Sain: Amendment 69 a fatally-flawed health-care proposal (column)
August 30, 2016
I am a mother of two, a wife, a daughter and I am a concerned health care consumer. I am also a dentist, a small business owner and supporter of a single-payer option. I am a registered Democrat, but, when it comes to Amendment 69, it does not matter what your party affiliation may be; the proposal known as ColoradoCare (Amendment 69) is not good for Coloradans.
When ColoradoCare first came across my radar a little over a year ago, it sounded promising — that is, until I started to do some of my own research. The oversights of this proposed amendment are so large and with such far reaching consequences that they cannot be ignored.
ColoradoCare proposes a single-payer model with health care for all, but the reality is that many Coloradans will be hurt by the proposed amendment. In order to pay for ColoradoCare, employees will be assessed a 3.33-percent tax on total payroll income, and employers will be assessed a 6.67-percent tax on total payroll on behalf of employees. Self-employed individuals will be strapped with the entire 10-percent tax on total income. In addition, there is a 10-percent tax on all other forms of income, including retirement income, with the exception of alimony and unemployment.
As a patient, ColoradoCare is concerning due to the lack of detail given regarding care and coverage. There are no specifics on exactly what will be covered, what co-pays will cost, if a referral will be required to see a specialist or what limitations or exclusions may exist. If you are a patient who has worked hard to obtain specialized insurance coverage for a specific condition, you are left hoping that your coverage will be replicated through ColoradoCare.
Even more troubling is that of coverage outside of the state of Colorado. ColoradoCare will only guarantee coverage in Colorado; there are no guarantees that out-of-state (and out-of-network) providers and hospitals will accept the fees of ColoradoCare. If one was to get hurt outside of the state and healt care providers/facilities do not agree to the terms of ColoradoCare, the patient will be stuck with exorbitant out-of-network fees. If you need medical care outside of the state, traditional private insurance with allowances for guaranteed out-of-network care would be highly preferable to ColoradoCare, so you won't be strapped with a costly out-of-network provider/facility bill.
Why is ColoradoCare so vague with regards to care and coverage? Might it be so that the governing board may easily change and eliminate coverage at will?
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If you are a retiree, ColoradoCare is concerning due to a large tax on retirement income. Only the first $24,000 of retirement income will be exempt from the 10-percent tax for those over 65. Retirees will keep their Medicare benefit, and ColoradoCare will act as secondary coverage. However, ColoradoCare will not pay for anything covered by Medicare parts A, B and D, so it cannot be considered a true supplement. In essence, retirees will be paying a 10-percent income tax for a program that they will receive little to no benefit from. Colorado will quickly become a state that is undesirable to retirees, and many will simply retire elsewhere or claim their primary residence in another state.
As a small business owner, ColoradoCare is concerning due to a large increase in taxes borne by the employer. Self-employed individuals will be taxed at 10 percent on total income. Employers will pay a 6.67-percent payroll tax on behalf of employees. Another concern for businesses is payment for ColoradoCare through taxes is not considered the purchase of a health-insurance policy. This means that businesses and self-employed individuals will no longer get a tax deduction for providing health insurance resulting in a greater tax burden.
Yet another concern is the issue surrounding workman's compensation. ColoradoCare will take over health care related costs of workman's compensation; however, it will not cover indemnity or loss of wages. Dividing health care related costs and indemnity will only serve to increase costs to employers. ColoradoCare will hit small businesses disproportionately, and the large tax burden may cripple many of them, resulting in closure or relocation.
As a taxpayer and resident of Colorado, the most concerning issue surrounding ColoradoCare is the structure of the governing board. ColoradoCare will be administered by a 21 board membership of elected individuals from across the state. The board members are not required to have any qualifications to make health care-related decisions and will have little accountability to the people of Colorado due to a lack of checks and balances. Board members will be held accountable by no agency of the state; they will conduct their own elections, they will certify their own election results, they will not be subject to recall and they will set their own compensation. Board members are given the power to vote out other board members and appoint a replacement without a vote of the public. In addition, the board will have the ability to raise the premium tax yearly as necessary to ensure the financial stability of ColoradoCare. This will result in a limitless tax increase to Colorado residents.
ColoradoCare may sound appealing at first glance. The problem lies in the complete lack of detail that will have far-reaching consequences for the residents of Colorado. Many prominent Democrats, Republicans and progressive groups have come out in opposition to ColoradoCare. Regardless of party affiliation, whether you are for or against single payer health care, it is not the answer to our health care crises.
Erin Sain lives in Silverthorne.
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