Wednesday, March 28, 2007

Report on 208 Commission

I spent 7 hours today at the 208 Commission meeting with 10-15 other public witnesses.

Three items worthy of note.

First, the 208 Commission held public meetings this past week requesting feedback on the criteria it plans to use to evaluate various proposals for health care reform. The meetings were held in Denver on March 22, and on March 24, in Alamosa, Colorado Springs, Greeley and Grand Junction. About 230 people showed up to hear the various commissioners talk about the Commission and of these, 97 spoke. According to the commissioners, most of the people that testified were either medical providers or part of some specific consumer group that is a high user of medical services, such as the disabled.

A few of the commissioners seemed disheartened that few business owners and employers attended, but one commissioner reminded them that small business owners and employers work more than 40 hours a week, and had little incentive to attend. The Commission Chair also pointed out that these public comment sessions most likely did not represent the views of most of the people of the State of Colorado, but rather only those who were providers, those who felt their health care was substantially lacking, or those who had no insurance.

Which bring me to the second point. According to Colorado voters there is no crisis of health care in Colorado. According to Colorado voters polled in December 2006 for the Denver-Metro Chamber of Commerce, 77% of Colorado voters believe their own health care is good or excellent and 60% believe the quality of health care in Colorado as a whole is good or excellent. More to the point, only 7% describe the situation in Colorado health care as a crisis.

This polling data was presented at the 208 Commission meeting by Chamber of Commerce public policy-wonk Tamra Ward, and is a bit higher, but similar, to national polling data by the Gallop and Pew organizations. Nationally, about 71% consider their own care is good or excellent, and 53% think that health care across the nation is good or excellent.

One interesting issue presented by this data is that while people think their own health care is above average, they seem to have been convinced that there is a problem for other people. The numbers are split about even on whether there is a major or minor problem in the "Colorado health care system". As stated above, 7% believe there is a crisis in the "health care system" and 39% believe there is a major problem, while 45% think there are only minor problems, 3% state there is no problem and 6% have no opinion. Of those who believe there is a major problem, the most significant issue is a concern for the cost of a major illness. The solution to that problem is catastrophic insurance coverage.

All of this is excellent news for Colorado and for those who value freedom and individual rights. To the extent that people understand that there is no crisis or major problem, then they are unlikely to be sympathetic to major, significant, wholesale changes in either medicine or health insurance.

The final item of information from the 208 Commission is that they have received 31 notices of intent from different persons or organizations who intend to submit health care reform proposals, with only one clearly in favor of the marketplace, and two that mention markets, but want to have either a private/public partnership, or involve government reinsurance and coordination. Most of the other notices indicated an intent to submit proposals for single-payer, comprehensive, universal, mandatory plans, or some combination thereof.

The next 208 Commission meeting is tentatively scheduled for April 27 where they intend to select a vendor for the economic modeling of three to five proposals of the thirty-one proposals that may be submitted.