Criticizing a single-payer health plan being considered by Colorado's Blue Ribbon Commission for Healthcare Reform, a September 17 editorial in the Rocky Mountain News misleadingly listed some medical treatments as among those that would have to be “ration[ed]” under the plan, even though the proposal did not include such a list of proscribed services.

After citing specific passages and examples from the proposal, the News asserted, “The plan would not be sustainable,” because "[o]verall health costs are rising faster than the plan's budget could grow." The News further asserted that the plan's governing board would be forced to “ration services,” adding, “Some Coloradans would not receive costly remedies, such as chemotherapy, innovative drugs and organ transplants. And elective surgery for conditions that aren't life-threatening (think joint replacements) would be delayed or denied.”

The News in previous paragraphs had cited specific components of the plan, such as specifically covered medical treatments and costs of doctor's visits and prescriptions, which appear in the text of the proposal itself or in an evaluation of it by The Lewin Group, a consultant retained by the commission. But the editorial's claim immediately following those passages -- that the plan would require “ration[ing]” of services -- misleadingly presented as fact a hypothetical list of specific treatments that would be rationed. Furthermore, the News failed to mention that according to the proposal, the single-payer plan “must, by legislative mandate, operate within its budget,” and that in response to public demand for “more services,” the legislature could increase the plan's budget by increasing “contributions and taxes.”

The editorial characterized the single-payer plan proposed by the group Health Care for All Coloradans as “recklessly generous.”

From the editorial titled “A sick way to save: Only way single payer can contain costs is to deny services,” in the September 17 issue of the Rocky Mountain News:

Of the four original proposals submitted to the Colorado Blue Ribbon Commission for Health Care Reform, only one would reportedly cost less than the system we now have: the single-payer plan.

[...]

We've spelled out some of our objections to the single-payer plan in an earlier editorial, and we haven't changed our minds.

But let's assume that this system indeed guaranteed medical coverage for every resident. And that its 15-member governing board, which will have “constitutional powers to contain costs,” kept overall medical spending in check.

Such fiscal discipline would come with an unacceptable price: dramatic compromises in the breadth and quality of care. Say the plan initially reduced overall medical expenses by the 11 percent Lewin suggests, by wringing out administrative inefficiencies and purchasing prescription drugs in bulk.

[...]

Moreover, the benefits package envisioned by its sponsors, Health Care for All Coloradans, would be recklessly generous.

Consider this, from the group's presentation to the commission: “All residents [would be] eligible for the same comprehensive benefits package which includes access to all primary and preventive care, specialty care, surgical care, hospitalization, laboratory and X-ray services, emergency care, automobile and work-related injuries, prescription drugs, durable medical equipment, pathology and autopsies, mental health services, substance abuse treatment, patient education, chiropractic services, dental services, basic vision care, audiology services and treatment, medical transport, physical therapy and rehabilitation and home health and hospice care.”

And you could get all those treatments with a nominal $5 co-payment for office visits, $15 for prescriptions or trips to the emergency room.

The plan would not be sustainable. Overall health costs are rising faster than the plan's budget could grow (its increases are limited to growth in state GDP). So the board would have to ration services. Some Coloradans would not receive costly remedies, such as chemotherapy, innovative drugs and organ transplants. And elective surgery for conditions that aren't life-threatening (think joint replacements) would be delayed or denied.

While the News speculated about the sustainability and outcomes of the single-payer proposal, the editorial did not cite the text of Health Care for All Coloradans' proposal, which acknowledges in a passage regarding "[s]ustainability" that health care spending at the state and local levels would eventually either have to be “reduced” or the program would have to secure more funding, depending on public demand:

In addition to numerous cost-saving and oversight mechanisms, what makes this program sustainable is that it must, by legislative mandate, operate within its budget. The CHS [Colorado Health Services program] needs to have the flexibility to grow with normal inflation, but if the public wishes to reduce the budget by reducing health care contributions and taxes, then they also must be involved in deciding what services are reduced or eliminated. If the public demands more services, then they must be willing to increase their health care contributions and taxes to do so. This program literally forces society to decide what it wants and needs, and what it can and cannot afford! In a sense, this is truly consumer-directed health care.

We assume that the amounts of state and county funding will be indexed by the allowable rate of growth in spending, i.e., GDP growth. Because health spending has grown considerably faster than rate of growth in state GDP, this will result in lower levels of health spending for state and county governments in future years. However, we assume that the amount of federal funding provided to the state in future years will be indexed to the average rate of growth in costs in these programs nationally -- designed to assure that federal funding for the state is not reduced over time (thus, the program is budget neutral from the federal perspective.

We assume that the program is required to constrain the rate of growth in health spending so it does not exceed the long-term rate of growth in GDP for Colorado. [emphases added]