Former Colorado Gov. Richard Lamm is playing an active role supporting the proposed Initiative 20, dubbed “ColoradoCare,” the ballot measure to provide universal health care in Colorado. Although he admits it’s an “uphill battle,” Lamm, a Democrat, says he’s solidly behind it. In the first part of a two-part interview with Catherine Strode, Lamm discusses the ballot measure and what he views as needed changes in the U.S. health care system.

Why are you backing universal health care in Colorado?

I think the single-payer system is a wonderful system. Canada keeps their people every bit as healthy as or healthier than we do (spending) 12 percent of their (gross domestic product), where we spend 17.2 percent. Every system has problems. Canada’s system does have problems. But I think that, overall, their problems are more human-centered than our problems. We do things like give chemotherapy to somebody in the last 30 days of their lives. They would never do that in Canada. When you take the profit motive out of medicine, I think you get a more humane system.

How would universal health care be more cost-efficient?

We have to get rid of for-profit health care. The insurance companies are one of the low hanging fruits in the health care reform. The insurance function provides very little or no advantage toward health care. It is a matter of distributing a risk. A single-payer system will eliminate the need for most health insurance, because you have a single fund that’s going to pay. It removes maybe 30 percent of health care that is spent on playing “Mother may I?” to be able to go and see another doctor.

Do you think the single-payer system is the solution to all high health care costs?

I don’t think there’s any one thing. We shouldn’t allow the distributors of oxygen and other medical durable equipment to charge what they are charging. I think there are so many outrageous elements of American health care that are wasteful and excessive that it will take the rest of my children’s lifetimes before they are all worked out. Every health care system is revising itself, making mid-course corrections. I think this would be a really good start. The single-payer system is much more efficient than fee-for-service medicine. Essentially, it would replace the (Affordable Care Act) here in Colorado. We will try to get a waiver from the ACA so the money that would otherwise flow through Obamacare would now come to our new system. We have every indication that will happen. But it’s expensive. We are going to charge people a 10-percent premium. It’s going to be hard to explain to people how this will ultimately save them money.

Why do you favor universal health care over the Affordable Care Act?

The ACA was the result of many compromises. I think its main weakness is in its cost control. It has not given an ability to government to do such things as bargain with the pharmaceutical companies for better prices. Second of all, it’s politically vulnerable — such things as the Cadillac Tax. I admire President Obama for getting it through. It’s a step in the right direction. It is not the end of the journey. I do not think it will make the changes needed.

Why do you think there is so much waste in our health care system?

It’s really hard to get the public to recognize there might be some limits on their health care, and they can’t have everything medical science has invented. One of the reasons I think Americans waste so much money on health care is, it’s easy to say something is beneficial and, thus, has to be delivered. There’s got to be some sense of appropriateness in healthcare. It’s called quite often “flat of the curve” medicine. When you start spending money in health care, you buy a lot of health care for your dollars. But you soon get up on the “flat of the curve,” where it is incredible how many things some doctor can call beneficial. But the net result is, it just drives our health care.

What other health care reform measures do you promote?

I am really trying to change the idea that the Hippocratic Oath allows a doctor to bill for anything they think might be beneficial. I think medical ethics, and certain aspects of medical ethics, are unethical public policy, because it drives too much possible spending. We have kids to educate and other demands on our taxpayer dollars. We can’t allow health care to continue to expand and metastasize all throughout the budget, pushing away other things. Good health care is important, but it isn’t the only thing we have to do with public dollars.

Are you optimistic about the universal health care ballot measure passing?

We spend $2.9 trillion on health care. Every dollar spent on health care is a dollar of income to somebody. We have a lot of rice bowls out there that are going to be broken. So it’s going to be really tough but at least we’re going to try.

Catherine Strode, MPA, is Advocacy Denver’s policy and outreach specialist.