Health Team

Colorado Editorial Roundup

Posted October 12

The Durango Herald, Oct. 11, on reinstating a presidential primary in Colorado:

Propositions 107 and 108 would recreate a presidential primary in Colorado and open all primaries to unaffiliated voters. Both should be approved.

Both measures would change state law. Both were initiated by proponents who gathered the required number of signatures.

Proposition 107 was prompted in part by the messy way this year's caucuses worked out. Democrats turned out in such numbers that many events were overwhelmed, while Republican officials chose not to have official preference polls. Too many people felt excluded. A homey relic of another era, caucuses favor party activists and are difficult for working men and women to attend. They are also time-consuming and lack the anonymity of a secret ballot.

Colorado had presidential primaries in 1992, 1996 and 2000 but quit to save money. It has a primary, for other offices but that is held later - this year, June 28 - so as not to conflict with the legislative session.

But by then presidential nominees are usually fixed. Proposition 107 sets the presidential primary in March, when contested races are usually still undecided. It would also allow unaffiliated voters to participate.

Proposition 108 would let unaffiliated voters vote in other primary races, which would still be held later in the year. It respects the parties' freedom of association by allowing them to opt out and hold caucuses instead. But it also respects the taxpayers by insisting they all be allowed to participate if they are paying for an election.

Given that more than a third of Colorado's registered voters are unaffiliated, the current system effectively disenfranchises too many people. The hope behind 107 and 108 is that opening primaries to unaffiliated voters could increase voter participation - and perhaps lessen the influence of the parties' more extreme elements.

Those goals are worth the effort. Vote 'Yes' on Propositions 107 and 108.



The Aurora Sentinel, Oct. 11, on the cost of health care:

If you're looking for a perfect solution to Colorado's health care quagmire, it doesn't exist. But there is a logical, affordable way out of the state's dire health insurance dilemma, and it starts by voting "yes" on Amendment 69.

Few things have been studied as intensely as America's health care industry. And yet few things remain as obscure and convoluted as to why the United States pays vastly more for health care than any other modern nation in the world. Make no mistake, we do.

The search for answers isn't academic. The personal, business and governmental cost of health care threatens the U.S. and Colorado economies like nothing else. The cost of health care especially threatens the middle class in Colorado and across the country more than any other economic woe. While wealthier Americans are luckily immune to the most serious effects of overpriced health care, and expanded national programs have created a huge relief to the country's poorer citizens, the middle class suffers immensely. And it's going to get much worse if something doesn't change now.

Not only have prices for health care continued to skyrocket, anyone who's been to a provider recently knows that appointments are harder to get, made further out, and the bureaucracy to get to a provider can be overwhelming.

If you live in rural Colorado, health care can practically be nonexistent.

The reasons why American health care costs continue to spiral out of the reach of middle-class Americans are as plentiful as the players involved. Here is the underlying problem: Not only are almost all providers of health care, health insurance and drugs for-profit entities, they're often massive, high-yield corporations whose priority is their bottom line — not your well-being.

Not only is health care in countries like Japan, Norway, Germany and others vastly more affordable, it is often rated superior to our own. Believing otherwise is part of the problem. Denial doesn't make health care any better or cheaper.

We can't have what they've got because the groups that make the most off of illness and disease also have the most clout in Congress and the Colorado Legislature.

So Amendment 69 comes to you as a citizen-initiative because special-interest insurance, drug companies, many hospitals and providers fear a loss of profits in a single-payer system that saves residents, businesses and taxpayers billions of dollars.

It only makes sense. If Amendment 69 reduces net spending on health care in Colorado, somebody's going to be making less money, and they're going to fight to prevent it.

These are health care businesses that have become nearly predatory in the United States and Colorado. Unregulated providers, pharmaceutical companies, hospitals and others have been free to gouge Americans because Congress was unable to enact critical controls when it created the Affordable Care Act in 2010. Because there was no "public option" and no way to stop or even slow the spiraling health care costs that led to the need of the Obamacare, costs have continued to mushroom.

Colorado Care picks up where Obamacare left off. This common-sense program is a taxpayer-owned and -operated health insurance plan that covers everyone who lives here. If approved, all Colorado residents would be able to enjoy pretty much the same benefits that Medicare and Medicaid recipients are allowed.

This isn't government insurance, however, in that the government collects taxes for the program, but then turns the money over to a large board of specially elected representatives that guide the program, essentially free of state and federal government — and lobbyist — intervention. Representatives will act only on your behalf, and not that of industry profits and turf wars.

The plan means you and your employer no longer have to pay exorbitant insurance premiums, co-pays or deductibles. And for most Colorado residents, the difference between new taxes for the program and what you pay now for health care in insurance premiums and uncovered costs will mean serious net savings.

It means better health care and more health care choices for everyone and more money for you at the end of the month and the end of the year.

It's not magic, nor is it a myth, it's just a system that works all over the world because the priority is access to quality and controlling costs — it's the opposite of a system dictated by corporate profits and market control.

Under Amendment 69, you keep and choose your doctor and hospitals. You don't make co-payments or have deductibles for primary and specialized care. You can still have outside insurance if you don't want Colorado Care, or you can buy insurance to supplement it, even though it appears unnecessary. If you qualify for and have Medicaid and Medicare, you keep it. If Obamacare changes, Colorado Care changes right along with it.

The plan not only saves most Colorado residents money, it save hundreds of millions of taxpayer dollars in government-provided health insurance for teachers, firefighters, police officers, engineers and myriad government jobs and workers.

The money to run the program comes from a new income tax: 3.3 percent for you, and 6.6 percent for each employee, paid by your employer. Not only does the new tax create a net saving immediately, the savings grow because the cost of private health insurance in Colorado and across the country is expected to continue to spiral out of control.

Lawmakers in Washington and the Colorado Capitol have signaled they have no plan for controlling costs that will make it the desk of the next president nor the governor, and residents here can no longer afford government's failure to act. The cost of their inaction is destroying the financial health of the middle class and the state itself.

In a better world, we would create a very different type of system to fund health care. But in the real world, the system we had before Obamacare, and the system we have now will collapse.

Universal health care is as inevitable as was legalized marijuana, where Colorado also was courageous and wise enough to lead the way. What will cement Colorado Care's success is when other states follow, creating a solid system that serves patients and not just profits. They will follow.

Despite the fear-mongering scare tactics of Colorado Care critics and those who simply parrot them, the plan has safeguards installed that call for a comprehensive and workable system before it even rolls out. If the system can't work or isn't tenable, it has to end, and we bring back the high-profit insurance industry. The real risk isn't so much that there are unanswered questions about the plan, but that it's impossible to know the full effect until it begins working.

What we do know, is that plans like this work all over the world, and the only reason why they don't work here is because industry lobbyists won't let state and federal lawmakers make it happen.

Vote "yes" on Amendment 69, and create a Colorado that's healthier for people, the economy and our personal finances.



The Daily Camera, Oct. 8, on amending the state constitution:

Of all the questionable claims made during this year's election campaign — admittedly, it's hard to keep track — few surprised us more than former Boulder Congressman David Skaggs' contention that the ballot initiative process is more susceptible to control by special interests than established political institutions.

If that were true, the oil and gas industry would no doubt oppose Amendment 71, the attempt to render it virtually impossible to amend the state constitution by petition. In fact, it is an ardent supporter. "Raise the bar," the campaign to enhance the power of entrenched political and business interests by making citizen initiatives more difficult, just picked up a $1 million contribution from the oil and gas front established to fight citizen initiatives to regulate fracking.

Adoption of Amendment 71 would allow the oil and gas industry to checkmate Colorado environmental interests. It already controls the executive, legislative and judicial branches of state government, the latter through the other two. As a result, it has won the right to override traditional land-use prerogatives of local communities and install fracking operations anywhere its friendly state regulators approve, including near residential subdivisions and schools, where heavy industry would normally be prohibited.

Aside from civil disobedience, the only remaining alternative for community and environmental groups is pursuing the initiative process to win back local control over land-use decisions.

It might seem contradictory that oil and gas interests would argue it is too easy to amend the state constitution after they prevented measures to regulate fracking from reaching the ballot for the second consecutive election cycle. Ask environmental organizations in Colorado how easy it is to overcome a campaign by well-heeled special interests to keep a proposed constitutional amendment from even making it to the voters. The best explanation for the oil and gas industry's interest here is that it doesn't want to have to spend so much to beat the fracking activists next time.

The argument that policies about fracking and most other subjects don't belong in the constitution is appealing but ignores a rather salient fact: That horse left the barn 106 years ago, when the initiative process was implemented. Many policy decisions are already there. For that reason, comparing the Colorado Constitution to the pristine U.S. Constitution is pure sophistry. The TABOR amendment, for example, was added to the Colorado Constitution by ballot initiative. The minimum wage is in there. Medical marijuana and recreational marijuana are in there.

Why? Well, at least in part because an initiated statute takes just as much work and can be changed immediately by the Legislature if the political powers that be don't like it. A better way to protect the constitution from the invasion of legislation would be to strengthen citizen-initiated statutes by requiring a super-majority of the Legislature to change them. That might make the initiated-statute route more attractive.

Unlikely bedfellows have united to oppose 71. On the left: Common Cause, Greenpeace and NARAL. On the right: the Independence Institute, Colorado Shooting Association and Colorado Right-to-Life. What these groups have in common is fear of government trampling the rights of the people.

A corrupt campaign finance system has rendered many politicians dependent on the contributions of special interests. If those interests manage to block the citizen initiative process as well, they will have consolidated control of Colorado's future.

Amendment 71 wouldn't just make it harder to amend the constitution. It would make it prohibitively expensive. The requirement to gather the signatures of at least 2 percent of registered voters — not active voters, the current standard — in 35 different state senate districts effectively gives any single state senate district veto power over a ballot issue. "Raise the bar" did not meet its own standard to reach the ballot.

Defending legal challenges from well-financed opponents to all 35 sets of signatures would rule out most public interest campaigns. Jon Caldara of the Independence Institute estimates the cost of getting an amendment on the ballot would rise at least 10-fold, from roughly half a million dollars, depending on the issue, to maybe $5 million.

If the backers of 71 had wanted to make it more difficult but not impossible to petition a constitutional amendment onto the ballot, they could have required signatures from each of Colorado's seven congressional districts, which is how U.S. Senate candidates petition their way onto a primary ballot. Instead, they chose a proposal that puts a constitutional amendment out of the reach of citizen groups.

Even if a citizen initiative did somehow survive the signature requirements in 35 districts and the legal challenges that followed, it would need 55 percent of the popular vote, not 50 percent plus one. The effect would be to lock into the constitution eternally a number of the things people complain shouldn't be in there now — from the minimum wage to TABOR. The only way to alter such provisions now is to propose new constitutional amendments, as the group seeking a minimum wage increase is doing this year.

This is how we have addressed our state constitution for a century — allowing the people to change it by initiative, and to change it again later, if they choose. It is an imperfect system, but it's better than handing over control of the constitution to the same interests that give government its marching orders now. We urge a "No" vote on Amendment 71.



The Denver Post, Oct. 11, on assisted suicide:

After a lot of soul-searching, we are asking voters to reject Proposition 106, a measure that would give patients the legal right to end their life, because we fear the cultural, legal and medical shift that it would create in Colorado.

Those facing their final months are in a vulnerable place, a time when an individual is susceptible to pressures both subtle and overt, susceptible to self-imposed guilt over burdening family and worries about spending hard-earned savings on care. Such patients also are susceptible to depression and its dark influences on decision-making.

The Denver Post editorial board has in the past supported proposed legislation that would have allowed doctors to prescribe life-ending drugs to patients with six months or less to live. We came down on the side of personal liberty before the bill failed in 2015.

But we worry the present measure fails to include reporting requirements in place in an Oregon law that Colorado's initiative draws from, and that Proposition 106 would entice insurers to drop expensive treatments for terminal patients even when medical advances might add months or years more to a life that a patient may wish to take.

Already doctors struggle to discuss end-of-life options like quitting treatment and going into hospice, or programs designed to control pain and suffering instead of trying to cure underlying illnesses. Under Proposition 106, the burden of counseling patients about suicide rests on the shoulders of the doctor who would be prescribing the fatal drug.

We don't have unfettered faith in all doctors' ability to handle that responsibility.

There are safeguards in place to guard against overt pressures. Two doctors must confirm the terminal diagnosis, attest to the patient's soundness of mind and hear two verbal requests and witness one written request for the fatal drugs.

In Oregon, where an aid-in-dying law has been legal for 19 years, 1,545 people have been prescribed the drugs and 991 patients have died from ingesting them. The Oregon Health Authority is required to track basic statistics about those who die, but the agency also surveys physicians who prescribed life-ending drugs about the patients after they have ingested the drug.

The Oregon studies show that historically only 22.6 percent of those who took their own lives listed "inadequate pain control or concern about it" as a primary end-of-life concern. But almost 91 percent said losing autonomy was a concern; 88 percent said being less able to engage in activities making life enjoyable; and 83 percent said a loss of dignity. Doctors were able to select multiple end-of-life concerns per patient.

We worry that the top reasons given for patients ending their lives are easily influenced by those around them and by the care they receive in their final days.

Also concerning is that there is no requirement in the proposition to report or track Colorado's program like there is in Oregon. So what little we do know about the experience in Oregon would not be known in Colorado.

In the end, despite our desire to support an individual's right to make this decision, we cannot support a law that would so easily open an irreversible door.



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