Many Coloradans struggle getting and affording the health care we all need. About 350,000 of us are uninsured, and at least 600,000 are underinsured. Even those with coverage are unsure how they will get the care they need or be able to afford it.

Despite the U.S. having some of the best health care providers, our overall health in the U.S. is not so good. We can see this in our lowered life expectancy, infant and maternal mortality rates, and in racial disparities in health outcomes. We need to do better.

The Health Care Cost Savings Act report, released in September 2021, showed that, compared to how we pay for our health care now and compared to a multi-payer universal system, a single, publicly funded, privately-delivered way to pay for our health care could cover everyone with better care and cost billions less.

House Bill 23-1209, the Analyze Statewide Publicly Financed Health Care Act, just introduced in our General Assembly, will look to answer the questions raised by the report. It would, if passed, charge the Colorado School of Public Health to do a holistic analysis into how publicly funded health care for all Coloradans might look and how it would impact individual and community health. The study will also investigate the potential impact this system could have on health care industries and workforce

Currently, competition among health insurance companies to pay for the health care we need  is a market failure. The incentives for insurance will always be to collect premiums and pay for as little heath care as possible. Insurance companies have learned how to do this well through high deductibles, prior authorizations, claims denials, and narrow provider networks. And, insurance companies are incentivized to collude with exorbitant drug and hospital charges, functioning together as a legal, price-fixing cartel.

Profit-driven private equity groups have been rushing in to take over many aspects of our health care. Our hard-to-deny need for good health care leaves us open to spending whatever it takes when the news is bad. This makes health care lucrative. 

Fortunately, we haven’t let the forces of privatization take over our fire departments – they’re clearly a public good. Even those who send their kids to private schools, or those with no kids at all, still pay for our public schools because they’re a public good. 

The way we pay for health care now successfully drives profits to concentrate wealth and power in the hands of the shareholders of insurance, drug, and large hospital corporations and their executives. It provides overall poor care and impoverishes many. Courageously shifting to paying for health care as a public good would work much better.

The experience of Americans today is too often that the system is rigged for the wealthy and powerful at the expense of the rest of us. Pre-COVID statistics showed 8 million to 11 million Americans being driven into poverty each year because of health care costs, while insurance, drug, and big hospital corporations have seen record profits.

So, that’s what’s not working. How can we spend less money and end up with a system that makes us healthier? Is this just too good to be true?

HB 23-1209 can give answers to questions that are important to us all–Republicans, Democrats and Independents. The Health Care Cost Savings Act Task Force report showed that seeing health care as a public good can give us the trust that when we need care, it will be there without driving us into poverty

But, can Colorado families trust that with public funding, care will be there when needed? We need answers to the many questions this raises:


How would such a system be funded? Would we pay based on income, and how much? How would this relate to Medicaid, Medicare, and other current insurances? How would providers be paid well? Would all medically necessary care be covered or would it be bare bones? Would we be able to choose our own providers?

Would there be charges at the time of service or would it be prepaid? Would it ease the administrative and moral burdens of providers? Would the racial disparities in health care be addressed? Would rural hospitals be more financially resilient? Would it eliminate medically driven bankruptcies? Overall, how would it save money and still pay for better care for all?

Affordable, guaranteed health care certainly sounds good. Now we need our legislators to support the analyses that HB 23-1209 will give, so the people of Colorado can have the answers to these questions.

We need the evidence. 

Bill Semple, of Boulder, is chairman of the Colorado Foundation for Universal Health Care.

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Bill Semple, of Boulder, is chairman of the Colorado Foundation for Universal Health Care.