◼ POLITICS Bloomberg Businessweek March 2, 202032
▼ U.S. consumer health
expenditures in 2018Hospital care
$1.19tPhysician and
clinical services
$0.73tPrescription drugs
$0.34tHealth insurance*
$0.26tHome health care†
$0.10tOther
$0.30tPublic health activities;
gov. admin. $0.14tMedical products and
equipment $0.12tDental services
$0.14tNursing and continuing-
care facilities†
$0.17twant to let people buy government coverage—
like that offered to Americans 65 and older via
Medicare—while their rivals to the left, Elizabeth
Warren and Bernie Sanders, would replace pri-
vate insurance entirely with benefits funded by tax-
payers. (Michael Bloomberg, founder and majority
owner of Bloomberg LP, Bloomberg Businessweek’s
parent, is seeking the Democratic presidential nom-
ination.) Colorado’s proposal is more modest than
what much of the Democratic field favors, since it
relies on private insurers to manage the plans. But
if the state is stymied by stiff opposition from hospi-
tals and insurers, it could force voters to recalibrate
their expectations for what a Democratic president
could achieve.
Democrats won control of the state legislature
in 2018, and Democratic Governor Jared Polis has
put reducing health-care costs at the top of his
agenda. Polis created an Office of Saving People
Money on Health Care and promoted a number
of ideas to lower spending, including the so-called
public option. Colorado follows Washington state,
which passed the first public health insurance
option last year. Delaware, Massachusetts, and New
Mexico have weighed their own versions in recent
years. Polis says the measure is part of a necessary
response to rising health-care costs, which he char-
acterized as a crisis at a recent event in Washington,
D.C. “People are fed up, and they want solutions.”
One of those fed-up people is Cindy Kahn, 59,
who leads a social justice nonprofit and lives in the
small mountain community of Carbondale, Colo.
When Kahn and her husband began buying their
own health insurance in 2018, they were “absolutely
gobsmacked” at the $2,000-a-month premium, she
says. An expensive surgery to treat a tumor in Kahn’s
husband’s jaw added to the mounting costs. Kahn
calls the financial toll “a toxicity in your life that lives
with you. It’s like one step from the precipice.” Partly
because of medical expenses, the couple decided to
sell their home and consider moving to a bigger city
where the market for insurance is more competitive.
Kahn says she supports a public option but worries it
may not be enough to make care affordable.
Colorado’s state-sponsored plans would start in
2022 and initially be targeted at the 7% of the popu-
lation who buy their own coverage directly, instead
of getting it from employers or through other gov-
ernment programs. The plans would offer premiums
about 11% lower than what’s available today, on aver-
age, in the state’s individual insurance market, and
as much as 17% lower in some places, according to
an outline of the proposal by health and insurance
authorities released last November.
To reduce costs, the state has taken aim at● The state’s public insurance push could
influence the national debate for DemocratsA Health-Care Test
In Colorado
For Democratic presidential candidates contem-
plating sweeping health-care overhauls, what hap-
pens in Colorado over the next few months will be
instructive. Lawmakers in Denver are preparing to
vote on a state-sponsored health plan that would
compete with private insurance and offer lower pre-
miums. Its approval could embolden Democrats eye-
ing the White House.
Moderate Democratic candidates such as Pete
Buttigieg, Michael Bloomberg, and Amy KlobucharTHE BOTTOM LINE With the Trump administration putting
trade pressure on members of the trans-Atlantic alliance, Europe
wonders how NATO might be calibrated for the future.also went hand in hand, but the correlation was
mostly positive. Then-Pentagon chief Ash Carter
said in 2015 that congressional approval for an Asia-
Pacific trade deal, the Trans-Pacific Partnership,
was as strategically important for the U.S. in Asia as
“another aircraft carrier.” Trump excised the U.S.
from the pact in one of his first acts as president.
One key uncertainty for officials in Europe is
the coming U.S. election and the prospects for
a second Trump term. If “America First” drove
White House policy in the first Trump presidency,
what might drive it in the second with a more
emboldened leader claiming voter validation of
his actions so far?
Most European policymakers take comfort in
the decades of NATO resilience. The Cold War
might be over, but NATO’s mandate of collective
defense is valued by many, as Vladimir Putin’s
Russia becomes more active in North Africa and
the Middle East and as Putin continues to make
mischief in parts of Eastern Europe. Even with
Turkey’s provocations, NATO isn’t at immediate
risk of a full split.
Still, “NATO would be fundamentally altered if
the United States was no longer prepared to give
other allies its security guarantee,” Thomson says.
“Threats like that from Mark Esper at Munich do
cause people to wonder what President Trump
might do next.” �Rosalind Mathieson