View From a Height
Commentary from the Mile High City
Tuesday, January 13, 2004

Wrong Diagnosis


Sunday's Denver Post carries a typically wrong-headed article about TABOR and its effect on Medicaid.



Diane Lucas needs a job.


Like many in Colorado, she lost hers when the small business she worked for folded.


Lucas is a pediatrician. Joining a lucrative private practice probably would be easy, but she wants to treat poor children whose parents qualify for Medicaid, the government's health insurance.



Diane Lucas can get a job. It says so two sentences later.



Faced with a monumental budget crisis, the legislature last session slashed Medicaid reimbursements. Health care programs for the poor lost $61 million in the last fiscal year.


That alone didn't bring down the practice, Lucas said, but it made it harder to make money.



So which is it? I have no idea what other fiscal problems were besetting Dr. Lucas's business. It sounds to me as though there's a workable model out there, a combination of a standard practice and a certain amount of pro bono work. Of course, it's so much easier to blame me for not paying higher taxes, on top of what I already pay for my own insurance. On top of what I do already give to charity.



So, more than any specific issue or pet program, advocates for seniors, children, the mentally ill and the uninsured will focus on tweaking TABOR this session.


During the past couple of sessions, "you have a tendency to feel like you're working in a triage unit," said Morie Kiusalaas of Colorado AARP. "But when you take the time to breathe, that's when we said, 'It's fine to keep treating the symptoms, but if we don't do something about the illness that is TABOR ..."'


At the Colorado Children's Campaign, the constituents may be different, but the thinking is similar.


"We think TABOR is the No. 1 children's issue" in Colorado, said Barbara O'Brien, the organization's president.


The ratcheting-down effect is real, but various "advocates" see state spending and taxing limits as the real enemy, and want to use any revision to eliminate the ratchet as a means to attack the whole notion. Usually these groups work independently. The fact that they're teaming up is an indication of both their weakness and the popularity of the amendment. Ms. O'Brien no doubt feels a particular need to point the spotlight onto TABOR. Her group is the main champion of one of the other legs of the triangle - Amendment 23, which mandates ever-higher spending on public education.


As is ever the case, the problem is that the state can't raise taxes at a whim. Ask California about that. Governor Owens strongly supports TABOR. If he wants to keep it, now may be the best time to cut a deal. He's termed out, and Colorado isn't so red a state that it couldn't elect a Democratic governor with a working legislative majority to gut the thing.



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