The American health care system stands at a dangerous crossroad – one that millions can feel in their wallets, health and daily lives. Insurance premiums have soared far faster than wages and inflation, leaving families squeezed and scrambling just to keep up.
A state single-payer system would replace today’s maze of insurance plans, networks and middlemen with one public, nonprofit payer that negotiates fair rates, pays providers directly and guarantees care as a right, not a gamble. It would do exactly what our fragmented, profit-driven system cannot: pay once, cover everyone and control prices.
Single-payer systems in other countries work because they have the power to set prices for services and procedures. This cuts out much of the waste driving U.S. health care inflation. A state single public-payer would be large enough to negotiate fair prices for hospital care, drugs and procedures, while slashing administrative overhead.
Taiwan’s single-payer program, modeled in part on Medicare, covers virtually everyone with comprehensive benefits while spending about a third of what the U.S. spends as a share of its economy.
For Coloradans, a single-payer system would mean insurance premiums, copays and deductibles would be replaced by income-based contributions, with everyone in one risk pool. A unified system could redirect the billions now wasted on billing, marketing, profits and claim denials into primary care, mental health, rural access and long-term care. Instead of families going into debt to pay for basic care, the system would be structured to prevent medical debt in the first place.
Colorado has already taken a crucial first step toward evaluating the feasibility of a single-payer system. Recently passed by the state Legislature, SB25-045 directs the Colorado School of Public Health to conduct a detailed analysis of a universal, single-payer, nonprofit, publicly financed payment system for our state. In this proposed system, health care would continue to be provided by privately owned practices and hospital systems. The school must use Colorado-specific data to examine benefits, costs, financing options, legal feasibility, provider payments and how such a system would interact with Medicare, Medicaid, employer coverage and long-term care.
If the study shows that a single-payer system is feasible, it will give lawmakers, communities and future ballot measures solid evidence to work with. It will show whether a Colorado single-payer plan could cover everyone, keep rural care stable, and save money compared to what we spend now. It will also answer basic questions in plain terms: How much would it cost? Who would pay what? How would hospitals, clinics and rural providers be supported? What would it mean for employers and workers? How would the new system be implemented?
By law, the CSPH can only launch this analysis if it secures enough gifts, grants and donations to cover the $405,000 study cost for the base study and an additional $345,000 for the study to include detailed analysis of a single-payer system for long-term care. So far, $653,000 has been raised and there are pledges for even more.
A state single-payer system may not solve every problem bearing down on patients these days, but it will save lives and keep many families out of bankruptcy because of medical debt. If Colorado is ever going to trade today’s high-cost chaos for a simpler, fairer, state single-payer system, this study is the bridge.
If you are interested in helping support the CSPH study, please make a tax-deductible gift through the CU Foundation by Jan. 31 at https://bit.ly/4qIf5pF. Your donation will be earmarked directly for this study. Donating to the CSPH’s analysis is not just supporting research – it’s helping build the road map to a health system that finally puts patients first.
Jan Phillips is a longtime Durango resident with a background in health education and is actively advocating for health care reform. Reach her at janp@sofcorp.com.
