Normally, that much uncertainty would by itself disqualify an amendment to the state constitution that seeks to send
We start with the one assertion upon which the members of our editorial board agree: The current system is broken, and not just broken in the way, say, that our national infrastructure system is broken. The latter is readily understandable: A dysfunctional political system has dramatically under-funded infrastructure development and maintenance over decades so that a very substantial investment is now required to catch up. The question is quite simple: When, if ever, will our elected leaders come together to make that investment?
Our health-care system is broken in a much more complicated way. It is well known that we spend more to get worse health outcomes than other advanced countries. Our system is built on a foundation of perverse incentives that saves its biggest rewards for insurance and pharmaceutical companies. It depends upon payments for health care from insurance companies whose profit margins depend upon maximizing premiums and minimizing claims. In other words, the institutions we rely upon to pay for our health care have incentives to pay for as little health care as possible.
The largely accidental development of an employer-based health-insurance system is also perverse in many ways. There is no natural reason for one's health care to depend upon one's employment, and lots of reasons for it not to when you consider the cascade effect of losing both. Our current system creates this perverse symbiosis. In many cases, when an employee with employer-provided health insurance loses a job, the outcome is a doubling or tripling of health insurance costs just as household income drops dramatically.
The Affordable Care Act, more commonly known as Obamacare, was an attempt to create an independent marketplace for group insurance rates so that Americans might buy their own plans free from the whims of employers and available to those without employers. The characteristics of the people who make up such groups determine how much those plans cost. Because the people buying insurance on the Obamacare exchanges are in need of more health care than was initially projected -- what the industry refers to as morbidity rates -- some insurance companies are exiting those exchanges and others are jacking up their rates at a furious pace.
Add all this up and it seems clear that a single, large pool, including both healthy and sick, is the best way to keep the cost of health care across the population reasonably affordable.
At a national level, however,
So we are inclined to agree with the backers of Amendment 69 on their diagnosis of the problem and with the broad outlines of a solution. On the other hand, like many others, we cringe at the myriad things that could go wrong building a
So we are stuck. The current system, in our view, is profoundly perverse and probably financially unsustainable, not to mention the unconscionable outcomes it produces when insurance companies block needed treatment. The proposed replacement is fraught with foreseeable and unforeseeable unknowns. Many seniors are apprehensive because ColoradoCare would have to apply to become an approved
Still, we are unwilling to simply say no, knowing this means tacit approval of a status quo we abhor. According to the polling, ColoradoCare is unlikely to pass. Opponents, led by big health insurance companies trying to protect their business, have dramatically out-spent proponents. So we see Amendment 69 playing the role of early referenda in various states regarding gay marriage or the legalization of marijuana. The path to reform has to start somewhere.
For those who agree that reform of the current system is necessary, we recommend, by a narrow majority among us, casting a protest vote in favor of Amendment 69 so that it gets enough support to encourage its backers to keep working to find a better way than we have at present to provide fair, quality health care for all.
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