In 2016, private health insurance coverage continued to be more prevalent than government coverage, at 67.5 percent and 37.3 percent, respectively. Of the subtypes of health insurance coverage, employer-based insurance covered 55.7 percent of the population for some or all of the calendar year, followed by Medicaid (19.4 percent), Medicare (16.7 percent), direct-purchase (16.2 percent), and military coverage (4.6 percent).
Here are some of the facts:
- As baby boomers turn 65, enrollment in Medicare will reach 64 million in 2020 and 80 million in 2030. With increasing longevity, in 2011, one in four people receiving Medicare benefits were 80 years old or older.
- Currently, 74 million people receive health coverage under Medicaid, a government program for low-income people, including adults with disabilities and children.
- Additionally, there are approximately 19.9million veterans, with 6.1 million receiving medical care in a VA facility in 2017.
The reality: Cost shifting is the culprit for privately insured since Medicare and Medicaid are reimbursing for services at a loss for providers, the way this is made up for is through charging more to the privately insured. As the numbers of people insured through government supported programs swell because of demographic and economic factors, this problem will continue to escalate.
The Salon: We hosted our first Salon at my home in June. These informal gatherings bring experts and constituents together to discuss issues of concern. Healthcare was the first topic. The group discussion focused a lot on insurance providers and the complexity of the “system”. Many wondered whether insurance companies should be non-profits or maybe B-corps. Other focus was on personal responsibility and rewards and consequences for our decisions that lead to health outcomes and the need for more education regarding how to be healthier. Innovation was another focus which of course is near and dear to my heart. There was praise for delivery models such as Appleton Clinics which provide a low cost flat monthly fee with enhanced services for education and disease management. This coupled with a safety net for major medical coverage was a desirable option. Other innovation in telemedicine, prescription cost, information and more were highlighted. Accessibility is also a critical issue, especially in rural areas. The availability of specialists is on the decline.
The Colorado Medical Society prioritizes maintaining liability caps and the reduction of administrative burdens as high priorities for controlling costs. The burden of the insurance complexities directly impacts providers offices and impede doctors from doing what they do best -- patient care.
What can the Colorado legislature do? Transparency of costs providing better customer choice has been brought forward and received positive results. But the choices are still too complex for most of us to navigate and maybe we are not being offered the best choices to begin with. Incentives and programs for healthy Coloradans seems to be a logical emphasis as well as new innovative and simpler choices for care. Utilizing our buying power as a state to bring costs down is also interesting while not sacrificing access and competition which helps to reduce costs.
I am interested in your ideas. Please don't hesitate to email me directly at email@example.com.