This is something many Latinos, especially those from Venezuela and Cuba, understood well. They know that there is a world of difference between what a public insurance option promises and what, historically, it has been able to deliver.
A public option, supporters promised, would have made affordable care more accessible to Coloradans. How would it do that?
The program’s “cost-saving” features would work by reimbursing doctors and other providers at a lower rate than private insurers typically do. In other words, the bill isn’t cost-saving, it is cost-shifting. It would hurt providers, of course, but Coloradans with private insurance would suffer, as well.
The public option, supporters claimed, would have “competed” with private plans. Perhaps they don’t understand the definition of compete.
The program would crowd-out private plans by offering artificially low premiums subsidized by taxpayers and those with private plans.
Put simply, these plans wouldn’t be able to “compete” because the playing field is tilted heavily toward the government-run option.
The result would be single-payer by another means, a process by which lawmakers would push private insurers and their policyholders to the margins. Research has shown this: A rise in the use of public health insurance programs results in a corresponding drop in the number of people covered by private insurance.
That isn’t the only problem with a public option. There is another that many Latinos understand well: Government-run care results in worse health outcomes.
Even in democratic countries like Canada and the United Kingdom, such programs have problems of their own. They regularly feature extraordinary wait times, rationing of even basic care, and a higher mortality rate for cancers than the U.S.
Washington state tried a public option, too, with poor results. A program that was supposed to feature lower insurance costs ended up with premiums 29 percent higher than private individual plans.
But the HB1232 amendment has other problems, namely its strict directives for private insurance companies to reduce premium costs by 18 percent over three years.
This target for this plan would be difficult to achieve, born of the mistaken belief that better and cheaper insurance plans can be simply mandated into existence by the lawmaker’s magic wand.
And, if insurance companies fail to meet this target, they would be required to offer a “standardized” plan designed by officials, unless they could demonstrate “network adequacy,” and reflect the diversity of their consumers to the “greatest extent possible.”
This is, to put it charitably, a vague standard. It is also a poor way to ensure better access to quality health care.
American medicine, of course, has its share of problems. While our country has some of the world’s best doctors, state-of-the-art equipment, and top-notch facilities, our health care system is often complex and riddled with mandates that force those in need of care to jump through hoops to get it.
The solution to these problems is not to double down on what's causing them. Instead, it’s a health care personal option that lowers costs, promotes price transparency, and places the patient — not bureaucrats and insurance companies — at the center of care.
We could start by expanding tax-free health savings accounts, which would offer Latinos, and all Americans, the ability to put money away for medical care and save on each expense. That would help more people get the care they need when they need it.
We must also work to promote price transparency. Too often, patients receive care without knowing what that care will cost — until, that is, they get a surprising and expensive medical bill in the mail.
In other words, implementing a personal option would preserve what works and reform what doesn’t in our care, rather than tossing the entire system out.
In the meantime, lawmakers should reject HB1232. We know this doesn’t work. And we know there are better ways to improve care.
Angel Merlos is coalitions director for The LIBRE Initiative-Colorado.