TAKE A STEP BACK AND LOOK AT THE BIG PICTURE (COLORADO AMENDMENT 69)

I have family members involved in the health care services industry as primarily providers.

My mother has worked at various trauma level centers for the better part of her adult life ranging from running an operating room at Parkland Hospital in Dallas to a diabetes educator to eventually making her way to the training side of nursing. I cannot recall a time I never saw her not wearing scrubs.

My aunt and her wife are both doctors. My aunt was a psychologist until she decided to go in a completely different direction by pursing a field in the non-profit sector offering her services as a contractor. Her wife is medical doctor. So if I get hurt, her wife can patch me up while my aunt can analyze why I got hurt.

I remember the battle over the passage of ObamaCare. I understand why the legislation was not to liberals liking, but it passed and was a key foundation of one of Obama’s many successes as president.

I also am aware of the nation’s long fight for health care coverage and insurance reform. This is an issue that has been advocated by one of the Founding Fathers and championed by both major political parties.

In 1798, John Adams signed “An Act for the Relief of Sick and Disabled Seamen” which authorized the creation of a government operated hospital service and mandated that privately employed sailors be required to health care insurance.

Abraham Lincoln’s second inaugural address in March 1865 included the line “to care for him who shall have born the battle, and for his widow, and his orphan.” That became part of the cornerstone of the Department of Veterans Affairs and that care for him who shall have born the battle led to the creation of a system of hospitals that serve veterans.

One of Teddy Roosevelt’s platform planks in his third-party bid for the presidency in 1912 was health care reform.

In a message to Congress in November 1945, Harry S. Truman proposed a national health care program calling that “the health of American children, like their education, should be recognized as a public responsibility.” Nearly twenty years later, Lyndon Johnson signed Medicare and Medicaid into law and at the signing ceremony presented the former president and his wife the first Medicare cards.

Nixon called for health care reform in a 1972 message to Congress and included it in his 1974 State of the Union. Unfortunately for Nixon, he lacked the political capital to implement his plan because there was something ELSE going on in 1974…

Jimmy Carter supported improving health services for children of low-income families in 1977. Ronald Reagan signed into law in 1986 that hospitals that receive any type of government funding must treat anyone who comes in with an emergency medical condition. George H.W. Bush proposed in 1992 that paper records be replaced with electronic means of storage, and we don’t remember him as being a technologically savvy president.

Bill Clinton tried to achieve universal health care coverage within the first two years of his first term. Despite lobbying from his wife in a dual role as First Lady and chair on the president’s task force on health care reform as well as Democrats controlling Congress, it was Congress that opposed the president and his plan. However, Clinton and Congressional Republicans were able to get SCHIP in 1997, a program to cover uninsured children in families that did not qualify for Medicaid.

There was George W. Bush signing Medicare Part D which subsidized the cost of prescription drugs.

Then came the biggest leap in health care reform since Johnson signing Medicare in July 1965.

Other countries have some form of health care coverage for their entire population. Sick Around the World, a PBS Frontline episode that aired in April 2008, T.R. Reid profiled five comparable democracies – the United Kingdom, Germany, Switzerland, Japan, and Taiwan – to investigate what ideas could be implemented here in the United States.

And, sort of by accident, we have used those countries’ models.

The Veterans’ Hospital is sort of modeled on the United Kingdom’s health system specifically with appointment scheduling and doctor assignment. We have accepted the German concept of medical insurance – first proposed by Otto von Bismarck in 1883 – and it was later imported to Switzerland and Japan which those countries require everyone to have coverage in the similar manner of ObamaCare’s individual mandate. Taiwan studied other countries health care plans and implemented a system similar to the US Medicare program in 1995.

Are there flaws which each of these plans? Of course.

The UK system is relied heavily on taxes, it can take time to see a doctor, and there are occasionally threats of privatization that are immediately shut down.

Japan boasts some of the better wellness statistics in the developed world in part due to diet and lifestyle and unlike the UK a patient can be seen by a doctor with ruthless efficiency, but there are concerns that health costs are too low and hospitals end up deep in the red.

Like Japan, Taiwan too faces budgetary issues of not bringing in enough money to cover the cost of health care. Because it is up to Taiwan’s parliament to approve an increase in insurance premiums, the situation can get political.

I can foresee the United States eventually adopting a combination of the German and Swiss systems with promoting prevention as the UK does. The concern in Germany is that doctors are not paid as much as their counterparts in the United States, but it should be noted that Germany allows for its citizens to attend medical school free of charge. The country also allows its richest 10% to opt out of the public insurance system and purchase private insurance instead. Switzerland is one of the most expensive systems in the world but can provide a discount if a plan includes a gatekeeper and other incentives as well.

One common theme is that no one goes bankrupt over not being able to pay medical bills in those countries. That concept is almost unheard of as those countries have ways to help give their citizens – regardless of income level – a way to access health care.

The supporters of ColoradoCare say that the proposed health care plan would cover everyone and include mental and behavior health services. The plan would allow dental, vision, and hearing coverage for children. Anyone who has a federal health care coverage plan such as Medicare, federal employee insurance plans, and veterans and military plans can use ColoradoCare for supplemental coverage.

So why can I not support ColoradoCare/Amendment 69?

For starters, Vermont tried to implement a similar plan for the state in 2014. But when the legislature saw the cost, they refused to pass it and Governor Peter Shumlin, a universal health care advocate, had no choice but to pull the legislative plug.

So if reliably blue-state Vermont cannot implement a single-payer system in its state, then what are the chances of it passing via a constitutional amendment in purple (with hints of blue) state Colorado?

The cost of ColoradoCare would have to raise $25 billion in new taxes to fund the program which nearly matches the Colorado state budget. It is also why ColoradoCare is on the ballot: TABOR. Any time there is a proposal to raise taxes, it must go to the voters. And when there is such a proposal, it is almost defeated.

Then there is the issue of using the ballot initiative process to implement this huge policy change into the state’s constitution. If implemented and there needs to be a change in the policy and procedures, then there would have to be another ballot initiative in order to do so.

And this next point is why I cannot support Amendment 69.

There are some people who are supporting this campaign that have chosen to attack allied organizations and other Democrats in the legislature who would be sympathetic to their cause. These people are engaged in a purity test and seeing that happen with Republicans is not something I want to see happen to the party.

In June, NARAL-Pro Choice Colorado issued a statement opposing Amendment 69 on the basis of it does not guarantee abortion access. In 1984, Colorado implemented a state version of the Hyde Amendment into its constitution.

One person responded to the NARAL’s opposition on Facebook as follows:

Lastly that “throwing women under the bus” line from NARAL is a total crock of shit. NARAL seem to think that we should keep 100+ thousand women from having healthcare because of the possibility that 37% of abortions might have to find alternative funding if no progress is made on the issue in 4 years.

If NARAL was a group worth donating to they would have been working on the ballot measure to fix abortion funding instead of trying to throw poor women under the bus by keeping them from having healthcare.

It should be noted that the person who said this was the campaign manager for Angela Williams’ opponent in the SD-33 Democratic primary and received a 5-to-1 drubbing in that election.

ProgressNow Colorado issued a statement in August staying that the proposal is “a well-intentioned but flawed proposal” and urged health care advocates to turn their attention towards reform on a national level. The Bell Policy also states their opposition to Amendment 69 stating that they too support health care reform but question the amendment’s ability to achieve its goals.

I would urge advocates to look towards the state legislature and work with their allies. Yes, there are a significant number of Democratic legislators who are opposed to Amendment 69, but that does not necessarily mean they are opposed to some of the proposals that the amendment offers. Build on that in order to eventually achieve the goal of universal health care coverage.

The state house is likely to remain under Democratic control while there is a good chance the state senate could flip from red to blue. It is widely believed that after his election in 1932 Franklin Roosevelt met with labor leader Sidney Hillman and after hearing Hillman’s pitch, Roosevelt said, “I agree with you, I want to do it, now make me do it.”

You will not get the ability to make them do it by demonizing your allies, and you most CERTAINLY will not if Republicans hold the Colorado Senate.

For now, it is important that to listen and have a view of the long game.

I would much rather take the time to create good, sound policy through the means of the state legislature with the ability to improve instead of implement a flawed policy in the state constitution that could face difficulties in reform later on or face complications due to the volatile nature of Colorado politics.

Hence, I urge a NO vote on Amendment 69.