HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Friday, January 21, 2005

More on Single-Payer Health Insurance

When the topic is national, universal health care coverage, the go-to people and groups are the usual blue-state suspects: Physicians for a National Health Program, NOW, National Health Care for the Homeless Council, the Massachusetts Nurses Association, American Medical Students Association, Congress of California Seniors, and Sydney Wolfe of Public Citizen's Health Research Group, to name only a few.  But you have to figure the idea is starting to get some traction when it attracts the attention and support of an overflow crowd of rural docs in Colorado.  You can read about it in a recent article in The Denver Post.  Here's how it starts:

Rocky White is an unlikely radical.

A Nebraska-bred country boy, a Republican- voting, ranch-owning, small-town doctor, he hardly fits the profile of a wild-eyed revolutionary.

But White and a handful of cohorts are, in fact, trying to foment upheaval.

The revolution they are proposing: a national health-insurance program.

Nothing short of that will fix what White calls "our god-awful broken system."

White says he didn't jump to this conclusion.

He was pushed.

Pushed by the same forces that plague health care across the country: steep insurance premiums; soaring prescription-drug costs; 45 million Americans without health insurance; bureaucracy; and Medicare and Medicaid reimbursements that don't cover costs.

If anything, these problems are accentuated in rural, and overwhelmingly poor, parts of the country like the San Luis Valley in Colorado:

That is what drove White to join forces with Dr. Gladys Richardson, an unabashed liberal, a woman who could hardly be more different from White.

In August, they invited virtually every health care provider in the five-county valley to hear their pitch for national health insurance.

The response was so huge they had to move the evening meeting from White's office to the largest conference room in the largest hotel in Alamosa.

Dr. White does a nice, succinct job of describing the "health-care death spiral":

As White sees it, the spiral goes something like this: Health care costs go up; fewer people can afford insurance. More people without insurance "creates more people that have to be seen in hospitals and emergency rooms, and who are unable to afford their bills."

So hospitals charge more to insured patients. Then, insurance companies pass those increased costs on in the form of higher insurance rates. "And then ... more people are off the insurance rolls."

Draw a straight line from East L.A. to Boston, and it runs right through the San Luis Valley in Colorado.  It turns out patients, doctors, and hospitals in those places all may have more in common than they'd have ever guessed.  [tm]

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