Friday, April 27, 2007

Last Opportunity to Influence 208 Commission

Today was another all-day 208 Commission hearing.

Make your Voice Heard

The most critical issue to a Colorado resident is that the Commission is seeking public comment with regard to important principles and features to evaluate the more than 28 proposals for health care reform that it has received. Watch this blog for summaries and analysis of all 28 proposals over the next few days.

The Commission intends to only evaluate 3 to 5 in detail. To get to this number, it has developed a two step winnowing process. On May 7, the Commission will flush 18 to 20 of the 28 proposals it has received. (From a Commission handout entitled "Major Coverage Strategies of Comprehensive Proposals," the Commission may have already tossed 5 proposals as "not comprehensive.") On May 17-18, the Commission will then review those remaining 8 to 10 proposals, purging all but 3 to 5.

The Commission is seeking public comment by May 12, and wants the public to address two questions:

1) What are the one or two most important features that you feel must be included in any Colorado health care reform? and
2) What is the most important principle that should be considered in any reform effort?

By listed order, the Commission values reform features over principles.

There are two ways to provide comment to the 208 Commission. 1) You may submit a comment in writing by e-mail to Any comment sent to this address will be posted on the Commission website and distributed to all Commissioners for review in advance of the May 17-18 meeting. But the e-mail must be received by May 12.

Alternatively, there are five meetings planned where public comment will be solicited and where you have the opportunity to speak before one or more commissioners. Current public meeting information is not yet up on the website but is supposed to be made available shortly. They still want you to submit written testimony at the time of your oral presentation.

Public Comment Meetings, including dates and locations
  • May 10 Metro Denver, 4 - 7 pm, Wheat Ridge Recreation Center, 4005 Kipling
  • May 10 Glenwood Springs, 4 - 7 pm, City Hall - Council Chambers, 101 W. 8th St, Main level 1st floor
  • May 12 Pueblo, 9 am - Noon, Convention Center, 320 Central Main Street
  • May 12 Durango, 9 am - Noon, Mercy Medical Center, 1010 Three Springs Blvd
  • May 12 Ft. Collins, 1 - 4 pm, Harmony Public Library, 4616 S. Shields Street
Although they will be seeking public comment later in the summer, this is the last opportunity to express your opinion about the most important principle (and features) to be used to select any proposal. This is the time to speak about capitalism v. government control, the individual rights of doctors and other providers v. the needs of some patients, and freedom in medicine and health insurance v. insurance mandates and other instances of government force.

More Commission News

No meeting summaries of any of the prior meetings have been approved by the Commission, are on-line or available to the public. These prior meeting summaries were to have been approved and available today, but were not available due to a "glitch." Chair Bill Lindsay promised that unapproved summaries would be on-line next week at the website.

Governor Ritter has appointed 3 new members to the Commission, two of whom took their places at the Commission meeting today. The new members are Peg Burnette, CFO for Denver Health; Donald Kortz, Chairman of the Board for Fuller & Company, and Lynn Westberg, Director of San Juan Basin Health Department. Ms. Burnette and Ms. Westberg were present today. There are now 27 Commission members.

The Commission also voted to hire a company to "model" the 3 to 5 proposals it selects next month. There were 2 firms considered by the entire Commission: The Lewin Group and Milliman. The Commission voted to accept Lewin's proposal over Milliman's. Their rationale: Lewin had a pre-programmed model designed to run on state samples from national surveys, and it works with lots of state agencies, task forces and commissions on health care reform, whereas Milliman had less government experience, but was experienced with private clients and Medicaid, including long-tem care, and was willing to construct a model for Colorado and include Colorado data. When I asked (during public comment) if there were measured results of Lewin's prior forecasts that would validate the accuracy of its forecasts, the response was that there was no such data because none of the assumptions and proposals that were used in its 18 years of forecasts ever were adopted by a legislative body as modeled. (That says an enormous amount about the various proposals modeled and the legislative process, and why a firm would choose to provide more government than private services in this area.)

Additionally, Commissioner Linda Gorman noted that Lewin did not generally use administrative costs data that was within the limits of that discussed in the literature, but used their own numbers. So, the Commission, relying on its Evaluation Committee, chose to pick a firm that was government oriented rather than market oriented (where its reputation depends on making accurate forecasts for its private clients) and where the Commission has said there is no ability to measure the accuracy of its forecasts. (By my count, there were only 4 Commissioners who voted for Milliman.)

Just another day at the Commission.