Health reform panel faces woes

Lacking time, group says it can't solve care crisis this year

David Montero, Rocky Mountain News

Thursday, September 20, 2007

The commission given the task of reforming health care in Colorado is underfunded, lacked enough time and can't solve the state's health care crisis this year, its chairman said Wednesday.

Many important matters are beyond the purview of the commission, said Bill Lindsay in comments during and after a panel discussion sponsored by the Colorado State Association of Underwriters at the Pepsi Center.

Some of those issues include studying the impact of technology on the system, and the way providers are reimbursed through Medicaid and Medicare. Those are significant factors that need to be studied but cannot be addressed by the commission.

"Unfortunately, the commission would have loved to have the time, the staff and budget to get into these items," Lindsay said. "But that wasn't available to us."

Lindsay said the best the commission can do is to make improvements in some areas of health care in Colorado, but the group won't solve the problems.

"This is just the beginning of a journey," he said.

Bill allocated $100,000

The Blue Ribbon Commission for Health Care Reform was created by the legislature in 2006 and solicited a variety of proposals to tackle the problems of rising health care costs and the growing population of the uninsured - numbering more than 780,000 in Colorado.

From that effort came a final group of four proposals submitted by different interest groups laying out their formulas for health care reform. A fifth proposal is currently being hashed out by the commission, and a first draft is due Monday.

The commission is supposed to complete its work by the end of January. Lawmakers will then have the option to pick any or none of the proposals to draft into legislation.

Lindsay said Colorado vastly underestimated the amount of money that would be needed to seriously reform the current system. The bill that created the commission allocated $100,000 to study the issue.

But Lindsay said similar groups studying health care reform in other states were given in excess of $1 million by their state lawmakers. To get to that figure, Lindsay said the Colorado commission had to solicit money from foundations and collect donations.

Doctor incentives eyed

The panel discussion, which lasted about two hours, centered on the need to attract physicians to Colorado to serve an expanding number of older people.

Dr. Cari Levy, who is with the Veterans Affairs Eastern Colorado Health Care System, said there aren't incentives for doctors to specialize in geriatrics. Levy said she spent an extra two years in medical school studying geriatric care and now makes $20,000 a year less than she did before switching to that field.

"We need to change the incentives," she said.

And John Sackett, chief executive officer of Avista Adventist Hospital in Louisville, said Medicare is not sustainable for the generation following the baby boomers - a fact that will strain the health care system even more.

He suggested changing Medicare from an entitlement program to a welfare program.

"Those who are of means are going to have to contribute to the solution, not the problem," he said.

Lack of consensus

None of the panelists - or the four speakers who went over the basics of the proposed plans - seemed to believe that any offered complete solutions to the rising health care costs for employers and employees.

And there wasn't consensus on whether employees should be required to have health insurance or face tax penalties if they don't or whether employers should be mandated to cover employees. The insurance underwriters oppose the latter option in their proposal.

The only speaker who appeared definitive about what approach would work was Dr. Rocky White, the key author for the so-called single-payer plan that would provide universal health care through the government for every resident in Colorado.

White said it is the only plan that saves money - cutting about $1.5 billion from the $30.1 billion currently spent on health care in Colorado. But he acknowledged it's also the most controversial plan.

White took questions from the audience about problems facing the plan, including whether illegal immigrants would be covered and the prospect of doctors being government employees. He wasn't able to answer the question of illegal immigration.

But he argued that doctors would remain in the private sector and that single-payer would reduce bureaucratic inefficiencies.