Our View - Sunday

Single-payer insanity

Using chemotherapy to treat the common cold

We’ll have time in the months ahead to more carefully dissect the options and recommendations put forward by the Blue Ribbon Commission for Health Care Reform, in response to the fact that many Coloradans lack health care coverage. But our initial response to one of the proposals, with a price tag of $26.6 billion a year, is that somebody hasn’t been taking their meds.

Give these people something to clear their heads, stat! Give it to them whether or not they have health insurance!

And get this. Proponents of this single-payer plan, which would be funded with a new payroll tax, along with higher income, alcohol and tobacco taxes, say it will actually “save” us all $4 billion a year, based on the fact that Coloradans now pay an estimated $30 billion a year on medical care.

Sounds like a bargain. Where do we sign up?

That’s sarcasm, in case you didn’t catch it. The $26.6 billion guesstimate is $8 billion more than the entire state budget, just to put things in context. And like all such guesstimates, it’s likely to be laughably low when all is said and done.

The relevant number isn’t the $30 billion Coloradans spend annually on health care. What matters, for the purpose of this debate, is how much is spent on caring for the indigent, and how much more the taxpayers and the insured spend to cover them. But proponents of a government-centered solution seek to fuzz distinctions by using irrelevant comparisons — and by treating the “uninsured” (whose numbers keep growing, every time we read a news story on the subject) in monolithic terms, in order to generate a sense of crisis.

We’ll reserve judgements on the other proposals until we’ve studied them further. But the single-payer solution amounts to using a howitzer to kill a hummingbird, since just 9 percent of Coloradans are chronically or temporarily uninsured. Another 8 percent counted among the uninsured are 1) illegal immigrants (who qualify for Medicaid in emergencies): 2) individuals who could get coverage through their employers, but don’t; 3) people who are eligible for Medicaid but aren’t enrolled; 4) people who can probably afford insurance but don’t have it.

Once we begin to look at the uninsured more closely, not only does the sense of “crisis” evaporate but one can see that a series of narrowly targeted responses is what’s needed, not a massive overhaul of the system.

At least one commission member also is shaking her head at the notion that we can “save” money with a single-payer system. “They just said we could save money if we go to a singlepayer plan that has a bigger plan of benefits than anything that exists?” asks Linda Gorman, the health care policy analyst at the Independence Institute. “Does that make sense to anybody?”

It apparently makes sense to somebody, or it wouldn’t have made the list of options. But this proposal won’t be acceptable to most Coloradans. We suspect it was placed on the list as a ploy — in order to make the other options appear reasonable.

Yes, this plan covers “everyone.” But not everyone needs coverage. A minority of Coloradans are contributing to the problem; asking the majority to embrace a socialized health care system in response isn’t just unreasonable, it’s insane.

If you have a common cold, do you treat it with chemotherapy? Of course not. And if a physician ordered such a treatment, you’d walk out of his office and report him to a medical licensing board. Colorado’s uninsured situation is more analogous to a case of sniffles than to terminal cancer, so any treatment we apply should be calibrated accordingly. This proposal constitutes a case of overkill, to say the least.

Up PERA-scope

Is it? Or isn’t it? A report in Tuesday’s Gazette about the financial footing of the state’s public employee pension fund began on a hopeful note, indicating that “the unfunded liability in Colorado’s Public Employees’ Retirement Association that drove legislators into near panic last year is slowly disappearing, and the system does not seem to need more help, members of the Legislative Audit Committee said Monday.”

And, indeed, the fund’s fiscal fortunes do seem to be looking up, thanks in part to a rules change that boosted contributions from members and placed a cap on cost of living increases for new participants. PERA increased its net assets by $4.1 billion in 2006, The Gazette reported.

What a relief, we thought — that’s one less pension liability time bomb ticking away. But the long-term prospects for PERA are far from rosy, as we learned a few paragraphs later.

“Still, the audit noted that the roughly $40.5 billion in investments remain about $10 billion short of being able to cover the retirements and benefits of all of PERA’s members 30 years out,” The Gazette reported. “Under expected conditions, the local government section of the investments could be fully funded in as soon 17 years, while the state government section is unlikely to reach that within the next 50 to 60 years, according to an actuarial study.”

A $10 billion shortfall is something to be concerned about, even if the day of reckoning is 30 years away — unless we’re going to succumb to the Social Security Syndrome and decide to just not worry about calamities that seem so far off in the future. A number of factors — including a downturn in financial markets, or a talked-about divestment of PERA funds from Sudan, Iran and other unsavory regimes — could easily turn this sunny prognosis cloudy again.

PERA is far from out of the dark financially. Taxpayers need to continually monitor the situation, and to demand that continued adjustments be made to ensure it’s responsibly managed, unless they want to be burdened with a future bailout.