This is the final question posed to the three candidates running for the Vermont House of Representatives. The Shelburne News thanks the candidates for their timely and honest responses and wishes them luck in the upcoming election.
What is your position on Vermont’s single payer health care bill? What factors influenced your decision?
In passing H.202, the Single Payer Healthcare Bill, Vermont lawmakers made it possible to transition the state to a Government financed single payer (called Green Mountain Care) and establish it as an insurance exchange. The Green Mountain Care Board consists of five members that will have the authority to adopt by rule – without further action by the legislature – measures having the force of law. Basically the board sets all the rules and regulations for reimbursement rate for doctors and hospitals. The bill calls for identification of costs in a definitive financing plan. Recently we learned that the plan which was to be available in January will not be available for a legislative vote until 2015, four years later than was initially promised.
There are many questions concerning how a single payer system will work. But the real weakness in the plan is the cost and how it will be paid for.
I believe when the bill was passed in 2011, it was well known that the cost and financing were not to be disclosed for years since there are many decisions and options to consider – it’s far from being the plan that the legislature passed.
What is frustrating to many including legislators is not being able to plan with any degree of certainty. Now the administration is saying we shouldn’t try to rush these plans.
When the cost question is brought up to the Green Mountain Care Board, the answer is: We don’t control the costs, which is a specious argument since most every issue the board decides has a bearing on cost. So if the board is not aware of how their actions affect cost, then the whole concept of Vermont’s approach to single payer health care is a serious problem.
It is difficult to state a position on Vermont’s single payer health care when so little information on costs or even a discussion of possible financing alternatives is not on the table.
I believe that, as Vermonters, we have a responsibility to take care of the most vulnerable and work together to reduce our rising health care costs. At this time, we simply haven’t seen evidence that a single-payer health care system will save Vermonters money. As your Representative, I will not support a policy if the numbers don’t add up. I’ve worked diligently throughout my career to use our State’s resources wisely, if elected; I pledge to continue to ask the tough questions in Montpelier on behalf of Shelburne and St. George.
I support staying on course to answer the question as to whether a single payer system can work in Vermont. Most people agree that the current trend in health care costs is unsustainable. In 2006, Vermonters spent $3.9 billion on health care. By 2009, this had risen to $4.7 billion. This year is projected to be $5.9 billion.
It comes as no surprise that there are some here in Vermont who are opposed to reform, particularly those of us for whom the current system is working. The message, however, has been distorted by the use of the term “single-payer” and its many negative connotations. I do not see that the current plan is actually “single-payer” as there are too many elements outside the control of the Green Mountain Care-run system. Medicare will be a part of the system. Employer plans that must abide by ERISA (the Employee Retirement Income Security Act) will still exist.
Up to now, the criticism of uncertainty is valid because the Green Mountain Care board is still in the planning stages. My problem here stems from the assertion that we don’t know the answer to certain questions, so we should not work to find the answer to those questions. This thinking simply does not make sense to me.
Let us remember the actual intent of Act 48 of 2011, for which I voted is as follows: “It is the intent of the General Assembly to create Green Mountain Care to contain costs and to provide, as a public good, comprehensive, affordable, high-quality, publicly financed health care coverage for all Vermont residents in a seamless manner regardless of income, assets, health status, or availability of other health coverage. It is the intent of the General Assembly to achieve health care reform through the coordinated efforts of an independent board, state government, and the citizens of Vermont, with input from health care professionals, businesses, and members of the public.”
There is wide agreement that the current system is not sustainable. There is substantial risk in not moving forward on system-wide reform. But let us not see that this is an insolvable problem. It will require compromise. We can do this.
One of the most talked about subjects in Vermont and on the national scene is health care reform. People want to know what it means, what it will cost, and how it will affect them. The question posed to us this week asks what we think about Vermont’s health care reform and what has influenced our decisions.
I am in favor of making health care affordable and accessible to all. We have heard so many times that we are the only industrialized nation that does not have universal health care. I am not proud of that fact. I believe Vermont is in a good position to pursue this direction and with much analysis, we can move forward in a systematic manner.
The goals of Vermont’s health care reform are to:
• Increase access to care for all Vermonters
• Improve the quality of care
• Reduce the rate of growth in health care spending
• Assure greater fairness and sustainability in how we pay for health care
These are goals that I am willing to work toward. According to the Vermont Health Care Expenditure Analysis (released in 2012 and uses data from 2010) Vermont health care costs are up $200 million from 2009-2010. That is over $500K per day. We must deal with reform! It is a slow and intentional process that we must engage in. During this last legislative session, we implemented the health care exchange that gets us into compliance with federal law. Some may be frustrated but we want to get it right and make sure it works for all.
I believe we need to make prevention and wellness part of this whole picture. People will be more aware of and responsible for their own health and ideally seek care at an earlier stage. This approach will save dollars. Vermonters have seen how beneficial our national health care reform has been with the policy of children under the age of 26 being able to stay on their parents’ health care plan. Another piece of health care reform that has been beneficial is the inclusion of coverage for pre-existing conditions.
I know this is not an easy task but it is the right thing to do and I am willing to help make it happen for the good of all Vermonters.