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No easy solutions to health care woes

BRECKENRIDGE – A solution to America’s health care crisis is likely nowhere on the horizon, forum speakers told a group of citizens in Breckenridge Monday night.

“There is no easy answer. There is no easy way out,” said Susan Alt, a forum speaker and owner of a health-care publication company. “Over the past 30 years, when a solution is found that solves one problem, a balloon pops out in another area. Our health-care system is incredibly complex.”

That statement incited little argument from the 30 or so people who attended the Colorado Mountain College and Keystone Center-sponsored forum. But attendees said they still felt frustrated that even current proposals to reform America’s health-care and insurance system could be doomed to fail.



America spends more on health care as part of its Gross Domestic Product than other comparable countries, said Peter Fox, a health insurance consultant. Yet, 41 million Americans – one in six people in Colorado – don’t have insurance.

Most of those people come from minority groups, notably Hispanics, whose culture doesn’t include opting into health insurance, Alt said. Others can’t afford the premiums and deductibles; many take their chances they won’t fall ill.



One problem, Fox said, is that Americans know hospitals won’t deny treatment to someone who is struck with a serious injury or illness. Another is that the break-even point for insurance companies to recoup costs is 25 or more employees, and the average number of employees at Colorado companies is eight, Fox said.

Another challenge is the wide variation of medical procedures and costs, Fox said. For example, a day in the hospital in Los Angeles – where there are lots of options – costs $1,600. That compares to $2,000 in San Francisco, and $2,800 in Sacramento, where there is one care system.

Also, the average American is living longer – and baby boomers are on the cusp of retiring, many of them without company benefits offered in past generations. Since 1980, the average life expectancy of an American has increased from 73.7 to 76.9 years – placing an additional burden on the system.

Insurance programs have changed over the decades, Alt said. People used to buy insurance for unforeseen, catastrophic medical emergencies – not for use when visiting the doctor for a cold. Paying insurance to cover lesser illnesses or routine procedures costs 3.5 times as much for an insured person than catastrophic coverage does.

And insurance companies don’t base their coverage criteria fairly, said Don Johnson, who co-owns the publishing company with Alt. Geography plays a part – particularly in Colorado, where companies say it is too difficult to provide coverage to people in far-flung regions – as does age.

“This makes them anti-small business, anti-senior, anti-consumer,” Johnson said. “Our rates are higher if we hire 20-somethings, so we can’t hire 20-somethings? And if we do, our rates go up, we have to raise our prices, and we’re not competitive.”

In the 1970s, Health Management Organizations debuted, making promises of cheaper coverage by insuring lots of people.

“In 10 years, HMOs have gone from something obscure to something that provided great hope in solving our health-care crisis,” Fox said. “Now, they’re the subject of jokes and late-night TV shows.” Most survey respondents in a Harris Poll said managed care needs a major overhaul.

“A lot of people want universal coverage,” Fox said. “But their second choice is to do nothing at all (to the system). That contributes to the problem, too.

Cooperative health insurance plans, which allow employees to choose from a wide array of plans and insurance companies, were crafted after double-digit price increases in the 1980s.

Other alternatives – associations, mandated insurance, tax credits, state and federal care programs – have been debated in recent years.

“To me, the best possible solution is cooperative health insurance purchasing,” Alt said. “But it didn’t survive, and there’s no way to revive it. I’m sad to say that.”

Two such cooperatives, The Alliance and CHIPS, existed in Colorado until the insurers killed them, Alt said. Now, there is one cooperative carrier – Blue Cross – available in Denver.

“With one carrier, there is no value to the employee,” she said. “No (similar) plans will be resurrected. Insurance companies are very strong lobbyists. They have sabotaged the ability of a plan to negotiate price.”

That’s what Sen. Joan Fitz-Gerald said legislators are running into with insurance reform bills this session. The Democrat from Golden said legislators have said repeatedly they are willing to allow more flexibility in what an insurance company agrees to cover, but insurance representatives say they can’t guarantee those concessions will lower the cost of coverage.

“We say we’ll give them “A’ and “B,'” she said, “but they won’t give us “C’ and “D.’ That’s not a workable solution.”

“It’s a political hot potato,” Alt said. “And no one is big, brave or strong enough to tackle it.”

Insurance statistics:

41 million Americans are uninsured

1 in 6 Coloradans are uninsured

Of the uninsured, 72 percent work full-time jobs

In companies with 10 or fewer employees, 33 percent are uninsured

In companies of 10 to 24 employees, 25 percent are uninsured

In companies of 25 to 99 employees, 16 percent are uninsured

Insurance costs are increasing 2.5 percent per year more than the Gross Domestic Product; by 2011, they’ll be 17 percent of the GDP

In 1997, the U.S. spent 13.6 percent of its GDP on health care. That compares with 10.4 percent for Germany, 9. 6 percent in France and 9.2 in Canada – all countries that offer universal health care

Doctors in America make almost twice that of their counterparts in other countries

20 percent of people surveyed in a Harris poll said America’s health care system is “OK and needs only minor changes.”

57 percent said there are good things about the system, but it needs major changes

23 percent said it should be completely rebuilt.

51 percent of insured people say they are very or somewhat worried about the costs of health care.

50 percent are very or somewhat worried they will lose some benefits.

Jane Stebbins can be reached at (970) 668-3998 ext. 228 or jstebbins@summitdaily.com.


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