Why Was Sanders ColoradoCare Rejected 80/20

[politicat]

12. Because a lot of us don't do the math, and don't really know how much our healthcare costs.

I did some voter education on CoCare, and almost every time, most people -- educated people in secure careers -- did not realize how much CoCare would save them, and how much we're already paying, because employer-provided healthcare is a pre-tax deduction. As consumers, we see the cost 27 times a year, on average: in October, at open enrollment, when HR tells us how much less our more expensive plans are going to cover and how much our copay is going up, and on each paycheck, when we see a line-item deduction, but that money never comes into our pockets, and we don't pay the monthly bill on it. Which means that by being outspent 5:1 meant we didn't have the resources to do the educational work that was critical to success. (Please be aware that we couldn't manage to remove slavery from the state constitution either -- that was a reading comprehension fail because that got severely undervoted, the tallies are extremely close, and it lost by coin-flip averages.)

The second issue is that health insurance work is a valuable industry. It's a secure, middle class career with sick time and vacation benefits and predictable hours. It's an office job that the average service industry worker aspires to have. It's a safe landing zone for new college grads, and it makes up a couple percentage points of the state economy, when you figure the various employer sides, the medical provider billing side, and the in-state insurance processing. That specific sector would have been limited under CoCare. That would have cost us jobs.

Small and medium businesses - the ones most likely to relocate - would have been more secure with CoCare, because employee health insurance costs are often in the top 5 line items of expenses, and under the 6.67% tax plan, they probably would have been spending less. So even assuming we didn't lose businesses to other states, we would have lost jobs.

Third, our co-op was failing spectacularly before the federal funding got yanked. The call centers were supposed to be in-state; they never were, so we never got those jobs. Payments to providers were slow and complicated. Registration was a mess, premium payments were lost, got returned, and plans got cancelled. Exchange plans were almost all designed with nearly impossibly narrow networks. Colorado is 80% urbanized, but the people who aren't in the Front Range are driving 9 hours across the Continental Divide for specialist care. We have to figure out an interstate insurance compact with Utah and New Mexico because for the Western Slope and southern Colorado, going to SLC or ABQ is more convenient, and when we're talking cancer, time in the car matters.

Fourth, I believe in CoCare, worked for it, and I want it to succeed, but it was flawed because it was built from compromises. It didn't provide enough protection for full reproductive rights, because it likely would have come into conflict with the Hyde Amendment. It came with 3 years of ramp-up, when most of the state was both paying the tax and paying for private healthcare through payroll deductions. That would have hurt. Our better bet would have been to transfer all employment based benefits -- payment and plans -- to the existing state administration during the ramp-up without the overlap, with a rolling transition to CoCare, while the state absorbs the existing insurance specialists. But that's awfully close to state confiscation, and that idea was dead in the water at the draft stage, and we have a parasitic piece of legislation in the constitution (TABOR) that we have to work around.

It sucks to lose. It sucks that it's going to take time to build up for another shot. But we will, and it will happen.

I write this as a provider who desperately wants to be drafted to a National Health Service. Private insurance is a tapeworm in my profession, as well as being a drain on the body politic. It distracts us from our primary job, promotes opacity and opportunities for graft, and it wastes time and effort we should be focusing elsewhere. It's a legacy of a war-time measure that has outlived its usefulness.