Lately, on these pages and around the Summit County community, many of you may have heard about the Peak Health Alliance and its new approach to health insurance. Peak Health is a result of work done by county leaders over the last year and a half, who, like most of us, are fed up with high health and health insurance prices. They were tired of the fact that there seemed to be no workable solutions. As Colorado Insurance Commissioner, I was fortunate to work with this dedicated group of people to introduce a new idea.
Why Summit County?
For the most part, I started working with Summit County because they've been working to find solutions to the health problem in the rural and mountainous areas of Colorado – health care prices are spiraling out of control. The dedication of your leaders in Summit County – Tamara Drangstveit, Sarah Vaine, Mark Spiers, Dan Gibbs, Thomas Davidson, MEP Julie McCluskie and others – is inspiring. Even before Peak Health, these people showed up at meetings in the insurance department, at Capitol hearings, and at Summit town halls to make sure people heard their problems and discuss possible solutions. They also shouted at me as insurance commissioner and working with them seemed to be the only way to get them to stop.
What is the community shopping model?
Today, our health care system continues to grow unbalanced. On the industrial side, consolidation and partnerships are giving hospitals and insurance companies more and more influence. However, the people who pay for health care and health insurance – individuals, families, small businesses, entrepreneurs, and our larger employers – are increasingly shattered and weaken their ability to demand better prices from hospitals, insurance companies, and pharmaceutical companies.
The commercial insurance market is initially divided into three areas – the single market, the small group market (for small employers) and the large group market (for large employers). But then we break up into smaller groups. The single market has the Affordable Care Act – compliant plans, short-term plans, plans for grandfathers, and others. The employer groups exist as their own silos, each trying to work out their own deal. Everyone is chasing something that they think will be lower rewards and a better value, but these often turn out to be short-term gains that exclude the sick, the vulnerable, and those with pre-existing conditions.
In my opinion, we need to find ways to enable consumers to act together, in a way that includes the sick, the weak and the people with pre-existing conditions. By bringing consumers together, we can leverage consumers to negotiate more reasonable prices with hospitals and doctors, rather than relying on insurance companies that negotiate for us. With these better prices, we can make insurance companies compete with each other for our collective business.
This is a suggestion that I call the shopping model of the community, and this is the idea that I have asked Summit County leaders to help me over a year ago. It sounds the same – the model gives power into the hands of the community – the people and businesses who buy health insurance and health insurance. It unites individuals, small businesses and large employers into a large purchasing network and gives the community a place at the negotiating table.
That's where the Peak Health Alliance comes in. You have two fantastic health advocates, Claire Brockbank and Bill Lindsay, who work with the thought leaders of your community to make that concept a reality. You are in deep negotiations with Centura, the other healthcare providers in the community, and with hospitals and hospital systems outside of Summit County, all of which demand better health care for you.
However, I can not stress everyone how important it is for the community of Summit County to remain united in these negotiations and this model. The community shopping model can provide sustainable relief for individuals purchasing health insurance in the single market, for the school district, for Summit County employees, for the towns of Summit County, for small business owners, and for large employers. But that will only happen if you stay united. We are stronger when we act together.
Summit County and beyond
I am fortunate that the people I worked with in Summit County last year have become friends. But the summit is only the first step. Once we've proven that this model can be successful, I plan to take it nationwide. Hospital costs and insurance premiums are rising in every district in Colorado. As your insurance agent, my job is to solve the problem.
I welcome all the work that has been done by the Peak Health Alliance people over the last year, as well as the untiring community support that Summit County leaders have made over the years. I am honored to work with them. The Community Purchasing Model is a viable solution that not only dances along the margins of health insurance premiums, but actually attacks the root causes of those premiums, and in a way that benefits everyone. His success in Summit County will lead to a path that will help all Coloradans.
Michael Conway is the Colorado Insurance Commissioner.