As you might have read in our activist diaries here at Daily Kos, single-payer has made it onto the ballot in Colorado. This will be the first ballot initiative to be voted on that would create a single-payer healthcare system in a state. Now that it's on the ballot, it's receiving some attention from the national traditional media, particularly political media, assessing how it will fare.
Supporters, who won approval this week for a 2016 ballot measure after securing nearly 110,000 signatures deemed valid, will sell the overhaul as an Obamacare replacement plan designed in Colorado, instead of in Washington.
"We're a purple state, and this is a purple plan," said T.R. Reid, a former Washington Post reporter who is working with ColoradoCareYES, the group that spearheaded the ballot initiative campaign. "There's broad appeal here."
Conservative opponents, though, are panning the model as an even bigger government intrusion into health care that would require unsustainable tax increases.
"People can say it's a repeal of Obamacare all they want, but it's not repealing Obamacare," said Jonathan Lockwood, executive director of the free market group Advancing Colorado. "It's giving a higher dosage of the same failed prescription that Coloradans have no interest in."
In addition to the presidential election, Democrat Michael Bennet is also seeking reelection to his Senate seat next year. Republicans are going to to try to tie him to this "radical" plan, and he has yet to take a position. The difficulty backers are going to face is clear: It's financed by a new payroll tax that is estimated to bring in $25 billion per year. Two-thirds of the tax would be paid by employers, the remaining third by workers. It would also use $11.6 billion in annual federal funding that currently goes to the state's Medicaid and Obamacare programs. (Maybe organizers should have figured out how to use some of the millions in tax revenues from pot sales.)
The program would provide health care to everyone but Medicare recipients, since it couldn't replace that federal program. That means it would also cover undocumented immigrants, which will probably be another angle of political attack. From a public health standpoint, that makes perfect sense—you get the maximum from public health dollars spent if you take care of the entire public. It would continue to allow private health insurance plans to compete with it, and would be be run by a board of trustees that would "govern operations, be responsible for setting provider reimbursement rates and could negotiate lower prices with pharmaceutical companies."
This plan is the probably the logical next step for healthcare reform. It's essentially what progressive activists were fighting for as the law was being written: A strong public option that would exist alongside private plans. But this would add the sweeteners of the state being able to set provider rates and negotiate drug prices. It's a solid, common-sense plan, that might just be the beginning of a national conversation about where to go from here in healthcare reform.