Directors Corner April 2020

The Rationale for Statewide Purchasing Alliance:
Colorado as a “Commonwealth”

Last month I addressed a question I have often been asked regarding The Colorado Purchasing Alliance: “How does it relate to the ‘public option’ in Colorado? (It doesn’t.) But here’s the second question that I am asked often – and in almost every community: “Since ‘all healthcare is local’ and since every community is different, why do we need a ‘statewide’ solution? We’re different here [name any city in Colorado.] Why would we want a ‘one-size fits all’ approach to health reform?” Fair question. Here’s my answer.

Of the 50 states in the US, four call themselves a “commonwealth:” Kentucky, Massachusetts, Pennsylvania, and Virginia. What’s the difference? Only the name. In their politics and under their laws, commonwealths are just like states. And, name aside, each shares this central, unifying, democratic principle: a tacit agreement of their people to function for the common good.

So what has that to do with why we formed The Colorado Purchasing Alliance as a statewide healthcare purchasing cooperative? Everything. Because if we assume that our goal in promoting affordability and more reliability in healthcare is to benefit ALL Coloradans as members of our shared commonwealth, then we can only achieve that goal if we do five things:

But isn’t each community different? Of course – in very specific and relevant ways that must be considered. Accordingly, while critical issues such as the under-use of primary care and mental health and over-use of low-value care – are universal across the state, solutions to these pressing problems must be formulated and executed locally – in concert with and led by community physicians. That’s why we have outlined an approach to this conundrum of Statewide vs. local solutions in a white paper with the rather lengthy title “Coordinating a Multi-Community Approach for Improving Healthcare Affordability and Outcomes Across Colorado: Goals, Premises and Alignment Strategies.” (The paper is only one page. Download it here.)

No, one-size certainly does not fit all. But if we are to benefit ALL Coloradans as much and as soon as possible -– on the plains and in the mountains, in the Front Range and on the Western Slope, in both rural and urban areas – we must draw a line around the four borders of our State and we must declare “THIS is our community. We are a commonwealth and we are working for the common good.”

To do that, we need a Statewide approach.