifth of the states in terms of the amount of state resources spent on Medicaid and in terms of its Medicaid eligibility standards. Forty-seven of Colorado’s 64 counties are considered “medically underserved” by the federal government. There is massive cost-shifting from uninsured to insured and from private to public programs. Medical providers complain that complex and wasteful administrative procedures interfere with their ability of provide services. The system is breaking down, and piecemeal reforms are unable to correct it.
While the system’s failure is experienced differently among individuals and among health care sectors, they all experience its failure. Widespread discontent with the health care system can provide the incentive to cooperate in pushing for comprehensive reform.
Colorado is not without the resources to fix a broken system. Its per capita income is 7th highest in the nation. Its poverty rate is below the national average. There are only two states in the nation whose total state and local taxes relative to personal income are lower than Colorado’s.
We have the resources and Senate Bill 208 gives us a procedure for reforming the health care system. What we need is to inform and motivate the public to take an active part in demanding comprehensive reform. |
