Colorado can lead the way on universal health care (Opinion) – Boulder Daily Camera

Analysis of Colorado’s Healthcare System in the Context of Sustainable Development Goals

Current Healthcare Challenges and Alignment with SDG 3: Good Health and Well-being

The current healthcare framework in the United States presents significant barriers to achieving Sustainable Development Goal 3 (Good Health and Well-being). An analysis of the system reveals several critical issues:

• Employment-Tied Coverage: Linking health insurance to employment creates instability and stress, particularly for individuals with chronic health conditions. This model is vulnerable to economic fluctuations, where job loss results in a loss of essential health coverage.
• Profit-Driven Insurance Model: The commercial health insurance industry’s primary objective is profit maximization. This leads to practices that conflict with public health goals, including high premiums, high deductibles, claim denials, and delays in care, which undermine the principle of accessible healthcare for all.
• Poor Health Outcomes: Despite spending more on healthcare than any other high-income nation, the U.S. demonstrates outcomes that are inconsistent with SDG 3 targets. According to the Commonwealth Fund, the nation has:
  • The lowest life expectancy at birth.
  • The highest rates of death from avoidable or treatable conditions.
  • The highest maternal and infant mortality rates.
  • Among the highest suicide rates.

These systemic failures directly contravene SDG Target 3.8, which calls for achieving universal health coverage, including financial risk protection and access to quality essential health-care services for all.

A Proposed State-Level Solution for Advancing Multiple SDGs

A state-managed, publicly funded healthcare enterprise in Colorado is proposed as a solution to address these challenges. The passage of Colorado Senate Bill 25-045, which mandates an analysis of options for a universal health care payment system, represents a significant policy step. This approach has the potential to advance several interconnected Sustainable Development Goals:

1. SDG 3 (Good Health and Well-being): By establishing a universal system, the state would directly pursue Target 3.8, ensuring all Coloradans have access to quality, affordable healthcare.
2. SDG 1 (No Poverty) & SDG 10 (Reduced Inequalities): A publicly funded system would mitigate the risk of citizens falling into poverty due to catastrophic medical expenses. It would reduce systemic inequalities by providing care based on need rather than the ability to pay.
3. SDG 8 (Decent Work and Economic Growth): Decoupling health insurance from employment would foster a more stable and flexible labor market, allowing for greater entrepreneurship and reducing the burden on employers. A healthier population is also a more productive one, contributing to sustainable economic growth.

Implementation Pathway and the Role of SDG 17: Partnerships for the Goals

The primary obstacle to implementing the analysis mandated by Senate Bill 25-045 is a lack of allocated funding. To overcome this, a multi-stakeholder partnership has formed, exemplifying the principles of SDG 17 (Partnerships for the Goals).

• Coalition-Led Fundraising: A coalition of healthcare advocates and volunteers is actively fundraising to secure the necessary $750,000 for the Colorado School of Public Health to conduct its independent, scientific analysis.
• Informed Policy-Making: The research aims to provide essential data to inform public policy decisions, a cornerstone of SDG 16 (Peace, Justice and Strong Institutions). This ensures that future healthcare reforms are evidence-based.
• Grassroots Mobilization: The effort relies on grassroots support, including financial donations and volunteerism, to advance the research and educate the public on its importance.

Conclusion: A Replicable Model for National Progress

Colorado’s initiative to explore a universal healthcare system serves as a potential model for other states and, ultimately, for national reform. The strategy of pursuing change on a state-by-state basis, similar to the process that established Canada’s national health plan, offers a viable path toward comprehensive coverage. By treating healthcare as a public good rather than a commodity, Colorado can take a leading role in ensuring the health and well-being of its residents, making significant strides toward fulfilling the promise of the Sustainable Development Goals.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being: This is the primary goal addressed. The article’s entire focus is on the failures of the current U.S. healthcare system and the need to ensure healthy lives and promote well-being for all. It directly discusses issues of healthcare access, cost, and poor health outcomes like mortality rates and life expectancy.
• SDG 10: Reduced Inequalities: The article highlights the inequality in healthcare access, stating, “You can buy health care if you can afford it.” The proposed solution of a state-managed, publicly funded system aims to reduce this inequality by providing “health care for all Coloradans,” regardless of their employment status or ability to pay high premiums.
• SDG 1: No Poverty: The article connects health insurance to employment, implying that job loss can lead to a loss of coverage and financial vulnerability. The discussion of “unaffordable premiums” and “high deductibles” points to how healthcare costs can be a significant financial burden, potentially pushing individuals and families towards poverty. A universal system would provide a social protection floor against such risks.
• SDG 16: Peace, Justice and Strong Institutions: The article discusses a legislative solution (Colorado Senate Bill 25-045) and the need for an “in-depth, independent and scientific analysis” to inform public policy. This reflects the process of developing effective, accountable, and transparent public institutions—in this case, a potential state-managed universal healthcare enterprise.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.8: Achieve universal health coverage (UHC), including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. The article directly advocates for this target by promoting a “universal health care payment system” and “health care for all.” It addresses the lack of financial risk protection by citing “high deductibles,” “unaffordable premiums,” and claim denials.
   • Target 3.1: By 2030, reduce the global maternal mortality ratio. The article explicitly states that the U.S. has the “highest maternal… mortality” among high-income countries, identifying a key problem that a universal healthcare system would aim to address.
   • Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age. This target is directly relevant as the article points out the U.S. has the “highest… infant mortality.”
   • Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. The article supports this target by highlighting that the U.S. has the “highest death rates for avoidable or treatable conditions” and “among the highest suicide rates,” both of which fall under this target’s scope.

2. SDG 10: Reduced Inequalities

   • Target 10.4: Adopt policies, especially fiscal, wage and social protection policies, and progressively achieve greater equality. The proposal for a “state-managed, publicly funded health care enterprise” is a clear example of a social protection policy designed to reduce the inequality of access to healthcare, moving away from a system where quality care is only for those who can afford it.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Life Expectancy at Birth: The article explicitly mentions that the U.S. has the “lowest life expectancy at birth” compared to other high-income countries. This is a key indicator of overall population health (SDG 3).
• Maternal and Infant Mortality Rates: The article directly states the U.S. has the “highest maternal and infant mortality.” These are direct measures for Targets 3.1 and 3.2.
• Mortality from Avoidable Causes: The mention of the “highest death rates for avoidable or treatable conditions” serves as a direct indicator for Target 3.4.
• Suicide Mortality Rate: The article points to the U.S. having “among the highest suicide rates,” which is a specific indicator for the mental health component of Target 3.4.
• Health Coverage: The central theme of achieving “guaranteed health coverage” for all implies that the proportion of the population covered by a health plan is a critical indicator for Target 3.8.
• Healthcare Expenditure: The article notes that the U.S. “spends more on health care than any other country” for worse outcomes. Per capita healthcare spending is an implied indicator used to measure the financial efficiency and burden of the system, relevant to Target 3.8.

SDGs, Targets, and Indicators Analysis

Source: dailycamera.com