Colorado Voters Could Enact Nation's First Single-Payer Health Care System this November

Posted June 8, 2016

MP3 Interview with Irene Aguilar, Democratic Colorado state senator and practicing physician, conducted by Scott Harris


As the Democratic presidential primary campaign between former Secretary of State Hillary Clinton and Vermont Sen. Bernie Sanders concludes, one of the defining issues that separated the two candidates was Sanders and his supporters' advocacy for establishing a single-payer, universal health care system in the United States. While the proposal, sometimes referred to as "Medicare for All," was promoted by Sanders as necessary to provide health insurance to the estimated 32 million still not covered by the Affordable Care Act. Clinton opposed the idea as too expensive for taxpayers and not politically viable.

As proponents pledge to pursue their objective of instituting a federal U.S. single-payer health care plan, as exists in virtually every other industrialized nation in the world, a new battleground for the issue has opened up in the state of Colorado. This November, Colorado voters will be able to vote for or against Amendment 69, a measure that would establish a single-payer, universal health care system for all of the state’s residents.

Advocates of the measure, known as ColoradoCare, say the goal is to provide health care to all Colorado residents regardless of financial circumstance, by collecting a premium based on resident's income. with an annual budget totaling $25 billion. Between the Lines’ Scott Harris spoke with Colorado state Sen. Irene Aguilar, a Democrat representing Denver County and the only practicing physician in Colorado’s state legislature. Here, Dr. Aguilar talks about why she supports the health care ballot measure and the health industry opponents that are campaigning to defeat Amendment 69 this fall. (Rush transcript)

DR. IRENE AGUILAR: Under the Affordable Care Act, there's a provision that allows states to get a waiver for innovations starting in 2017. And the state needs to show that their idea for a waiver would cover at least as many people with at least the same level of benefit and not cost people anything more than (what) an actuary would find to increase the deficit more than what would happen under the ACA over the next 10 years. So Amendment 69 would allow Colorado to create a universal health care system that meets those criteria.

BETWEEN THE LINES: What would single-payer cost if Colorado voters approve Amendment 69 this November?

DR. IRENE AGUILAR: Well, for each state it would be tied to what your state currently spends on health care. So we estimate that people, in the form of premiums and out-of-pocket cost spend about $30 billion a year, or will be spending about $30 billion a year in 2019 in Colorado for health care. And under Amendment 69, we could cut that amount to $25 billion by getting rid of the administrative overhead, simplifying billing and by also getting rid of the incentive to order more tests than are needed, and helping us do some negotiating for prices based on value of health care.

BETWEEN THE LINES: State Sen. Aguilar, there's a lot of discussion about the consequences of adopting a single-payer health care program as we debate it in this country, but also when it comes to other countries who have long had, in most other industrial nations of the world, of course, do have single-payer universal health care. But there's a discussion about rationing. It's a disjointed discussion, because when we have so many millions of people in this country without health insurance, we have a natural system of rationing. But there is a concern about many who have insurance now, through a private insurer, that somehow a single-payer system would invoke some kind of rationing that would be some kind of consequence for them and their families.

DR. IRENE AGUILAR: When this discussion comes up, I always remind people first, that unfortunately, we already have rationing in our country. If rationing became necessary, and I don't think it would, but if it did become necessary, we would have what I like to call rational rationing, where it was based on what kinds of evidence there was, a treatment was beneficial to people. But more important than that, most people who are working full-time are still pretty healthy and they're under the impression that they have great insurance. You meet very few people who've developed some kind of serious illness or complications who have that impression because you don't see what the faults are in our current system until you really need to depend on it.

BETWEEN THE LINES: Dr. Aguilar, as we close out here, tell our listeners a bit about the forces lining up for and against this referendum vote. And folks like the billionaire Koch brothers who will certainly be contributing to defeat single-payer health care in Colorado.

DR. IRENE AGUILAR: Yes, and their money will be hidden because they can give it in a different way, and they're working through Americans for Prosperity in our state. The other groups lining up of course, are the people who are making huge profits off our health care system and I call it the medical industrial complex. So, for example, Anthem Blue Cross Blue Shield has donated a million dollars to defeat our amendment. And what I remind people of is, that that's a million dollars of your premium dollars that they have that they're so concerned about losing access to the profits that their shareholders have they're willing to risk your premium dollar to try and defeat this.

And then, interestingly, a number of hospitals are contributing against this effort. Our only for-profit hospital system in our state is HealthONE, and they've been a large contributor. But even our faith-based hospitals that are supposed to be there to help guarantee access to health care are contributing money, Centura Health and SCL Health, which are owned by different nun groups. So it's really fascinating that the $3 trillion a year that the United States spends on health care that makes it really one of the most lucrative investment markets in our state, those folks are really being careful to try and protect their interests and their investments in the future.

For more information, visit Colorado Care website at; Physicians for A National Health Program at; Health care for all Colorado at; on Facebook at

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