StopColoradoCare Presentation For Distribution

Amendment 69 A Terrible Idea
StopColoradoCare.com
Prepared by Richard D. Turnquist
toadvancefreedom.com
richard@toadvancefreedom.com
Copyright (c) Richard D. Turnquist 2016 All
Rights Reserved
Introduction
This presentation is about a ballot initiative

titled Amendment 69, which would add an
Article XXX to the Colorado Constitution
entitled Colorado Care
It will give you an overview of what
Amendment 69 is and what it will do. Then it
will present the arguments put forward by the
proponents and highlight their weaknesses
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What is Amendment 69?
Its a constitutional amendment. (Read Section 1

Paragraph 2)
If passed, it would be implemented in 2 phases:
Within 60 days of becoming effective, an interim 15

member board is to be appointed by the Senate
President and minority leader, the House speaker and
minority leader and the governor.
This transitional phase would last for up to three
years, during which the Interim Board would be
required to schedule an election for a permanent
board, which would consist of 21 members
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Once the elected board is in place, Colorado Care is up and

running
Nature of Interim and Elected Boards
ColoradoCare divides Colorado into 7 districts, each having

the same approximate number of residents
Any board member can be removed for cause by a
majority of other board members
Supposed to be non-partisan
Elected board members are not subject to recall elections
Vacancies are filled by appointing a new trustee from the
district
Term limited to 8 years
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Board Powers (described in Section 5, page 5)
Promulgate bylaws, procedures, rules and policies

Hire an executive team (high salaries see health coop CEO)
Establish central purchasing authority
Provide funds to create new bureaucracy for
Ombudsman Offices for beneficiaries and providers
Establish and fund an office for fraud prevention
ESTABLISH PROCEDURES FOR ENSURING FINANCIAL
SUSTAINABILITY BY ADJUSTING PAYMENTS AND
BENEFITS
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Board Powers (described in Section 5, page 5)

Allows ColoradoCare to maintain a central
database of medical records
Administer all state funds for health care services
Establish an appeals procedure
Authorize reasonable compensation and
expense reimbursements for themselves
Others including audits, budgets and recordkeeping and transparency
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Thoughts on the Board
Instead of market pricing mechanisms, all decisions regarding

healthcare services and providers will be made by this Board
The Board is not accountable to anyone not the governor, not the
General Assembly, or anyone else
Dissenting voices will be purged and only conformist thinking will be
allowed. This board will be highly political, and members will vote in
the interest of staying on the board, not whats best for Coloradans
Not subject to recall means that once elected they are in for up to 8
years.
Elections every four years means that well be having campaigns to
pick our health care overlords
Four years is a long time, and they can do a lot of damage in that time.

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Funding How will ColoradoCare be funded?

There will be a transitional tax structure:
The Permanent tax structure:

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With non-payroll income, this represents a tax
increase of the Colorado income tax from 4.63%
to 14.63%, or a 216% tax increase.
During the transitional period, for payroll income,
it represents an increase from 4.63% to 4.93%, a
6% tax increase. After that it increases the tax
rate from 4.63% to 7.96%, a 72% tax increase
All forms of income are taxed except Alimony and
Unemployment Insurance (see the Income
Section of Form 1040).
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The Colorado Care Yes website says that there is

an exclusion of up to $33,000 (single) or $60,000
(joint) for non-payroll income, however, there is
no language in the Amendment itself that
supports this statement.
They try to make it seem as if the 10% isnt really
10%, but taxes are complex, and their
explanation doesnt hold water for filers who
dont itemize their taxes.
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Impact on businesses
All businesses will be paying a 0.6%/6.67% on
all payroll employees. This will satisfy their
obligation to pay health insurance for their
employees
May not impact large, multinational C-Corp
businesses and could even provide a savings if
they drop health insurance as a benefit
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Impact on businesses
However, small business owners (Schedule C
or C-EZ, partnerships, S corporations, etc.) will
be hit twice first with the payroll tax on
employees and then with their personal
taxable income to the tune of up to 50.9%
during the transitional period then 10%
thereafter
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Cannot opt out. ColoradoCare will be mandatory.

Regardless of what proponents say, it IS a state
agency and is to be funded through taxation,
which is levied with the implicit threat of force
It represents almost a 100% increase in the state
budget - $25 Billion against the upcoming fiscal
year budget of $27 Billion
Other estimates of the cost are up to $38 Billion.
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It would be nave to assume it will stay at $25

Billion. It will most likely increase every year.
When Medicare started in 1966 it cost $3
Billion.
House Ways and Means estimated it would
cost $12 billion in 1990, in reality it cost $107
Billion, a missed projection of almost 800%!
Medicares budget for 2015 was $526 Billion
(or $52.6 Billion for each state on average)
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Arguments For and Against
The proponents of A69 talk about a $4.5 billion

savings over current system
This $4.5 billion is a completely fabricated
number. First, it is based on PROJECTED costs
under our current system of $31.2 billion in 2019
three years from now! over ESTIMATED costs
of ColoradoCare of $26.7 billion.
Still expecting to pay out of pocket for dental and
some for medical. Proponents are saying these
would be free but the amendment language
does not support that assertion.
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Proponents say that savings would come from

the following:
Reducing administrative expenses by $6.2B
Paying less for durable equipment and
pharmaceuticals by using bulk purchasing
power
Unified billing system would save $0.6 billion

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Problems:
None of the numbers used by the proponents on

their website are linked to any reliable source, i.e.
they are IMAGINARY numbers
The cost of the CEO/CFO/CMO and the rest of the
bureaucracy this would create are not taken into
account could cost easily the same amount or
more. The 2016-2017 state budget includes
appropriation for Department of Health Care
Policy and Financing of $9.1 Billion
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Problems:
The idea of paying less for durable medical equipment

and pharmaceuticals using bulk purchasing power
means simply: They think they would be able to
negotiate the prices they want, regardless of provider
costs. If providers would lose money, the products or
services would become unavailable or scarce
meaning that rationing would come into play
There is no evidence that there is $600 million of
fraud involved in the system
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Benefits promised include no deductibles, no

co-pays and waived copayments if they would
cause financial hardship
They promise savings of $4.5 billion in 3 years
They project a surplus! of $1.5 billion to offset
future costs. If you believe this
Mythical gain of $1.1 billion from (undefined)
tax deductions
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Employers are promised reductions of costs

for providing employee health insurance of
$3.8 billion, including no more administrative
costs
Changes the market incentives for the
employer/employee relationship.
May not impact large employers, but could
have a significant impact on small businesses
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For Providers, Colorado Care promises
Providers would receive prompt, adequate

payment for every patient
The billing system would be simplified
ColoradoCare would be able to support practical
innovation, responsiveness to community needs,
and improved access for patients, especially in
rural areas
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Perhaps the most fanciful claims are:
By redirecting the mythical $4.5 billion in out-ofstate spending to in-state spending, Colorado
would see a net gain of 32,000 jobs in 2019.
This equates to 32,000 jobs paying $140,625 per
year.
The proponents give no sources or data to support
these numbers or to define what types of jobs
these would be.
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Im a big believer in evaluating proposed

legislation and ballot initiatives in light of the
Principles of Liberty, which are:
Individual Liberty
Personal Responsibility
Property Rights
Free Markets
Limited Government
State vs. Federal Balance of Power
Fiscal Responsibility
Equal Protection/Rule of Law

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Arguments For and Against (10

minutes)
Amendment 69 violates most of these principles.

It violates Individual Liberty by depriving
individuals of their property through increased
taxation and freedom of healthcare choices
It violates Personal Responsibility by eliminating
co-pays and deductibles, thereby removing selfgoverning mechanisms normally provided by
price and having to pay for a service
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It violates Property Rights through increased

taxation and prohibiting providers and
businesses from setting market prices for
goods and services
It violates Free Markets by its very nature
Amendment 69 represents a massive increase
in government, which violates the principle of
Limited Government
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It violates the principle of Fiscal Responsibility

because government cannot provide anything it has
not first taken from the people. Private markets are
subject to competitive pressures on price, services,
products, quality and profitability; the government is
not.
Ive heard it said that Obamacare was designed to fail
in order to make single payer healthcare more
politically acceptable. Colorado is the perfect petri dish
for this progressive goal and I believe ColoradoCare is a
test to see if it can be passed nationally.
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Failures and Problems of Single Payer

HealthCare in Other Places
In 2010 Vermont elected a governor who ran on a

single payer platform
VermontCare would have imposed an 11.5% tax on
payrolls instead of 6.67%
The individual income tax rate would have been up to
9.5% on top of the existing 8.95%
The architects promised cost savings of $0.9 to $1.4
billion by 2019, something the Governors fiscal staff
found not practical to achieve
In December 2014, Vermont Governor Peter Schumlin
(Democrat) pulled the plug on VermontCare.
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Canada and the UK both have single payer

healthcare
In Canadas healthcare system long wait times
for medically necessary treatment is the norm
on average four and a half months
In England the wait after General Practitioner
referral can be up to four months
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Theres never enough money!
The UKs National Health Service is projected to

face budget shortfalls of 30 Billion Pounds ($47
Billion) annually by 2020. The government
responds byrationing care!
The number of family practice doctors who appeal
to the NHS to STOP ACCEPTING new patients
doubled in 2013 and nearly 16,000 operations
were cancelled for non-medical reasons
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In the UK, as care becomes scarce, British

people take matters in their own hands by
paying out of pocket for treatment which
allows them to jump ahead on the waiting list.
This just means that the rich can still get
treatment while everyone else suffers, and
disproportionately hurts lower income
families.
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I could go on, butthese are the adverse

impacts of single payer healthcare, as
described by the Heritage Foundation:
Result in substantially lower payments to

physicians and other health care providers
compared to a multiple-payer system;
Reduce the quality of care by limiting the ability of
physicians to invest in advanced medical
equipment that takes advantage of new
technology;
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Limit access to care in the near term, as current

physicians retire earlier or otherwise leave the
profession
Limit access to care even more substantially in the
long term, as the prospect of lower lifetime
earnings reduces the incentive for talented people
to choose careers in health care; and
Reduce the rate of medical progress, because
fewer talented people receiving medical training
decreases the supply of talented medical
researchers
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Impacts in Colorado
All of the above; AND doctors will close their

practices and move out of state, reducing access
to care
Specialists and high-earning physicians will have
their earnings impaired, reducing incentives to
practice and impairing access to care
Healthcare providers will essentially become
employees of the state, which will impair their
earnings and drive out the best and brightest
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Impacts in Colorado
Once healthcare providers become employees of

the state, there will be a drive to unionize, and
then wed have another public-sector union that
would kill competition, merit based
compensation, demand lavish retirement
benefits, and
Be a huge new source of campaign contributions
for Democrats!
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Conclusion
A Terrible Idea as I researched and prepared

this presentation, it just became more and
more apparent what a horrible idea this
ColoradoCare is
NO Republicans that I am aware of support it
Prominent Democrats including former
Governor Bill Ritter and current Governor
John Hickenlooper oppose Colorado Care
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Conclusion
Many Democrats support it, including sitting

legislators (Aguilar, Nicholson, McCann,
among others)
According to Democratic representative Lois
Court in the Denver Post, Senator Aguilar has
asked sitting Democratic state legislators to
remain silent about Amendment 69.
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Conclusion
Other groups fighting Colorado Care:
Fight has been led for months by Jonathan

Lockwood and his group Advancing Colorado
Americans for Prosperity is working against it
Healthcare Options That Work
The Denver Metro Chamber of Commerce
A group of leaders calling themselves Coloradans
for Coloradans led by Bill Ritter and Republican
Treasurer Walker Stapleton are fighting it
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Conclusion
CALL TO ACTION
The key to defeating this is to raise awareness.
Talk to your neighbors, co-workers, church
friends, family members, doctors and others
Give money to the groups fighting this
Join AFP on a day of action to make calls and walk
neighborhoods
Get active on social media (Facebook and Twitter)
Write letters to the editor of various publications
Write posts for my site StopColoradoCare.com!
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Amendment 69 A Terrible Idea

This presentation is about a ballot initiative

What is Amendment 69?

Its a constitutional amendment. (Read Section 1

Within 60 days of becoming effective, an interim 15

What is Amendment 69?

Once the elected board is in place, Colorado Care is up and

Nature of Interim and Elected Boards

ColoradoCare divides Colorado into 7 districts, each having

What is Amendment 69?

Board Powers (described in Section 5, page 5)

Promulgate bylaws, procedures, rules and policies

What is Amendment 69?

Board Powers (described in Section 5, page 5)

What is Amendment 69?

Thoughts on the Board

Instead of market pricing mechanisms, all decisions regarding

Copyright (c) Richard D. Turnquist 2016 All

What is Amendment 69?

Funding How will ColoradoCare be funded?

The Permanent tax structure:

Copyright (c) Richard D. Turnquist 2016 All

What is Amendment 69?

What is Amendment 69?

The Colorado Care Yes website says that there is

What is Amendment 69?

What is Amendment 69?

What is Amendment 69?

Cannot opt out. ColoradoCare will be mandatory.

What is Amendment 69?

It would be nave to assume it will stay at $25

Arguments For and Against

The proponents of A69 talk about a $4.5 billion

Arguments For and Against

Proponents say that savings would come from

Copyright (c) Richard D. Turnquist 2016 All

Arguments For and Against

None of the numbers used by the proponents on

Arguments For and Against

The idea of paying less for durable medical equipment

Arguments For and Against

Benefits promised include no deductibles, no

Arguments For and Against

Employers are promised reductions of costs

Arguments For and Against

For Providers, Colorado Care promises

Providers would receive prompt, adequate

Arguments For and Against

Perhaps the most fanciful claims are:

Arguments For and Against

Im a big believer in evaluating proposed

Copyright (c) Richard D. Turnquist 2016 All

Arguments For and Against (10

Amendment 69 violates most of these principles.

Arguments For and Against

It violates Property Rights through increased

Arguments For and Against

It violates the principle of Fiscal Responsibility

Failures and Problems of Single Payer

In 2010 Vermont elected a governor who ran on a

Failures and Problems of Single Payer

Canada and the UK both have single payer

Failures and Problems of Single Payer