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Hot Issues in Health Care 2014: Day Two

Highlights and Takeaways from Day Two of the 2014 Hot Issues in Health Care conference in Colorado Springs:

A Day Two highlight, and maybe even a 2014 highlight, was the rare opportunity to hear from three past governors – Richard Lamm (1975 to 1987), Bill Owens (1999 to 2007) and Bill Ritter (2007 to 2011) – on health care policy.

The panel, moderated by Chris Wiant, president and chief executive officer of the Caring for Colorado Foundation, ranged across many aspects of policy and politics. While the three former governors agreed on many things – more than might be anticipated – there were differing opinions as well.

Wiant asked them whether it is good news or bad news that one of five Coloradans is now covered by Medicaid, and that when you add in other public insurance programs the percentage rises.

“It can’t escape anyone in this room how balkanized the insurance system is, between the state, the feds, military and the veterans administration,” said Governor Lamm. “It’s good news that we’re getting additional people covered, but I don’t think our model is anything to brag about. And it’s wrong that we have an incredibly inefficient health care system.”

Lamm said his fundamental belief is that health care systems should cover all citizens of Colorado. It is a moral imperative that health care is a “thing you don’t want to leave your neighbor without,” he said.

Governor Ritter talked about the “false choice” between offering or not offering health insurance coverage to more people.

 “The tension here is really between coverage and cost containment,” he said, adding that he had hoped there would be more provisions related to containing the cost of health care in the Affordable Care Act.

“The fact of the matter is that we have a way to control costs in health care, and we shouldn’t choose between coverage and costs,” he said. “That’s a false choice. We need to be courageous enough to take on the people within the system that would resist cost containment.”

He said the market is distorted, with way too many places to hide costs and the wrong kinds of competition because of the complexity and lack of transparency.

Governor Owens added that he doesn’t think there needs to be a distinction between covering everybody and affording it. Rather, there should be better managed care for everybody and a targeted approach to government-subsidized health insurance for those who most need it, he said.

The panel ended with a standing ovation for these three men who, together, led Colorado for nearly a quarter century.

The day began with opening remarks from Colorado Health Institute President Michele Lueck titled “Colorado in Context.” One of her key themes was the complexity of health care policy and the need to think about health policy work within a framework that recognizes the need to increase agreement about the need for a policy and the certainty about how it can best be accomplished.

Keynote speaker Susan Urahn, executive vice president of The Pew Charitable Trusts and an expert on financing state government, provided much food for thought.

States are positioned to do the most innovative policy work surrounding health care, she said. “And Colorado is really at the forefront of doing a lot of interesting things that the nation is going to learn from.”

She pointed to three broad areas that will significantly impact health policy in the coming years: the aging of the Baby Boomers, the unsustainable level of spending on health care, and the challenge to maintaining quality while expanding access to care.

Hot Issues Sightings:

Two health policy leaders starting brand new jobs: Gretchen Hammer, Colorado’s new Medicaid Director in the Colorado Department of Health Care Policy and Financing, formerly Executive Director of the Colorado Coalition for the Medically Underserved; and Katherine Blair Mulready, the new Vice President for Legislative Policy and Chief Strategy Officer at the Colorado Hospital Association, formerly health policy adviser to Governor John Hickenlooper.

CHI board members Ruth Benton, Dr. Bruce Cooper, Dr. Art Davidson, Linda Reiner, Leo Tokar and Chris Woolsey.

Best Quote of the Conference:

Sen. Ellen Roberts turning to Rep. Jonathan Singer, as they served on a Legislator Panel moderated by CHI’s Joe Hanel: “I didn’t know you were funny.”