Hmm. I generally agree that single payer health care in only one state probably won't work very well due to the already mentioned issue with high earners and healthy people moving out of CO while low earners and retirees move in, and doctors potentially leaving if they earn less money from this program. But then again, it also happened this way in Canada where one province started with universal hospitalization coverage and it progressively became national universal health care. I also think the *10% tax!* is rather misleading when this plan would eliminate people's need to buy health insurance, and eliminate the need of companies to buy insurance for their employees, as well give the single payer huge leverage to eliminate the cycle of suppliers gouging hospitals who gouge insurers who gouge their customers.
First of all, we don't actually know whether it eliminates the need of anyone to buy insurance because we don't know what it covers. All we know is what it costs. Even if I subtract out my health insurance premiums, this thing is going to cost me gobs and gobs of money. The only way I'd stay in Colorado is if somehow my company and my wife's company decided to raise our salaries to compensate... which is highly unlikely.
Not a private company, a nonprofit co-op whose members (and owners) are CO residents for 1 year over 18, who elect a board of trustees,
You didn't quite write that correctly, so I had to dig to figure out where the misunderstanding is. It appears that the owners are all of the residents of the state... rather than residents of the state. Big (but subtle) difference. That's actually disheartening to me because it makes it more likely that this will pass. So you're right, it's not a private company with a monopoly, it's a public company with a monopoly.
Impossible.
Rates realistically couldn't be known because they haven't been negotiated yet, but this co-op would have far more leverage than any existing private insurer in Colorado so it will almost certainly receive better rates, and would lower overall costs to providers by vastly reducing paperwork and admin costs.
...because our healthcare providers won't accept private insurance anymore?
They could get better rates because they can reduce payouts to the point where doctors flee. Or they could get worse rates because they have a guaranteed income and who really cares right? Regardless, the balance will be wrong. Always wrong. It will either be too low - preventing us from having high quality facilities, or too high - running businesses and customers with money out of the state.
List of benefits on page 11. Agree that it's not super clear but it is required to meet what Medicare and Obamacare covers and will have no deductible or co-pay.
I'm not exactly in a hurry to get on Medicare or Obamacare.
For comparison,
here's the breakdown from the provincial health care plan I'm under. It pays for services or surgeries medically necessary, hospital visits, etc. No elective cosmetic surgery and no quackery (acupuncture, homeopathy etc.). I can't imagine this plan being much different. There's no long list of stuff Ontario covers because "all medically necessary procedures" are covered.
...so long as your doctor thinks you absolutely need it and you're willing to wait in line. I've heard a lot of horror stories about Canadian health care. Mostly what I hear is that if it's not life threatening, you wait or don't get treated. Apparently being confined to a wheelchair for months on end is acceptable while you wait. I'm not in a hurry to recreate that in my state.
P. 11, *If there were a financial strain on ColoradoCare as a result of people with high cost health care needs moving to Colorado for affordable health care, ColoradoCare could establish one-year pre-existing condition limits for new residents. Such limits would need to be in compliance with Medicaid and Affordable Care Act waivers.
...which prevents pre-existing condition limits.
There's no other comparable system in the US but I'd think that RomneyCare would have had the same thing (retirees moving in), as it gives free insurance to people earning less than 1.5 times the poverty line. Most retirees would be under that line by income, wouldn't they have moved to MA to take advantage of these benefits?
First of all, MA is not CO. Colorado is a way more attractive place to live. Secondly, it's all about the level of guaranteed coverage. If it exceeds Medicare/aid, they'll come here.
Think of it as analogous to the school voucher system I've seen talked about on here before.
Not even remotely close. It's more analogous to public schools. There's no "voucher". There's no incentive to keep costs down... only incentive to wring every last drop of service you can out of the system by mastering the paperwork and loopholes.
It's not clear what exactly it would cover outside the state but I don't see why it wouldn't be covered outside the state.
...because everyone outside of the state wants more money than they're willing to pay?
There's already god knows how many insurance companies and for a hospital outside CO this would be just one of many health insurance providers that hospitals already deal with. Would there be a legal avenue to get emergency and urgent care insurance for the rest of the country? It seems analogous to when Canadians go to the US, we get private insurance that covers travel and it's usually not very expensive since the odds of needing emergency care out of state are low.
So you end up getting private insurance anyway.
Because the single payer has all the leverage. They're the only insurer in the state/country so the doctor/hospital can choose to either do business with them or nobody. If they try to charge more than the single payer sets out, they simply won't get it. Other than in tiny niche disciplines, there's no way for another insurer to compete with the volume and guaranteed revenue of a single payer. That doesn't mean the single payer can be cheap either. The single payer has a vested interest in keeping doctors in the state/country,
...and what is that vested interest? As long as they can blame greedy doctors, and can tell a story to keep their seat running the company, their interests are met. If the majority of the cost is burdened on the minority, the voting system starts out rigged anyway.
For drugs a single payer massively reduces costs because of the volumes involved. Right now drug companies can choose insurers who will pay more for their drugs, while with a single payer they would either sell to the single payer or not at all.
I do love the notion that we can just cut revenue to drug companies and it's mana from heaven without any adverse effects. In this case, one adverse effect may be that we can't get certain drugs in the state. Another could be that whole swathes of drugs are missing. If done at a national level, it means drastically reduced R&D from pharmaceutical companies and lower quality care as a result. No free lunches.
Again, the single payer has a vested interest in having drugs available, so it will offer a profit to drug companies but has the leverage to avoid being gouged. I sound like a broken record here but again, the single payer has the leverage to refuse hospitals gouging them in response to suppliers gouging them, but are forced to pay a fair rate or else the services won't be provided.
It's an ongoing theme... take this deal or get out. Lots will opt to get out, resulting in a shortage, resulting in waiting lines.
I won't pay what amounts to... let me do the math for a second... 30 times as much for healthcare as I do now for worse service and to be told to wait in line behind someone who is not paying at all. I'll leave the state, and many many others will make the same decision. Ultimately people will move in looking for handouts, and jobs will move out following people who don't feel like paying the highest income tax rate in the country by far (and CA was already doing a fantastic job on that one). So with additional unemployment and handouts, the single payer system has to cut costs to survive, driving doctors out, causing a shortage - and ultimately driving people back out of the state. Property values will go down (in the long term, in the short term they may go up due to retirees looking for handouts), people will leave, industry will leave, doctors will leave, and the state will be... for all intents and purposes... trashed by the ridiculous notion that you can get everyone else to pay for your healthcare costs so that you don't have to worry about the size of the bill you run up.
Maybe I should put a for sale sign out today. People are greedy, given the opportunity for 80% to vote away the property of the other 20%, they will... even if it kills the golden goose.