Colorado has embarked on a complex course of comprehensive health care reform. A successful outcome depends on a fair and factual public discussion of the various reform proposals. The “Single-payer baloney” editorial (RMN, 8/2/2007) was not helpful in furthering that discussion.

The editorial labels the single payer proposal as “baloney” for three reasons. First, the editorial raises the specter of massive new taxes, while dismissing the savings from eliminating private insurance and other costs. The Lewin Group, independent experts in cost-benefit analysis, calculate that there could be large net decrease in what Colorado residents would pay for health care — even while providing universal health care.

Second, the editorial argues that there would be “big-time rationing.” The writer seems to forget that we already have rationing-big time! We ration by depriving a large part of our population of adequate health care; private insurance companies ration by refusing coverage to some, by setting premiums high enough to exclude high risk members, by limiting what medical care will be covered, and so forth. Medicare and Medicaid also ration. Rationing is unavoidable; the demand for medical care will always exceed the supply. The relevant questions are, “Who do we want to make the rationing decisions?” and “How do we decide what medical care has the highest priority?”

Third, the editorial raises the fear of outsiders coming to Colorado for “free” medical care, even though it acknowledges that enabling legislation could discourage this. Those who raise this fear assume the low-income population is ready to pick up and go and has the means to do so. We have numerous examples of unequal benefits offered by different states, but the editorial provides no evidence that these lead to outsiders taking advantage of the benefits.

The Colorado Progressive Coalition is conducting public health care forums throughout Colorado to learn about the residents’ experience with health care and what they want in health care reform. Our purpose is not to promote any particular reform proposal, but to listen to the public.

The forums have been held in various communities with very different participants, including hospital administrators, insurance underwriters and the uninsured. We have heard an honest and thoughtful dialogue about health reform. We have also encountered an overwhelming support for a single payer system. The proposal should not, and cannot, be dismissed as “baloney.”

Clark Bouton, Ph.D. , is a volunteer Health Justice Organizer in the Colorado Progressive Coalition. He is a resident of Denver.