ColoradoCare spurs debate between docs on Western Slope
October 23, 2016
Editor's note: This is the last in a five-part series on Amendment 69. Check http://www.summitdaily.com for the previous installments.
Since summer 2015, and for several years leading up to Amendment 69's placement on this November's ballot, Dr. Christine Ebert-Santos, M.D. M.P.S., has been on a mission to change the conversation on health care from that of a privilege to being a guaranteed right.
The Frisco-based pediatrician has made stops all over the county and across the Western Slope pitching ColoradoCare, the citizen-launched initiative to establish a new tax to create a universal system ensuring every Coloradan has health coverage. In her nearly two decades practicing in Summit, she's only seen the percentages of people who are uninsured or on Medicaid tick up, and believes a new approach in the state could have dramatic benefits for those living in the mountain community.
"Young people up here are working three jobs, are struggling to get housing and are afraid to go to the doctor," said Ebert-Santos. "They're getting squeezed by their college loans, but have got to have a place to live, so health care is the last thing they're going to pay for and they're rolling the dice. They'd better not go skiing or snowboarding."
“It’s time we remove the inequality within this system. We need to stop withholding health care from people, and make it a right.”Dr. Christine Ebert-SantosM.D. M.P.S.
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Summit and many of its neighboring counties persist with some of the highest insurance premiums in the nation. And in 2017, the rates are going up. In September, the state's Division of Insurance approved average hikes throughout the state of 20 percent, while some rural and mountain populations could see increases of more than 40 percent.
By the numbers, the passage of the Affordable Care Act in 2010 under President Obama — colloquially dubbed "Obamacare" — has helped to insure tens of millions more Americans, and also significantly decreased those in Colorado without coverage. Data from the Summit Community Care Clinic, the area's safety-net health center, confirms that 85 percent of its patients were uninsured in 2011, and year to date for 2016 that's now down to about 62 percent. Conversely, about 25 percent of those who visit today have Medicaid, up from about 8 percent over that same time frame.
That's not kept actual costs in check on the Western Slope, however, and county leadership acknowledges its led to many residents having to choose between paying their rent or for their family's health care. "The Affordable Care Act is not working in the High Country," Commissioner Thomas Davidson said at an election forum in October, with fellow Commissioner Dan Gibbs often noting that the status quo does not work for the community, leading some to the breaking point of being forced to leave the region.
Everyone seems to consent that change is necessary. The problem is no one yet quite agrees how to go about it, and ColoradoCare, spearheaded by former doctor and state Sen. Irene Aguilar (D-Denver) and endorsed by U.S. Sen. Bernie Sanders (I-Vermont), proposes a paradigm shift.
Although some pose arguments against the passage of Amendment 69 based solely on a procedural stance — that such a measure does not belong in the state constitution — for many others the single-payer system's funding mechanism is at the core of the quarrel. Several conflicting studies have been produced as to whether such a statewide program, which would be financed through a 10 percent payroll tax split between employers (6.6 percent) and employees (3.3 percent), could be solvent long term.
In one study released in August by independent health policy research outfit the Colorado Health Institute (CHI), estimated deficits could reach upwards of $8 billion once ColoradoCare has been in effect for a decade. A follow-up analysis conducted by Dr. Ivan J. Miller, Ph.D., a Boulder-based psychologist who acts as executive director of the Colorado Foundation for Universal Health Care, disputes these findings. It claims the CHI study failed to include states revenues from Medicaid and Child Health Plan Plus (CHP+), as well as the slowed growth of health care inflation from a single-payer system.
Still, it's this potential financial chasm that has Dr. Andrew Catron, M.D. OB-GYN, another local physician out of the Swan Mountain Women's Center in Breckenridge, advocating strongly against Amendment 69. He maintains that, as written, the initiative is unsustainable and will ultimately reduce the number of health care options along the Western Slope if passed by voters.
"Some of the best practitioners in this area will not stay," said Catron. "Many doctors have said they will leave the state or retire, and our access to quality medical care will suffer as a result. Backers are overpromising, and when they under deliver, they won't be the ones held accountable, it'll be the citizens of Colorado. Of course if it's financially unstable, it will require greater tax increases, or reduced quality or quantity of care, to make up for that loss."
Perhaps not surprisingly, some of the biggest financial donors to the campaign against Amendment 69, labeling itself "Coloradans for Coloradans," are major health care companies such as Anthem, United Healthcare, Centura Health, DaVita and Cigna. Others to oppose ColoradoCare include Gov. John Hickenlooper, the Colorado Medical Society, Colorado Hospital Association and Club 20, a Grand Junction-based nonprofit that positions itself as the "Voice of the Western Slope."
Under the current system though, Ebert-Santos contends that a lack of transparency prevents anyone from ever really knowing the price of a doctor or hospital visit, or procedure, until well after the fact. Spreading that cost, among individuals and small businesses, is a way to streamline those expenses, and she encouraged each to take a look at what their specific taxes would be under the new structure at: http://www.coloradocare.org/calculator
"It's time we remove the inequality within this system," said Ebert-Santos. "We need to stop withholding health care from people, and make it a right."
Kaeli Subberwal contributed to the reporting of this story