In my work, I attempt to involve as many stakeholders as possible so as to solicit as many good ideas as possible. In the case of overhauling the nation's health care infrastructure, the number of stakeholders is about equal to the population of the United States. In spite of this, the very small number of GOP senators, including our own Cory Gardner, has decided to not even hold Senate committee hearings about their bill.
I wrote Sen. Gardner asking him specifically to commit to holding in-person, respectful, town hall meetings around the state before any vote is held on the GOP plan. He sent me back what amounted to talking points about how bad the Affordable Care Act, aka Obamacare, is. He did not even address my question of holding committee or town hall meetings to discuss. It is always easier to call out the bad in somebody else's work. The GOP has been doing that since before the passage of the ACA. And while they claim they have been working on their replacement for seven years, they knew there was no pressure to be thoughtful because they could trust President Obama to veto their bill. Now they have majorities in the House and Senate and they have the White House. And, they have full ownership of what they pass. They will not be able to blame Obama any longer.
While this paragraph sounds like criticism of the GOP, I actually want them to succeed because the ACA fixed some major shortcomings of what was in place. Before the ACA, pre-existing conditions were grounds for denying health insurance. Policies did not need to cover essential health services. A very large percentage of bankruptcies were due to medical bills, and of those, most people did have insurance. There was no limit on how much profit insurance companies could make, and the flip side of that was that there was no mandate that insurance companies spent a certain percentage of their revenue on actual health care. The economic incentive outweighed the health care incentive.
Under the ACA, insurance companies were required to spend 80 percent of their revenue on health services. Under the ACA, children could be covered on their parents policies up to age 26. Under the ACA, essential services were covered on every policy. Problems I see with the ACA include leaving in place the concept of geographical risk pools. What benefit is there to this? Rural areas, like Delta County, have small populations. Those small numbers of people make it so that if a very small number of people in those require expensive treatments, the premiums skyrocket for people in that area. In large urban areas, where the population is much greater, the larger risk pools have more people to spread health care costs around. Why not have one risk pool for the state? Or the country? Then all of us are helping all of us, either state or nationwide.
A problem I see with the House health care bill is allowing policies which do not cover essential services. We consumers may think we know what we need for health insurance but the fact is none of us do. Some of us will live perfectly healthy lives. Others may get hit by a drunk driver, or get bit by a West Nile Virus infected mosquito, or contract cancer. Because of this I favor preservation of inclusion of essential benefits on all policies. But even more fundamental, I ask: What value do insurance companies bring to the health care arena? People on Medicare, the federal system for elderly, almost universally want to keep their Medicare coverage. Medicare has lower overhead costs than private insurers. Do insurance companies bring value to the health care market which Medicare does not?
In ending this, let me ask you all to think about what you want in a health care system. Think about it from a blank sheet of paper point of view. Ignore what the politicians and lobbyists say. There are good and bad ideas in the ACA. There are good and bad ideas in other nations' health care systems. Are we not smart enough to pick the best ideas from all of these and make a unique system that serves all Americans, something which we can unite around and be truly proud of? I think we are. But I do not think that can happen if the GOP refuses to consult with us stakeholders.