Wennberg: Health care freedom at risk

Editor’s note: This op-ed is by Jeff Wennberg, the executive director of Vermonters for Health Care Freedom.

Apparently Vermonters for Health Care Freedom is making progress. The fury and frequency of attacks leveled against the organization from advocates of the single-payer takeover of Vermont’s health care system have reached a fever pitch. Single payer zealots seem most offended by the use of the word “freedom” in the organization’s name. Freedom, they claim, is their goal. In fact, at least one of the single payer advocates is so incensed he has publicly called for media outlets to refuse to carry VHCF’s paid messages. Apparently nothing protects freedom like censorship.

Through a combination of the Vermont single payer “Green Mountain Care” plan and the federal Obama Care program the government will 1) mandate that you purchase health insurance; 2) outlaw competition in the insurance market and force you to buy insurance from a single, state-selected provider; 3) limit your choice of plans down to a handful of options which the state has designed and specified; and 4) — and this is a real beauty – not tell you how much this will cost or how it will all be paid for until it is too late to choose a different approach.

The health care system is vast and complex. It is so complicated that even those who spend their lives working in it profess only partial knowledge. Green Mountain Care is poised to unleash comprehensive reforms across all aspects of the system, from how doctors are compensated, to how payment is made, to how hospital budgets are approved and managed, to the way health care insurance is offered, managed and paid for. There is no corner of this massive $5.3 billion per year industry that will remain unchanged under Green Mountain Care.

Is it unreasonable to urge our governor and lawmakers to be cautious, consider all options, proceed in a stepwise fashion and listen to the concerns of health care providers and consumers? And given that the state of Vermont attempted without success to operate the 54-bed state hospital, is it unreasonable to question whether this state can successfully assume near-total control of the entire health care industry?

In a recent meeting between Anya Rader Wallack, chair of the Green Mountain Care Board, and doctors at the Rutland Regional Medical Center, one doctor observed, “What you want is a rationing system which is something that can be done in a rationale way but only if physicians are the ones coming up with it.” Wallack did not disagree. In another meeting in St. Albans between doctors, dentists and legislators a show of hands was requested for doctors who had started to investigate moving their practice out of state as a result the passage of the Vermont reform law last year. Half of the 25 doctors in the room raised a hand.

Any reform that drives doctors out of state and scares away those who might want to practice here cannot increase access. Any reform that severely limits our coverage options and relies upon rationing threatens our health care freedom.

Unfortunately the governor has the votes in the Legislature to impose Green Mountain Care regardless of the risks – or the costs. They are under no obligation to consider alternatives, present and defend a budget or address the objections of Vermonters for Health Care Freedom, or anyone else who disagrees with this reckless plan. Only if enough Vermonters become aware of what is happening and demand a different direction will our leaders be forced to slow down and listen.

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Avram Patt
3 years 10 months ago

My father was a family doc. When Medicare was first proposed, he was thrown out of his county medical society for speaking to senior groups and saying that this would be a good thing. He wanted to be a doctor because it was his way of making the world a little better. The docs that despised the idea of universal coverage back in the early 1960s chose their profession for other reasns. They were dead wrong and my father was right. He died in 1972, but if he was alive today he would be sorely pissed that the sane scare… Read more »

walter carpenter
3 years 10 months ago

“Only if enough Vermonters become aware of what is happening and demand a different direction will our leaders be forced to slow down and listen.”

More than enough Vermonters, far more, have become aware of what is happening, and are demanding a “different direction,” which is why there is the Green Mountain Health Care Board and the move toward reform.

Ann Raynolds
3 years 10 months ago

Mr. Wennberg mistakenly conflates the Obama Exchanges with the Shumlin Single Payer plan in paragraph 2. There would be no insurance to “purchase” under a single payer plan, no insurance for-profit national Insurance plans to choose a plan from under the single payer plan. And the people of Vermont will decide through their own “insurance board”, the Green Mt. Care Board, what the benefits are. No one today has any power over what the national profit-making Insurance Companies provide or how much you pay for them; competition among them is virtually non-existent. Mostly Mr. Wennberg is talking about the Obama… Read more »

Patrick Cashman
3 years 10 months ago

In the interest of context it should be noted that Ms. Raynolds is listed as a board member of the organization “Vermont Health Care for All”, a single payer advocacy group.

howie ires
3 years 10 months ago

Health Care Freedom? Free to die without health care? Free to go bankrupt to pay for health care? This is just another right wing “Big Lie”! Tell the people of Canada, Britain, Sweden, Germany, France, Norway, Denmark and every other industrialized nation where health care is a right and not a privilege of the wealthy and well employed, tell them that single payer health care doesn’t work! I have a friend who was a dentist in the USA and emigrated to Sweden, where he can be a dentist without having to be an “entrepreneur.” Yes, he makes less money, but… Read more »

Patricia Crocker
3 years 10 months ago

Vermont is heading for the kinds of problems we see in Canada under single healthcare. Don’t believe me? Watch this movie free this weekend. Go to this website: http://aapsonline.us1.list-manage1.com/track/click?u=30a32513ae04f5445c95f3239&id=291016674b&e=9832521730

Brad Morgan
3 years 10 months ago

Welcome to the Dark Side, Jeff. In the spirit of transparency, would you please list the financial supporters of your organization? Most Vermonters have heard that VtHCF is an organ of the insurance industry. Would you prove them wrong?

Wendy Wilton
3 years 10 months ago

Eyes Wide open on this folks. The people of the state and the legislature should be asking good questions, getting answers and doing their own due diligence before moving forward. There is no evidence this direction will work for VT (in fact, single payer countries are now looking at insurance solutions to curtail costs!), and the risk to the state is in billions (not millions) of dollars. Unfortunately, the Administration, aided and abetted by a naive legislature, is hiring staff to beat the band and racking up million in costs before we even know if the concept is sound!

Doug Hoffer
3 years 10 months ago

1. The state is currently doing the due diligence. 2. There is plenty of evidence that the current system does not work (for Vermont or any other state) so it’s a bit ironic that you express concern about the future. Moreover, everything that’s being said now was said in the 1950’s and early 1960’s about Medicare. The sky didn’t fall then and it won’t fall now. 3. It is patently false that “the risk to the state is in billions.” We are already spending the money. 4. I’m not sure how you can reconcile your concern about due diligence with… Read more »

3 years 10 months ago

“According to the non-partisan Congressional Budget Office (CBO), Medicare will go bankrupt in 2020 unless we do something to save it.” Is your long term proposal to fund GMC to raise taxes on businesses, families, and individuals using a progressive funding scheme similar to the VT property tax system? That sure seems to be where GMC will have to head when the $5 billion you capture is not enough to pay for it all. So much for the $500 million savings from the Hsiao report. Why can’t this financial reality be communicated to the VT population now before we are… Read more »

Wendy Wilton
3 years 10 months ago

Hey Doug–If I could do the projection, the state (meaning the Administration and the legislature) could certainly present and review a model, or several. The costs are fairly easy to quantify; it’s the funding piece that’s the house of cards. The state is NOT doing its due diligence without a true revenue vs. expense projection. I have repeatedly offered to debate you on this issue and you won’t do it. Why not? Could it be you know I’m right? Would you start even the smallest of businesses without a business plan, including a income statement or cash flow projection? So… Read more »

Doug Hoffer
3 years 10 months ago

Your plaintive cries are not persuasive. 1. No one is starting a business any time soon. At best, the new system cannot be in place for four to eight years and you know it. Therefore, the repeated calls for data before it’s ready is primarily about characterizing the state as a bad actor. That stuff just poisons the discourse. 2. I agree that the costs are not difficult to estimate but (as I’ve said before) your figures are terribly inflated. Indeed, the state is NOT “embarking on a $5 BILLION enterprise.” In fact, it’s about a third of that but… Read more »

David Kreindler
3 years 10 months ago

Vermonters in growing numbers are suffering and dying needlessly while insurance companies continue to profit from our broken healthcare system. It is understandable that Mr. Wennberg would try to stop progress on reforming this broken healthcare system. After all, his job is to serve the interests of the profiteers, not to ensure that every Vermonter receive the care they need when they need it. Mr. Wennberg is being paid to try to maintain the profitable healthcare system status quo — without regard for the cost in human lives. Can we blame Mr. Wennberg for trying to do his job? Can… Read more »

3 years 10 months ago

This is another editorial from someone associated with the Vermont Worker’s Center. Many would like to know who funds your operations and why you have no respect for the opinions of others who disagree with your socialist philosophy?

Joyce Wilson
3 years 10 months ago

As far as Green Mountain Care attracting more businesses as written in a comment above, I think we better address immediately how we are going to pay for this as I think people are getting uneasy about the prolonged uncertainty. Dr Hsaio recommended hefty payroll taxes to finance Green Mountain Care in Vermont. The very people that are supposed to be heavily funding it may leave, and the taxes will discourage others from moving to Vermont. Vermont is rated #48th (#1 being the best of the 50 states) on the 2011 Small Business Survival Index and this hefty payroll tax… Read more »

Walter Carpenter
3 years 10 months ago

“there is no evidence that this will work in Vermont.”

So all the people in Vermont on Medicare. Medicaid, and the va say that it does not work? There is evidence all over the world that it does work. They work much better than the insurance market. It will work much better than what we have now, where Vermonters are excluded from insurance because they cannot afford it, or forces them to pay thousands in premiums and high-deductibles before they can even use the insurance. It is the current broken system that is malfunctioning.

Daniel Barlow
3 years 10 months ago

It’s interesting that Jeff Wennberg’s column makes no mention of the tens of thousands of Vermonters who can’t afford health insurance, the more than 100,000 Vermonters who are under-insured or the crippling effect our employer-based health insurance system has on our economy.

He also makes no mention of who Vermonters for Health Care Freedom are beyond himself and the organization’s founder. Who is funding this group? Who knows? They don’t seem to want to be transparent.

Estella Leach
3 years 10 months ago

@Doug Hoffer–regarding your due diligence point. YOu say you can’t reconcile due diligence without the related costs, but they have, they have done exactly that. They passed legislation without fulling understanding what they were doing.

Also once again, if it is so great, why are you forcing me to buy from the exhange or not buy at all. FORCE is exerted to get someone to do something they wouldn’t otherwise do.

Create your exchange and let it stand on its own merits.

Doug Hoffer
3 years 10 months ago

Ms. Leach

The legislation did not create a new health care system. It established a process to gather and evaluate data so that policymakers will have the information necessary to move ahead if they so choose. This process is the due diligence. You sound as if you think something has actually been decided. Notwithstanding the scare tactics of the opposition, that is not the case. We will have years to figure this out.

Art Bell
3 years 10 months ago

Exactly how we were warned the spin doctors would try to put in place their reality distortion field.

Wendell Potter former Cigna executive predicted how it would all appear ‘innocent and balanced’ as they quietly undermine and kill any efforts to control costs and improve heath care for all vermonters – From Last weeks Seven Days:

http://www.7dvt.com/2012spin-doctors

Peggy Carey
3 years 10 months ago

If there exists a “takeover’ of healthcare reform as Wennburg suggests, we wouldn’t have the methodical and open working process of the Green Mountain Care Board that is the real situation. This group of five very thoughtful people is thoroughly taking testimony weekly from experts in all arenas of the healthcare field. This groundwork will allow them to craft quality healthcare reform that will include coverage for ALL Vermonters.

Jason Kelley
3 years 10 months ago

It’s fascinating how much we laud foresighted individuals who lauch risky ventures, often risking their own careers and their capital. We marvel at the Bill Gates’s and the Steve Jobs’; we place venture capitalists on pedestals; our adulation of Warren Buffett knows no bounds. But when it comes to 625,000 people banding together to self insure their health care system, the naysayers rush forward to warn that its risky and Vermonters shouldn’t take risks. Suddenly Vermonters can’t afford to take the sorts of risks that have paid off in such disparate countries as Slovenia, South Africa, and Taiwan as well… Read more »

Ellen Oxfeld
3 years 10 months ago

One thing that the critics of single payer always do is bring up the figures from the Hsiao report on how to fund Green Mountain Care. However, Hsiao was very clear that what he described was NOT necessarily the suggested mix of taxes a legislature would actually put together to raise revenue. It was just an example and in real life you would use a mix of taxes, and not just rely on payroll alone. So, instead of a flat payroll tax on all businesses, it is more likely that Green Mountain Care could use a mix of payroll and… Read more »

Bob Zeliff
3 years 10 months ago

Wennberg calls for health freedom for Vermonters. That is a good idea because right now about 8% of Vermonters have the freedom to have no health insurance. It sounds like he wants to increase that number. Right now many more Vermonters have the freedom to have high cost, high deductible, limited coverage insurance. It sound like Wennberg wants to spread that so called freedom to more Vermonters. I don’t think VErmonters want his kind of Freedom. VErmonters work to solve problem and have led the way by not being afraid of innovating and taking the lead. He will not tell… Read more »

Ed Deegan
3 years 10 months ago

To all the comments above who are wondering how we are going to pay for this. We already are paying for it. What this will do is stop paying for administration in the form of MILLIONS of dollars in unneeded bureaucracy to run a system based on profit. $6,000,000 ++ bonus for one person in the not-for-profit sector needs to be banished. We pay twice what the rest of the civilized world pays for inferior quality under the present system, very well documented. The people of Vermont understand (we are the smartest state) that the present system is broken and… Read more »

Tom Licata
3 years 10 months ago

Here’s the crux of our problem in the state of Vermont from something I wrote back in Dec. 11, 2011: “In his superb book, “The Battle,” Arthur C. Brooks outlines this war: “This is not a fight over guns, abortions, religion, and gays. Nor is it about Republicans versus Democrats. Rather, it is a struggle between two competing visions of America’s future. In one, America will continue to be a unique and exceptional nation organized around the principles of free enterprise. In the other, America will move toward European-style statism grounded in expanding bureaucracies, increasing income redistribution, and government-controlled corporations.… Read more »

Al Walskey
3 years 10 months ago

Jeff Wennberg’s attempt to turn the tables on the use of the word “freedom” is one of the reasons why many mistrust the so called facts that the “Vermonters for Health Care Freedom” regularly puts out to thwart all attempts at meaningful health care reform. It was the VHCF itself that made a big stink over the use of the word “freedom” by others as if the VHCF has a copyright on its usage. Their attempt to usurp the word freedom is similar to the “fair and balanced” controversy fostered by Fox. In a free America every free person should… Read more »

Tom Licata
3 years 10 months ago

In order to truly flourish, free enterprise requires a strong, vibrant and independent civil society that is free to interact with one another and separate from the coercive nature of an unlimited government. Hence, this requires government to be limited, enabling the free-will of its citizens to creatively interact among themselves. Limited government requires a representative form of government, for without such, the citizens in civil society would spend more of their time directing government than in the free exchange of ideas and commerce that make life enhancing and rewarding; leading to the pursuit of happiness. Finally, representative government requires… Read more »

Walter Carpenter
3 years 10 months ago

Al: several years ago I was almost one of those 60 Vermonters who die each year because of how our health care system works to deny care and then lack of access to health care.

Ron Pulcer
3 years 10 months ago

Mr. Wennberg began his criticism with the “insurance mandates” of the so-called “Obama-Care” law: “Through a combination of the Vermont single-payer ‘Green Mountain Care’ plan and the federal Obama Care program, the government will: 1) mandate that you purchase health insurance …” Obama-Care was based on Romney-Care, the healthcare reform bill that Mitt Romney signed as Governor of Massachusetts. Our neighbor to the south has a healthcare mandate, as part of the Romney-Care law. OK, now can Mr. Wennberg explain why so many of his cohorts in Vermont are publicly supporting (endorsing) Mitt Romney for President, when he was for… Read more »

Karen McCauliffe
3 years 10 months ago

As far as the insurance exchange, do not forget Vermont is doing what no other state is doing by forcing businesses under 50 employees and individuals into the exchange. In all other states including Mass.,it is a choice to go in the exchange or stay out of the insurance exchange. (see #3 in piece) In Vermont, the businesses under 50 employees will see their premiums go up at least 18% and possibly as much as 40% as they are forced into the exchange. Let those employers stay out of the exchange and offer their employees health coverage then let the… Read more »

Bob Zeliff
3 years 10 months ago

Karen McCauliffe Your statement that business with under 50 employees will see their premium go up atleadt 18% possible 40% is flat WRONG. It is a shame that some so called Vermonters are pushing TV and media with information that is wrong…trying desperately to spread fear. It seems you are quoting from that. You should check out the Act 48 Integration Report, that was prepared for the legislature so they would have facts to base their decision on. You can find it on the state web site. Just to get the facts out. Some businesses have long been member of… Read more »

Karen McCauliffe
3 years 10 months ago

Bob, The Chamber of Commerce plan that we have is an association plan and as a small business forced into the exchange our rates will go up at least 18% and possibly 40%! The only state forcing people and businesses into the exchange is Vermont!!! A lot of the businesses in VT under 50 employees being forced into the exchange do belong to associations and their premiums will go up over 18% and possibly as high as a 40% increase. Plus I am speaking of H559 that is the insurance exchange bill. So perhaps you want to check here. The… Read more »

Bob Zeliff
3 years 10 months ago

Karen, I understand that you have had the advantage of low insurance rates via you association. You have enjoyed a self selecting low risk group that has permitted these low rates. You probably have enjoyed these for a long time. There are other small business that have higher risk and much higher costs. It turns out that Individuals have been paying much more that you too. See http://hcr.vermont.gov/sites/hcr/files/RJL%20Final%20Integration%20Report%20Act%2048%20Exchange.pdf page 38 and tables will show you the details of this Some associations will see rate go up 18%, other will go down 8% and the largest numbers of Individuals will see… Read more »

Karen McCauliffe
3 years 10 months ago

Bob, The only businesses being forced into the exchange are small businesses with under 50 employees. No I do not think this coercion represents freedom or liberty. No other state is forcing anyone into the exchange. This is our very first year of using an association. We have had insurance through an association for 3 months not several years, so not a long time as you thought possibly in your response. Many different people and groups can join the Chamber of Commerce and use their health plans. I am not sure what you are calling high risk groups as the… Read more »

walter carpenter
3 years 10 months ago

“No freedom of choice for those business owners and their employees!” Actually, there is more freedom of choice here. Now, employees have no choice. You either take the employer’s plan, if they even offer one, or leave it. In a given company, not all employees even qualify for health insurance from the employer. That is an employee’s choice. If the employer switches plans, say to a high deductible, or health insurance companies, the employee either has to go along or opt out. Those are the choices available. If an employee is lucky enough he or she just might be making… Read more »

Karen McCauliffe
3 years 10 months ago

Walter,If it is truly about choice for those employees that work for businesses under 50 employees then let those employees decide to stay with their employer’s plan outside of the exchange and then let those very same employees jump into the insurance exchange if they desire. Let me emphasize again those employees can, will and are very capable make an educated decision. Plus Walter your premium amounts are way off with the small business owner with the VACE BCBS plan going through the Chamber of Commerce. Consumer driven health plans (high ded. coupled with a health savings account)can be a… Read more »

Craig Powers
3 years 10 months ago

Karen, Walter is 100% committed to his ideals that the State of VT should have Single Payer and that it should be funded with higher taxes on businesses, families and individuals. He really dislikes insurance companies and posts this intense dislike every time he writes on a chat board. I do admire Walter for his devotion to this issue but he does not have any room for compromise with those who disagree with him. I agree that HSA’s do work quite well and they do allow many people to accrue money to take care of themselves in the future. Walter… Read more »

Walter Carpenter
3 years 10 months ago

Karen: I was not going through the chamber of commerce plans. Just individuals, on their own. And high deductible plans are idiotic. I have lived under them before. The only plan that my employer at the time offered. You have to deal with a $2,500, $3,000, $5,000 deductible before you can use the insurance that you are paying monthly for. And for insurance outside the exchanges, the difference will, again, be the affordability of them, versus the exchange. I also bet that private insurers will try to entice younger, healthier workes with the illusions that these low cost, high deductible… Read more »

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