This article originally appeared in the print edition of the Boulder Daily Camera on March 31, 2012.
The Colorado Trust is a statewide grant-making foundation with assets exceeding $400 million. It claims to be “dedicated to achieving access to health for all Coloradans.” The Trust and its grantees use shifty arguments to support ObamaCare’s individual mandate, which requires Americans to purchase a politically-approved health plan. With the Supreme Court’s hearings on the mandate’s Constitutionality just completed, it’s time to reveal the flaws and deceptions behind the Trust’s advocacy.
The Colorado Trust perpetuates the typical boogeyman justification for mandatory insurance: the uninsured cost-shift. ”As more uninsured patients seek care in emergency departments, more cost shifting will … raise the cost of care for the insured,” writes Ned Calogne, the Trust’s President and CEO. The mandate “ask[s] people to take responsibility to pay for health care services rather than burden their neighbors with health care bills,” says Dede de Percin, head of the Trust-funded Colorado Consumer Health Initiative. With mandatory insurance, “free-riders are not allowed, therefore no cost shifting,” writes Gena Akers of SanLuisValleyHealth.org, another Colorado Trust grantee.
Get it? Cost-shifting is wrong, as free-riders make you finance their treatment. But the Colorado Trust merely appears to oppose cost-shifting and promote personal responsibility. The Trust actually loves cost-shifting policies that make you responsible for other people’s health care bills.
Mandatory insurance is among others cost-shifting scheme that the Trust promotes: Medicare, Medicaid, and single-payer socialized medicine. Each involves more cost-shifting than does the problem of the uninsured.
Per insured Coloradan, uninsured cost-shift was on average less than $85 per year according to the Lewin Group’s 2008 Final Report to Colorado General Assembly. The Urban Institute’s national study concludes that “even if all private funding for uncompensated care were recouped from private insurance payments, this would still amount to only 1.7% of private insurance premiums.”
As evidence of Colorado Trust’s insincerity, note that if preventing unpaid emergency room bills truly motivated mandatory insurance, authorities would only mandate coverage for emergency medical treatment. But ObamaCare threatens to ban low-cost high-deductible plans. It makes you pay extra for non-emergency coverage including mental health, substance abuse, newborn, and selected pediatric care, regardless of their value to you.
The cost-shift from these mandates erases the insured cost-shift. Each one increases high-deductible plan premiums by around half a percent, concludes economist Amanda Kowalski. That’s not the only ObamaCare cost-shift. Its insurance price controls force the young to subsidize the old: “$42 a month more” for those under 35, reports the AP.
Every dollar matters. “For every 1 percent increase in premiums in Colorado, 2,500 people lose their health insurance,” said Ned Calogne in the Washington Post before he joined the Colorado Trust.
If the Trust sincerely objected to cost-shifting, it would not only decry ObamaCare’s cost-shifting, but cost-shifting from Medicare and Medicaid. A Coloradan earning $56,000, median income in Colorado, pays thousands of dollars in taxes annually to support these programs, says MyGovCost.org. But these programs underpay doctors, which increases annual insurance premiums by around $1800 for a family of four, concludes a Milliman actuarial study. “If there were no cost shift, commercial hospital and physician costs would be 15% lower,” it adds.
Despite Medicare taxes you pay when employed, they “won’t cover what you’ll cost,” reports the AP. “With Medicare, we are all still making out like bandits, shoving all those costs to future generations,” says an Urban Institute researcher.
Yet the Colorado Trust promotes these cost-shifting programs. In 2009 the Trust’s President celebrated a new Colorado law expanding Medicaid eligibility. Medicare, Medicaid, and ObamaCare are among SanLuisHealth.org’s historical health care “improvements.” The list includes the mother of all cost-shifting schemes: a single payer “national health insurance program.”
Don’t be fooled. Mandatory insurance isn’t about personal responsibility or reducing cost-shifting. It’s about using politically-controlled health plans to advance political control of your medical care. This is incompatible with ensuring that Coloradans have timely access to affordable quality medical care.