Colorado’s single-payer health insurance proposal; Amendment 69, is a deeply flawed initiative that can be easily fixed.
My view of 69 is a mixed one, I agree with the goal; single-payer healthcare, but disagree with the plans to achieve it. There are actually some dangerous ideas in 69 including a 10% state income tax and worse; an effort to create what amounts to a second state legislature that would be largely unaccountable to voters.
Fortunately these flaws; which I outlined earlier would be easy to fix. Here is how to achieve that goal:
- Scrap the whole concept of an elected board to administer the health system called Colorado Care. Instead make the Colorado State Legislature “the board” that administers Colorado Care. That would save money because no additional board with 21 highly-paid directors would be necessary. The legislature would also be more divers; more representative of the state’s population and more accountable to voters. Money would be saved by eliminating the expense of board elections, board salaries and operating the board.
- Replace the board with a corporate style power structure of a Chief Executive Officer, Chief Technology Officer, Chief Financial Officer, Chief Medical Officer, Chief Insurance Officer, Corporate Counsel and Chief Information Officer. That would create a streamlined administration that would be able to tap private industry for expertise.
- The executives would be nominated by the governor and confirmed by the state Senate.
- To finance the system implement a state value added tax (VAT) of 1% on all goods and services with no exceptions. That can be augmented by an additional 5% on alcohol, tobacco, marijuana, candy and soft drinks.
- Ask for a 5% income tax instead of 10%.
- Collect the tax on all personal income levels of over $25,000 a year.
- Eliminate the existing Colorado Income Tax of 4.63%. The state government can be financed by eliminating the holes in the state sales tax system, for example by taxing services, real estate and construction materials.
- Create a board of medical advisors to advise Colorado Care on Medical Issues. The board would be composed of doctors and professors from the University of Colorado Medical School.
- Create a board of business and technology advisors drawn from business to advise Colorado Care on business, insurance and technology matters.
These changes would not create a perfect system, but they would form the basis for a better system than the one in Amendment 69.