business any place in Colorado and people have plenty to say about
the skyrocketing costs of health insurance.
are frustrated because they want their employees to have access to
quality health care but can no longer absorb annual premiums
increases of 15 to 70 percent. So, employees, asked to share the
rising cost of premiums, are unhappy, too.
people on Main Street don’t have time to figure out what’s wrong
with Colorado’s insurance market, they do have time to tell
legislators that they expect us to deal with the problem this
problems contributing to our health insurance chaos were created
by well-intentioned legislators who wanted help a particular
group, but in doing so, they loaded additional costs onto all
health care consumers.
health insurance market suffers from a multiplicity of factors
which either drive up costs or shift costs from those who receive
care to others who pay the bill, three elements must be addressed:
Prior to enactment of “community rating,” premiums were directly
related to the health of each person purchasing insurance.
enacted community rating in order to protect small business from
wildly fluctuating premiums and to keep insurance affordable for
consumers with existing health problems. Unfortunately, this
replaced wildly-fluctuating costs with rapidly-increasing costs
and disproportionately shifted costs to healthy consumers, causing
many to simply leave the market.
Look at it
this way: You and I go to lunch together everyday. Both of us pay
$10 for lunch, but everyday, I get an $18 steak and you get a $2
cheese sandwich. How long are you going to subsidize my steak and
be satisfied with your cheese sandwich? That’s the predicament
which community rating imposes upon healthy consumers.
And it gets
worse, because when healthy consumers leave the market, the
high-risk consumers who remain now must bear an even higher cost.
allow insurers to offer a “good health discount” to attract
healthy consumers back into the market.
Everyone who purchases health insurance through the small group
market in Colorado is required to pay for 17 mandatory coverages.
example, everyone is required by law to purchase pregnancy and
maternity coverage – that’s everyone, including men and women who
are beyond child-bearing age. And everyone is required to pay for
child health supervision services and for mental illness. Colorado
law mandates virtually the best coverage money can buy. Trouble
is, few people can afford it.
for legislators to trust consumers to make their own choices about
what their family needs and can afford. Consumers who can’t afford
every conceivable coverage are clearly better off with a basic
policy than with no insurance at all.
Runaway juries awarding lottery-style judgments are making medical
malpractice insurance unaffordable for doctors in several states,
causing physicians to refuse to perform certain high-risk
procedures or to leave for states with liability limits.
reacted to a medical malpractice crisis in 1998 by limiting
non-economic damages -- including pain and suffering, emotional
stress, inconvenience and quality of life -- to $250,000, except
in extreme cases. Injured patients are still entitled to fully
recover medical costs and lost earnings.
the Colorado Supreme Court began to chip away at those
limitations. Though juries may feel justified in awarding millions
of dollars to a sympathetic victim, consumers ultimately pay the
must head-off another medical malpractice crisis by re-affirming
the limitations which allow injured patients to be compensated but
limit runaway verdicts.
Mark Hillman (R-Burlington) represents 12 counties on the Eastern
Plains and served on the Health Care Systems Interim Committee.
Please see also: http://www.markhillman.com.