BackboneAmerica

Observers of Colorado’s Blue Ribbon 208 Commission on Health Care have generously withheld our comments, pending completion of the commission’s deliberations. After their final report to the legislature on Jan. 31, it’s now time for the awards ceremony.

First Prize should be awarded to the project managers at Lewin, the consulting firm. Their data models and reports were sophisticated, straight-shooting. It’s the best information on Colorado’s health care system since the Colorado Hospital Association put a knife in the lower abdomen and gutted the Colorado Health Data Commission back in the early 1990s. Very good stuff!!

Second Prize should go to Senate Minority Leader Andy McElhany. His appointment of Bill Lindsay, Colorado’s silver-haired, premier health insurance salesman, resulted in the key recommendation of the 208 Commission being to require all citizens in the State of Colorado to buy — surprise — health insurance. The group health insurance association must be uncorking bottles of the bubbly right now. Who would have ever thought that if you put an insurance peddler in charge he would recommend everyone buy health insurance? Absolutely counter-intuitive.

Third Prize has to go to Gov. Bill Ritter. He was honest in admitting up front that as an attorney and former prosecutor he knew very little about health care and would require a committee to advise him. He also knew nothing about education or transportation and has required committees for those areas too. Come to think of it, he knows little about nothing and the whole strategy of the state seems dependent on committees. Each committee has determined (surprise again) that an additional expenditure of about $1 billion a year is necessary to fund their respective area.

Factoring in the unpredictability of such matters, it is likely taxes will eventually have to be raised $3 billion a year for health care alone, since the population of uninsured is sure to grow and age and require more care over time in an inflationary health market.

Fourth Prize, last and least, goes to our legislature. In their infinite wisdom they chose to throw out all of the previous learning we had achieved about health care reform and reinvent the wheel. With one ear to the ground and the other ear whispered into by the insurance lobby they crafted Bill 208. Left unsaid, the real mission for the Commission was how to deal with Medicaid, which is rapidly losing the support of doctors who are being forced to discount their services. Medicaid, which has long been treated by the state as a perverse form of economic development, because of federal matching funds, is now eating us alive.

At any rate, the legislature commissioned a fool’s errand. Instead of a report that demonstrates a profound understanding of the economic dynamics that drive health care inflation, the State now has a report that elaborates on the social and political considerations of health care. It calls for the blunt instruments of tax-and-spend mandates and lacks a finesse solution to an otherwise difficult situation.

All that remains is for the legislature to thank everyone, give out certificates and shelve the report. Then the staff and commissioners can have their 5 minutes in the sunshine being interviewed by the media. This will give them a pulpit from which to preach their ideology.

Let me make a prediction. Once this legislative session is complete and the 2008 elections are well underway, a new conventional wisdom will emerge. “Let’s wait and see what the Feds come up with”. Soon it will be 2010 and it will be back to business as usual.