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A prescription for change
  
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By Peter Jones
While Democrats and Republicans have debated health care reform in Washington, D.C., business leaders in the South Metro area have been writing their own prescription for overhauling health care in Colorado.
After setbacks from a blue-ribbon commission and within the state Legislature, the local entrepreneurs have remained undeterred as they pitch their ideas to lawmakers and stakeholders across the state.
Say what you will, the product they are selling is innovative — even by standards set by the current health care-reform Zeitgeist. What this small group of self-described capitalists has conceived is arguably more revolutionary than anything under consideration by either party in Congress.
“In Washington, Democrats and Republicans are both arguing about how do you keep the current system in place,” said Paul Archer, who co-authored the broad-reaching initiative. “One of our fundamental tenets is what’s wrong with our current system — is the current system.”
Archer, president of Automated Business Products, is not your typical advocate for radical reform. But this year, the Centennial resident and a group of like-minded largely Republican free-market business owners drafted a self-styled framework that would offer health care to every Colorado citizen.
The ambitious plan surprised many on both sides of the aisle. Its mix of single-payer and private-industry models has raised the eyebrows of some fiscal conservatives while intriguing some liberals, who wished the group had pushed the envelope even further.
According to Archer, the group strived to find what they felt was the right balance, one that could not please all competing interests — least of all, free-market purists.
“The real powerful part of the plan,” he said, “is we have an appropriate role for government and we have an appropriate role for free enterprise.”
A place at the table
The Health Policy Task Force, co-chaired by Archer, was convened almost five years ago by the South Metro Denver of Commerce, an organization whose world view transcends its provincial name.
The leaders of a chamber known for its adventurous streak had realized that the writing was on the wall when it came to American health care. Reform was going to happen, whether they liked it or not.
“The current system is unacceptable. It’s unsustainable,” Archer said.
The chamber, a booster for south metro commerce, reasoned that the small businesses that constitute most of its membership had the most to lose — and the most to gain — as health care reform inevitably took shape.
“We had a saying and we still use it regularly,” Archer said. “If you’re not at the table, you’re on the menu.”
The main course, as far as the Health Policy Task Force was concerned, was universal coverage — seasoned by dashes of individual choice, free enterprise and, most surprising to some, a healthy dose of quasi-governmental involvement.
“The priorities were everybody should be covered and there should be no connection between healthcare decisions and employment,” Archer said. “Another fundamental issue was free markets are the best way to reduce cost and improve quality. The most important relationship is between the individual and his healthcare provider.”
The chamber’s remedy
The chamber plan’s major tenets include:
Colorado citizens would be required to buy health insurance policies. Fines would be imposed on violators.
Insurance companies would be compelled to sell policies to anyone as part of a three-tiered system designed to lower premiums. A mix of government and private-industry funds would essentially work in concert to cover all facets of healthcare.
The employer-provided insurance model would be eliminated in favor of a system of portable insurance policies.
The so-called Tier 1 would focus on preventative coverage and be administered by the state government or an independent third party. The tier would essentially operate under a “no charge” single-payer model and include such services as immunizations and medical tests.
According to Archer, the cost of Tier 1 could be covered by some private insurance dollars and by redirecting existing state resources currently tied to Medicare, Medicaid and other programs.
The plan would not involve a tax increase of any kind, according to Archer.
“There’s already $11 billion of public money in the health care system,” he said.
Mandated private insurance would kick in with Tier 2, where patients would receive the lion’s share of their maintenance coverage — physical check-ups, prescription drugs and noncatastrophic services ranging from knee replacements to tonsil removal.
A consumer’s premium rates would reflect adverse lifestyle choices, including smoking and alcohol abuse. All insurers in the state would be required to offer a basic plan to everyone, regardless of their age, history or pre-existing conditions.
According to Archer, the cost of such policies would would be drastically reduced by removing catastrophic care from Tier 2’s for-profit equation. The elimination of the workplace health care benefit would also allow employers to increase compensation to workers.
“Your employer would still have a role in financing your health care,” he said. “But it’s your policy. You choose it. You manage it. If you quit, it goes with you. You don’t have the goofy portability things you have today like COBRA.”
Unemployed and low-income workers would receive free or cost-reduced Tier 2 vouchers paid for by other savings in the system.
Tier 3 would include catastrophic coverage. Like Tier 1, it would operate under a single-payer program administered by the government or an independent third party and funded by a mix of public funds and designated insurance premiums.
Closing the deal
Brainstorming a potential new reality for Colorado health care has been the easy part for the Health Policy Task Force. Selling the chamber’s plan to the powers that be has been more like a trip to the dentist.
In 2007, the task force presented its proposal to the 208 Commission established by Gov. Bill Owens. The blue-ribbon panel named for the Senate bill that created it was charged with studying a range of proposals to provide health insurance to all Coloradans while reducing costs.
Although the chamber’s public-private hybrid was a semi-finalist for recommendation by the commission largely comprised of healthcare industry professionals, the initiative was eventually rejected as a 208 finalist.
Still, the chamber was undeterred.
“We decided we’re not going to give up,” Archer said. “We have what we think is the most innovative plan and a plan that actually addresses cost, access and quality. So we created a strategy for finding an audience of one.”
Enter state Rep. Joe Rice, a moderate Littleton Democrat who agreed to carry the bill for the Republican-led business leaders during the 2009 legislative session.
At Rice’s urging, the task force met with single-payer advocates in an effort to iron out a compromise. The well-organized single-payer contingency had been pushing competing legislation and Rice feared both bills would fail if they were presented simultaneously.
Rice, serving in Iraq with the Army Reserve, could not be reached for comment.
Although spirited conversations and new friendships developed from meetings between the two groups, Archer says the two sides ultimately agreed to disagree on the future of health care reform.
“We had wonderful discussions,” he said, “but we reached a point where we couldn’t come together. We told them at our first meeting, we’re capitalists.”
After the single-payer bill died a slow death, Rice finally introduced the chamber’s initiative in April under late-bill status, but soon pulled it when he realized there would not be time for the complex and potentially controversial bill to receive a fair hearing.
The legislator reportedly plans to reintroduce the bill when the next legislative session begins in January. The bill may have a hard road to hoe on both sides of the political spectrum.
Take state Rep. Spencer Swalm, a conservative Republican and an insurance broker who has advocated market-based solutions to the health care crisis. The Centennial legislator counts himself dubious.
“I don’t believe the bill does anything to address underlying costs,” he said. “And when you basically have a governmental entity designing health insurance plans, it creates a perfect opportunity for activists to urge that certain things be included. That tends to drive up the cost.”
Single-payer advocates may be equally skeptical. Rep. Morgan Carroll, D-Aurora, has her doubts about the kind of market-based solutions that the chamber says would drive down costs when catastrophic care is placed on a separate balance sheet.
“The free market works extremely well for wants, where you have the freedom to walk away if you don’t think you’re getting a good value,” she said. “I don’t think the pure free market works well for needs — water, healthcare, air.”
For Archer’s part, he says a blame game has been played for too long in the health care debate — even in the task force’s early meetings — and he says it is time for all stakeholders to come together.
“If the hospitals weren’t there, they were the problem. If the physicians weren’t represented, they were the problem. If the insurance companies weren’t represented, they were the problem. And so on,” he said. “We’re not going to give up.”
After setbacks from a blue-ribbon commission and within the state Legislature, the local entrepreneurs have remained undeterred as they pitch their ideas to lawmakers and stakeholders across the state.
Say what you will, the product they are selling is innovative — even by standards set by the current health care-reform Zeitgeist. What this small group of self-described capitalists has conceived is arguably more revolutionary than anything under consideration by either party in Congress.
“In Washington, Democrats and Republicans are both arguing about how do you keep the current system in place,” said Paul Archer, who co-authored the broad-reaching initiative. “One of our fundamental tenets is what’s wrong with our current system — is the current system.”
Archer, president of Automated Business Products, is not your typical advocate for radical reform. But this year, the Centennial resident and a group of like-minded largely Republican free-market business owners drafted a self-styled framework that would offer health care to every Colorado citizen.
The ambitious plan surprised many on both sides of the aisle. Its mix of single-payer and private-industry models has raised the eyebrows of some fiscal conservatives while intriguing some liberals, who wished the group had pushed the envelope even further.
According to Archer, the group strived to find what they felt was the right balance, one that could not please all competing interests — least of all, free-market purists.
“The real powerful part of the plan,” he said, “is we have an appropriate role for government and we have an appropriate role for free enterprise.”
A place at the table
The Health Policy Task Force, co-chaired by Archer, was convened almost five years ago by the South Metro Denver of Commerce, an organization whose world view transcends its provincial name.
The leaders of a chamber known for its adventurous streak had realized that the writing was on the wall when it came to American health care. Reform was going to happen, whether they liked it or not.
“The current system is unacceptable. It’s unsustainable,” Archer said.
The chamber, a booster for south metro commerce, reasoned that the small businesses that constitute most of its membership had the most to lose — and the most to gain — as health care reform inevitably took shape.
“We had a saying and we still use it regularly,” Archer said. “If you’re not at the table, you’re on the menu.”
The main course, as far as the Health Policy Task Force was concerned, was universal coverage — seasoned by dashes of individual choice, free enterprise and, most surprising to some, a healthy dose of quasi-governmental involvement.
“The priorities were everybody should be covered and there should be no connection between healthcare decisions and employment,” Archer said. “Another fundamental issue was free markets are the best way to reduce cost and improve quality. The most important relationship is between the individual and his healthcare provider.”
The chamber’s remedy
The chamber plan’s major tenets include:
Colorado citizens would be required to buy health insurance policies. Fines would be imposed on violators.
Insurance companies would be compelled to sell policies to anyone as part of a three-tiered system designed to lower premiums. A mix of government and private-industry funds would essentially work in concert to cover all facets of healthcare.
The employer-provided insurance model would be eliminated in favor of a system of portable insurance policies.
The so-called Tier 1 would focus on preventative coverage and be administered by the state government or an independent third party. The tier would essentially operate under a “no charge” single-payer model and include such services as immunizations and medical tests.
According to Archer, the cost of Tier 1 could be covered by some private insurance dollars and by redirecting existing state resources currently tied to Medicare, Medicaid and other programs.
The plan would not involve a tax increase of any kind, according to Archer.
“There’s already $11 billion of public money in the health care system,” he said.
Mandated private insurance would kick in with Tier 2, where patients would receive the lion’s share of their maintenance coverage — physical check-ups, prescription drugs and noncatastrophic services ranging from knee replacements to tonsil removal.
A consumer’s premium rates would reflect adverse lifestyle choices, including smoking and alcohol abuse. All insurers in the state would be required to offer a basic plan to everyone, regardless of their age, history or pre-existing conditions.
According to Archer, the cost of such policies would would be drastically reduced by removing catastrophic care from Tier 2’s for-profit equation. The elimination of the workplace health care benefit would also allow employers to increase compensation to workers.
“Your employer would still have a role in financing your health care,” he said. “But it’s your policy. You choose it. You manage it. If you quit, it goes with you. You don’t have the goofy portability things you have today like COBRA.”
Unemployed and low-income workers would receive free or cost-reduced Tier 2 vouchers paid for by other savings in the system.
Tier 3 would include catastrophic coverage. Like Tier 1, it would operate under a single-payer program administered by the government or an independent third party and funded by a mix of public funds and designated insurance premiums.
Closing the deal
Brainstorming a potential new reality for Colorado health care has been the easy part for the Health Policy Task Force. Selling the chamber’s plan to the powers that be has been more like a trip to the dentist.
In 2007, the task force presented its proposal to the 208 Commission established by Gov. Bill Owens. The blue-ribbon panel named for the Senate bill that created it was charged with studying a range of proposals to provide health insurance to all Coloradans while reducing costs.
Although the chamber’s public-private hybrid was a semi-finalist for recommendation by the commission largely comprised of healthcare industry professionals, the initiative was eventually rejected as a 208 finalist.
Still, the chamber was undeterred.
“We decided we’re not going to give up,” Archer said. “We have what we think is the most innovative plan and a plan that actually addresses cost, access and quality. So we created a strategy for finding an audience of one.”
Enter state Rep. Joe Rice, a moderate Littleton Democrat who agreed to carry the bill for the Republican-led business leaders during the 2009 legislative session.
At Rice’s urging, the task force met with single-payer advocates in an effort to iron out a compromise. The well-organized single-payer contingency had been pushing competing legislation and Rice feared both bills would fail if they were presented simultaneously.
Rice, serving in Iraq with the Army Reserve, could not be reached for comment.
Although spirited conversations and new friendships developed from meetings between the two groups, Archer says the two sides ultimately agreed to disagree on the future of health care reform.
“We had wonderful discussions,” he said, “but we reached a point where we couldn’t come together. We told them at our first meeting, we’re capitalists.”
After the single-payer bill died a slow death, Rice finally introduced the chamber’s initiative in April under late-bill status, but soon pulled it when he realized there would not be time for the complex and potentially controversial bill to receive a fair hearing.
The legislator reportedly plans to reintroduce the bill when the next legislative session begins in January. The bill may have a hard road to hoe on both sides of the political spectrum.
Take state Rep. Spencer Swalm, a conservative Republican and an insurance broker who has advocated market-based solutions to the health care crisis. The Centennial legislator counts himself dubious.
“I don’t believe the bill does anything to address underlying costs,” he said. “And when you basically have a governmental entity designing health insurance plans, it creates a perfect opportunity for activists to urge that certain things be included. That tends to drive up the cost.”
Single-payer advocates may be equally skeptical. Rep. Morgan Carroll, D-Aurora, has her doubts about the kind of market-based solutions that the chamber says would drive down costs when catastrophic care is placed on a separate balance sheet.
“The free market works extremely well for wants, where you have the freedom to walk away if you don’t think you’re getting a good value,” she said. “I don’t think the pure free market works well for needs — water, healthcare, air.”
For Archer’s part, he says a blame game has been played for too long in the health care debate — even in the task force’s early meetings — and he says it is time for all stakeholders to come together.
“If the hospitals weren’t there, they were the problem. If the physicians weren’t represented, they were the problem. If the insurance companies weren’t represented, they were the problem. And so on,” he said. “We’re not going to give up.”
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