What's right with Colorado health care
by Ari Armstrong, April 8, 2007
We've heard plenty about what's wrong with health care. Perhaps we've heard too much about what's supposedly wrong from those who hope to turn sky-is-falling hysterics into political advantage.
True, there are some real problems with medicine and health insurance in America; problems that can be solved through greater liberty. Yet, despite the problems, nearly everyone has ready access to the best medicine in the world.
Lin Zinser, founder of Freedom and Individual Rights in Medicine (WeStandFirm.org), worries perhaps as much about the sorts of "reforms" that many propose as a cure. Zinser said, "The main problem is government interference in insurance and medicine. The second problem is the misdirection by some misguided reformers who claim that we need more government control of medicine and health insurance."
Seventy-seven percent of Coloradans polled said they receive good or excellent quality of health care, according to polling data from Hill Research Consultants reviewed at a March 28 meeting of Colorado's Blue Ribbon Commission for Healthcare Reform (also known as the "208 Commission" after its authorizing legislation. A representative of the Denver Metro Chamber of Commerce presented the information).
Coloradans are even more enthusiastic about the health care they receive than are people elsewhere in the nation, according to a comparison to Gallup statistics, by a margin of 77 percent to 65 percent.
However, while most people are happy with their own health care, they're concerned about medical care "as a whole." The polling data reveal that 60 percent of Coloradans think the quality of health care in Colorado "as a whole" is good or excellent. Only 33 percent think that health care "coverage" in the "state as a whole" is good or excellent. Part of the drop probably has something to do with all the political preachers of health care doom and gloom.
What's interesting is that, while most people think their own health care is good to excellent, many people worry about their neighbors' health care. But the fact that so many of our neighbors are happy with their own health care suggests that both the quality and coverage of care in the state "as a whole" is pretty good.
The "most urgent health care problem facing Colorado today," according to the poll, is "expense of care (including direct cost, price of insurance and the affordability of prescription drugs)," a top concern of 32 percent of those polled. 24 percent mentioned insurance availability as their top concern. While the costs of health care and insurance are distinct, the problems with insurance are what cause many of the overall problems of cost.
Thankfully, there's also some good news on the insurance front. Tax-deductible Health Savings Accounts (HSAs), intended for use with high-deductible insurance, became available starting in December, 2003.
Peg Brown writes for the Fall, 2006, Colorado Regulator, "In Colorado's small group market, in 2004, 1,075 individuals were covered by HSA qualifying HDHPs [high deductible health plans]. By December, 2005 this had increased to more than 26,000 individuals -- just in the small group [employer] market... One of the interesting aspects of HDHPs is that a significant proportion of those purchasing them were previously uninsured." Hopefully it is a trend that will expand.
What about insurance generally? According to a November 9 report by the Metro Denver Health and Wellness Commission that cites three 2005 sources, 83 percent of Coloradans have some sort of health insurance, including 7 percent with individual plans.
The estimated 17 percent uninsured is bad news, but how bad? According to David Gratzer's book The Cure, the percentage of Americans without insurance has remained roughly constant since 1991. Gratzer describes as a myth the idea that "health insurance equals health service." He writes that "billions of dollars a year are spent on health care for the uninsured."
Gratzer suggests that typical claims purporting to link a lack of insurance to deaths among the poor fail to account for the "complex variables" that determine health. In other words, a lack of insurance in some cases is but a symptom of a much larger problem of poverty, unemployment, and/or imprudent behavior.
But some people decline to buy insurance because they're healthy or they make enough money to cover expected costs. According to a Census Bureau review of national 2005 data, 41 percent of the uninsured are ages 18-34, when people are less likely to contract high-cost diseases, and 35 percent of the uninsured earn over $50,000 per year for a household.
No, it's not time to page Dr. Pangloss -- we do not live in the best of all possible worlds. But serious reforms do not begin with the opposite presumption that American medicine is in ruins and must be subjected to wholesale, government-controlled reform. Medicine is in reasonable health and can be improved by greater doses of the American values of individual rights, liberty, and freedom of choice.
Ari Armstrong is a senior fellow with the Independence Institute and edits FreeColorado.com. He and his wife, previously uninsured, recently applied for high-deductible individual health insurance in conjunction with a Health Savings Account.