Would the Colorado Health Care Authority be part of the government? No matter how much its supporters claim that it would not be, and how Colorado HB 1273 defines it, it is. So long as it gets your tax dollars and sets rules forbidding you from contracting with a doctor, it’s operationally part of the state government. As a true authority, this Authority will consist of people appointed by politicians, and will have the power to define what legal insurance is, and is not.
It will be “the benefits administrator and payer for health care services defined by the authority.” The Authority would “create a health care system in Colorado that is the administrator and payer for health care services.” Not “an administrator.” The, one and only, administrator. This sounds rather authoritarian to me. If the authority is the “administrator and payer for health care services,” then is it not a crime for you to hire a physician on your own? What am I missing here? (No snarky answers, please.)
As the bill states: the Authority will be a “political subdivision of the state” that will generate revenue from “fund moneys appropriated by the general assembly and any federal moneys received…” Yet the bill also states that the Authority “shall not be an agency of state government, and that shall not be subject to administrative direction or control by any department, commission, board, bureau, or agency of the state.” I don’t see how this is important given how much power it would have over our medical choices.
Yet, in a letter published in the Denver Daily News in response to my article, Irene Aguilar, MD (President of “Health Care for All Colorado”) writes:
HB 1273 does not create a Canadian-style health system. The bill establishes the Colorado Health Care Authority to create a health care system in Colorado. The authority is specifically defined as being separate from state government. The authority will be the payer for privately delivered health care. Coloradans will pick their health care providers — Kaiser or the Rocky Mountain Health Plans, for example — and the authority will handle the payment.
If it is separate from state government, but the “authority will be the payer for privately delivered health care,” what happens to people who do want to buy their health insurance or prepaid health care directly from people who sell insurance? What happens if you agree to pay a doctor for a checkup? Do you both face criminal charges? That is, what if they do not want to deal with “the Authority”?
(Anguilar refers to “health care,” but I think she means health insurance/prepaid health care plan. To me a “health care provider” is someone who provides medical treatment, like a physician, surgeon or nurse. Not someone who works for an insurance company. Remember, coverage is not care.)
Anguilar says you can pick your insurance providers. But so what? They would just be government contractors, not independent institutions. If all of an organization’s revenue comes from government, then it’s effectively part of government.
If this Authority is separate from government, then individuals should be able to do business with it, or choose not to, on voluntary basis. We do this with businesses all the time. But somehow I doubt this will be the case, since it will be “the payer for privately delivered health care.” That’s what “single payer” means. And “authority” means you comply with it, or you face criminal penalties.
If the Authority is the single payer of insurance/prepaid health care companies, then the Authority is their only customer. If these companies want to receive money from the Authority, they will have to do what the Authority says. To quote the text of HB 1273, the Authority will have a Board, which will consider many restrictions on what insurance companies can do. For example:
appropriate and cost-effective benefit design and eligibility requirements, standards and qualifications for health care providers, provider rates, and any other provisions
and determine
the fee or premium structure and approval process, including a means-based fee or premium that ensures all income earners and employers are contributing an amount that is affordable, fair, and consistent with current funding sources for health care in Colorado.
And this is just the tip of the iceberg. The “required covered benefits” already includes 13 mandates.
Here are some more excerpts from the bill (emphasis added):
There is hereby created the Colorado health care authority, that shall be a body corporate and a political subdivision of the state, that shall not be an agency of state government, and that shall not be subject to administrative direction or control by any department, commission, board, bureau, or agency of the state.
The authority and its corporate existence shall continue until terminated by law …
There is hereby established in the state treasury the health care authority fund, referred to in this section as the “fund”, for the purpose of implementing and administering this article. The moneys in the fund shall be subject to annual appropriation to the state department for allocation to the authority. The fund shall consist of any general fund moneys appropriated by the general assembly and any federal moneys received for the purpose of implementing this article. The moneys in the fund and any interest earned on moneys in the fund shall remain in the fund and not revert to any other fund at the end of any fiscal year.
For anyone who thinks the Colorado Health Care Authority is a great idea, then be entrepreneurial about it. Set up a business plan, find investors, and then find customers who are willing to pay the Authority for its services. I mean, if it’s so good, why must it be “the administrator and payer for health care services,” i.e., a monopoly?
