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.

Comments

  1. Avram Patt :

    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 tactics have reared their VERY ugly head, again. Shameful.

  2. walter carpenter :

    “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.

  3. Ann Raynolds :

    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 Exchanges which are only a current, and single payer advocates hope temporary, health care plan. Too many people are confused and mixing up the two very different plans. We hope this is not feigned confusion to spread confusion and misunderstanding; and that it is simply ignorance.

    • Patrick Cashman :

      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.

  4. howie ires :

    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 he can practice his profession without worry, and his health care and his children’s health care is taken care of (their education too, but that’s another topic!).

    Single payer care will attract BETTER health care workers, people who care more about taking care of others than they do about making money, people who want to live in a place where all the citizens have good health care! It will attract MORE businesses, who want to have healthy workers without paying exorbitant health care insurance bills, without spending days trying to decide which insurance provider will actually cover the illnesses you need covered….

  5. Patricia Crocker :

    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

  6. Brad Morgan :

    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?

  7. Wendy Wilton :

    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 :

      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 your concern about the related costs. We can’t do the former without the latter.

      • “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 four years into this? Political concerns???

        Have you looked at the implications of GMC completely ruining the worker’s compensation coverage system in VT, which is in the property casualty side of the insurance market? Why would any PC company continue to insure just the disability side of a claim to pay lost wages when they cannot control the medical cost portion? I have already heard from PC carriers that they will no longer offer WC policies to cover just the disability portion of a worker’s comp claim. What is your answer to that issue when businesses can no longer get mandated WC coverage except from a high risk (and high priced) carrier because there is no market left for WC? Should we start thinking about creating another VT program to help?

        The unintended consequences of this massive change are monstrous when you really begin to look at all the different ways that GMC/single payer will impact all of the other pieces of the economy and our lives. There is no doubt that some form of change is needed but the super majority, who are completely ideologically blinded at this point, are setting us all up for other major pitfalls. I guess that is ok to some, because we will have health care for all, and that is the answer to all the world’s complexities and problems.

      • Wendy Wilton :

        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 then why is the state embarking on a $5 BILLION enterprise without one?

        Re: risk–while individuals, employers, the feds and insurance companies are currently bearing the risk (and spending the money) for about 75% of the state…the state itself is currently bearing only a partial risk for the Medicaid group. Conversely, once we go to Green Mountain Care ALL the risk, and it is in billions, arrives at the feet of the state’s taxpayers and the long term liability will be enormous. For a state bureacracy that can’t even effectively run a 54 bed state mental hosptial, this health care thing is going to be a tall order!

        • Doug Hoffer :

          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 you insist on inflating the numbers to scare people. The only part of the $5 billion currently being spent that is relevant here is the amount paid in premiums (a fact you consistently refuse to acknowledge).

          3. You might think the funding piece is “a house of cards” but that is largely because a) you have badly misrepresented the amount to be raised and b) you insist on refusing to consider a tax based on more than wage & salary income (presumably to avoid taxing the wealthy and that huge amount of unearned income).

          4. Finally, I have no desire to debate you because your projections are deeply flawed and should not be the point of departure for a discussion. Unlike you, I’m in no rush and am content to wait for the state to produce figures that will be the official basis for public debate.

  8. David Kreindler :

    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 we blame the insurance industry for hurting and killing people whose health they purport to ensure?

    Understandable as it is, the fact remains that Mr. Wennberg’s strategy is obstructionism: he is attempting to frighten, confuse and instill doubt, in whatever ways he can. Succeeding at his job would mean that more Vermonters would suffer and die needlessly.

    Tens of thousands of Vermonters are engaged in building a healthcare system that serves our needs. We understand that healthcare is a human right. The barrage of paid advertising that seeks to instill fear, uncertainty and doubt is an annoyance, but it is understandable, and it was expected.

    This barrage of paid advertising from Mr. Wennberg’s group and other servants of the 1% will not distract us from our goal: a universal, publicly-financed healthcare system that provides every Vermonter with the care they need when they need it.

    The vast majority of Vermonters share this goal. We say: Healthcare Is a Human Right.

    • 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?

  9. Joyce Wilson :

    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 will make it even worse.
    http://sbecouncil.org/survivalindex2011/
    Small businesses in Vermont employ 2/3rds of working Vermonters. The payroll taxes suggested in the final report by Hsaio were 14.5% that the employer pays on his income as both employer and employee, then pays 10.9% on each employee. The employee pays 3.6%. Do the math and if you are working for a small business person, you might want to ask if that small business will even be here in Vermont with these payroll taxes? If not payroll taxes, than what taxes will be used to finance the single payer system, to cover the costs of the uninsured, and higher costs if the mandated benefit package is significantly greater than what many now have. If Gov Shumlin and the people that voted for Act 48 have a better financing plan, let Vermonters hear it as we are waiting with open ears.
    I have read comments posted on other blogs since last year and some people have already left the state and others prepare to flee. Just look at the recent falling of home prices particularly in Vermont.
    http://www.vermontbiz.com/news/march/homes-sales-vermont-prices-down
    Home sales are up in Vermont, but prices down 15.4%!!! This is significant and worrying! Yes there were 11 more homes sold in 2012 VS 2011 but note the inventory up almost 2,000 homes in Vermont from last year. Vermonters need to be aware of this worrisome trend. Add to the above a bill that just passed the house to raise our taxes an additional 5%. I can not criticize those who are looking for greener pastures in other states.

  10. Walter Carpenter :

    “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.

  11. Daniel Barlow :

    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.

  12. Estella Leach :

    @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 :

      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.

  13. Art Bell :

    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

  14. Peggy Carey :

    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.

  15. Jason Kelley :

    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 as virtually all of Western Europe.

    Universal Health Care financing isn’t even visionary anymore; it’s been alive and well in developed nations and emerging nations alike for 60 years or longer.

    Let’s shake off this mantle of can’t-do pessimism. We’re VERMONT PROUD and we should be, because we are going to be the first state in the nation to have cost-contained universal health care!

  16. Ellen Oxfeld :

    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 unearned income, and other sources. Also, that payroll might also be graduated. 11% payroll may seem like a lot to a small business, but for the big businesses and muncipalities — they are already paying much more for their health care packages.

    So, of course, a fair mix has to be raised. But the opponents of single payer are just trying to scare people so that single payer will never come to pass. Of course, they have no better suggestions and as Hsiao clearly showed, if we do nothing, we will pay much more (and not everyone will have health care) than we will if we implement single payer.

  17. Bob Zeliff :

    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 us where he gets his 501c4 money. I’d bet it was from out of state and paid by the endurance companies because they are deathly afraid that Vermont will make single payer work and put them out of business in this state. His paid job is to keep the status quo of poor and expensive insurance by spreading miss information, confusion and fear of change.

    His partner in miss information, Wendy Wilton has chimed in. She claims to have a model of Green Mountain Care costs. It is nothing but a miss leading sham. It is not based on a Single payer model, then here are many she could have chosen, nor is base on a model of Vermont self insuring its people like the big companies do…ie IBM. GE etc when that would have been more accurate.
    What she does is choses and out of state traditional insurance policy offered from MVP under Catamount health. Yep Catamount Health! If she is comparing traditional insurance I wonder why she ignores an identical but 12% cheeper policy on the same Catamount web page from Vt Blue cross.

    She then goes thru a whole set of generally bogu assumptions to add cost to this traditional insurance cost. She then…adds them all up and calls it a cost model of GMC.

    What a piece of fiction. The truly sad thing a lot of the Republican leadership have not given her work a critical eye and have bought in to her sham.
    Vermonters deserve better.

  18. Ed Deegan :

    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 simply needs to be fixed.

  19. Tom Licata :

    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. … This is about whether America will move toward social democracy (aka democratic socialism) like many other developed nations, or remain the America of entrepreneurs, individual opportunity, and limited government.”

    The necessary gradualism toward democratic socialism (think “fusion” progressive/democratic Chittenden County State Senator Tim Ashe) has been ongoing in Vermont for more than a decade, and its speed and intensity increased with the election of Peter Shumlin and an overwhelming democratic socialist legislature.

    Traditional democrats (think Grand Isle County State Senator Dick Mazza), whose values are in the free enterprise system, haven’t fully distinguished their values from their “fusion” progressive/democratic rivals, as traditional democratic party faithful continue to gullibly fuel the fire that is Montpelier’s socialist ruse. Electing “progressive” democrats over “free-enterprise” republicans, Vermont’s “traditional” democrats scratch their heads in bewilderment as they continue to vote party label over party values.

    In Vermont, this adult conversation of gradualism, from democratic capitalism to democratic socialism is often quickly extinguished as derisive; ridiculing anyone or any institution who dares to expose these political and economic realities.

    U.S. Senator Bernie Sanders speaks volumes to these realities, this from his Wikipedia page: “Sanders is a self-described democratic socialist and has praised European social democracy.” Bernie, one of the three Presidential electors for the Socialist Workers Party ticket in 1980, is an influential standard-bearer to what is now Vermont’s “fusion” Progressive/Democratic Party.”

  20. Al Walskey :

    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 feel free to use the word freedom or free without it becoming a bone of contention. More important is how the entity that uses a given word actually interprets that word for its membership. For some as the song goes “Freedom is just another word for nothing left to lose.”

    I’m wary of just how sincere VHFC is about adhering the word freedom as it is commonly used. Freedom as discussed by the VHCF in the public meeting sponsored by Senator Brock in Conference Room 10 at the statehouse last March means the freedom to declare, “Health care is a personal responsibility.”

    He who you wish to destroy you must first vilify. The prevailing sentiment expressed by spokespersons in the room was that health issues are created solely by the individual who doesn’t take good of him or herself so they deserve to get sick. By denigrating those who are ill the opponents justify excluding them from the health care debate by characterizing them as the scum of the earth who never did an honest day of work in their lives and have been sucking the lifeblood out of noble taxpayer who is being victimized. If that wasn’t bad enough, the name of Hitler, Stalin, Mao, Pol Pot, the brown shirts and more was invoked to describe health care proponents. Needless to say this is not the way to win friends and influence people. I challenge the VHCF to cut the crap and join in to craft a bulletproof health care plan that will serve the interests of ALL the people rather than the financial interests of the few. WE need to join forces to prevent the death of the 60 Vermonters who die each year because they can’t afford health care! The cynical view seems to be that they don’t matter because they can’t vote.

  21. Tom Licata :

    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 and demands limited government for, without limited government or with a government so inculcated into civil society, the government wouldn’t have anything to represent, as a government-dependent civil society would no longer be “citizens” of their government but rather, claimants on it and ultimately on themselves.

    The United States of America needs a restoration of the principles that lie beneath the free enterprise system and these principles can be found in our Creator-endowed founding document, known as the Declaration of Independence.

    Free people interacting freely among themselves in a free enterprise system and separate from the coercive nature of an unlimited government will provide man the nearest assent possible to excellence and to the divinity of his Creator.

  22. Walter Carpenter :

    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.

  23. Ron Pulcer :

    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 “health insurance mandates”? Of course, that was before Mitt was against the mandates. So Mitt is for “Freedom”, but that was after he was for “Un-Freedom”.

    Flip Flop Fly … Mitt Romney is your guy!

    http://m.mittromney.com/blogs/mitts-view/2012/02/mitt-romney-announces-additional-vermont-endorsements

    Beware to those who endorse the Etch-A-Sketch candidate, Mitt Romney for President. I was a young child when his well-respected father George Romney was Governor of my home-state of Michigan. I was curious why George Romney was respected by people in both political parties and was re-elected. So I recently did some reading on George Romney.

    Gov. George Romney, a Republican, was sympathetic to situation of auto workers (UAW) in the 1960s, and was sympathetic to civil rights movement and the cause of Martin Luther King. Michigan had/has a diaspora of both poor blacks and whites that moved north for manufacturing jobs, and some of them brought their attitudes with them. George Romney in his younger years was a liaison between the U.S. Government and the manufacturing sector, during World War II.

    http://en.wikipedia.org/wiki/George_W._Romney

    “In 1939 he moved to Detroit and joined the American Automobile Manufacturers Association, where he served as the chief spokesman for the automobile industry during World War II and headed a cooperative arrangement in which companies could share production improvements.”

    “In 1940, as World War II raged overseas, Romney helped start the Automotive Committee for Air Defense, which coordinated planning between the automobile and aircraft industries.”

    When I worked at the GM’s Main Plant in Lansing, MI (formerly Oldsmobile), there was a very large B&W mural in the stairwell that showed planes and bombers being built during WWII in the same plant.

    If Mitt Romney pivots during the general election and turns out to hold similar values as his well-respected father, George Romney, today’s GOT (Grand Old Tea) Party members may be very surprised.

    If Mitt Romney shares his father’s values, he may well be sympathetic to minorities, the UAW and working union people, and would want the U.S. Manufacturing Economy and the Midwest (Michigan, et al) to prosper once again.

    Maybe then, if Mitt was like his father George, the United States could “afford” healthcare for every U.S. citizen.

  24. Karen McCauliffe :

    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 employees decide to keep what their employer provides or the employee can jump into the exchange. The employee can make an educated decision. Freedom and choice for all employers and all employees in Vermont just like the freedom and choice offered in all the other states!

  25. Bob Zeliff :

    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 business association and used these to provide their insurance. Some of these associations, are in fact low risk pools. This has allowed them to enjoy the appropriate low costs. Other small business are not low risk..ie farmers, loggers, you get the idea. Their insurance is much more expensive.

    Vermont wants to provide fairly priced insurance to all Vermonters.

    The state did the homework to find out what would happen to the costs if the cost more evenly spread across all people.

    What the report said: Some business in associations could see their rates go up as much as 18%. Other small business would see their rates go down 8%. More importantly the larger group of individuals would see their rates go down 12%. When you put this together in the aggregate there would a net REDUCTION in what Vermonters will pay.

    I think the exchange providing a net reduction to Vermonters overall is a good thing. Moving in the right direction

  26. Karen McCauliffe :

    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 bill should now be in the house.
    http://www.leg.state.vt.us/docs/2012/bills/House/H-559.pdf

    It is already difficult being a small business in this state. Did you realize that small businesses employ 2/3rds of working Vermonters? Did you realize that in the 2011 Small Business Survival Index that Vt was ranked 48th (best to worst)?
    http://www.sbecouncil.org/survivalindex2011/

    Again,let me emphasize let the small business owner decide to offer coverage out of the exchange and then let the employee decide to take this health plan or the employee can jump in the exchange! The employees are very capable of making an educated decision. Liberty and freedom for all ,both the employers and employees just like the liberty and freedom offered in other the other states!!!

    The only reason that businesses are being forced into the exchange is to get the federal subsidies!!! It is not about the employers and employees that are forced into the exchange!! Freedom and choice for all even in VT!!!

    There is even concern about how much that rates will go up for the people that are now Catamount and VHAP when put into the exchange.

  27. Bob Zeliff :

    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 their rate go down 12%.

    I think most people in Vermont can say they have had to work hard. ..business and individuals. It is precisely for this reason we need to make health insurance cost as low as possible and, at the same time, level the cost to be equal for all business and individuals. This is precisely what the Vermont implementation of the Exchange does. For you it seems your rates will go up. This is because you have enjoyed lower than typical rates for some time. In the future you will be paying the rates equal to other Vermonters. Seems fair.

    You want to opt out. have a special exclusion so you can avoid paying what the rest of us have to. Ding so is in your self interest,. I, and many Vermonters, favor being fair to all Vermonters, especially when the aggregate total cost of insurance will go down.

    It seems that you call for your freedom and liberty really means you want to pay less and do not care that means others will have to pay more. I don’t think that aligns with the Vermont ethos of every one pulling their equal load.

    I have heard much over the last several years why Vermont is poor for business, expensive, etc, etc. We are now just beginning to exit the worst recession in 70 years. Our unemployment rate is among the very lowest. Our housing prices have held up among the best. Our foreclosure rate is among the lowest. We must be doing something right. Not that is not a lot or room for improvement. I see Green Mountain Care as part of that improvement. I see taking the cost of insurance off business as a way to make business more competitive. Businesses in Europe, Asia do not have to include health insurance in their costs…would you like that too?

  28. Karen McCauliffe :

    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 private insurance industry does not even factor in cigarette smoking etc. The Chamber of Commerce serves the communities and does not screen business people or their employees to decide if they can purchase their VACE BCBS.

    There are numerous groups throughout the state such as teachers that band together for insurance and to get lower rates. They are not being forced into the exchange! The only ones being forced into the exchange are the businesses with under 50 employees. Give everyone freedom the freedom to stay out of the exchange, or jump into the exchange if they so choose. I think that is truly fair. Liberty and freedom for all groups but not forcing one group into the exchange, particularly when no other state is requiring it.

    You are right that it is encouraging with Vermont’s unemployment rate.

    Housing although is quite discouraging with a recent article in Vermont Biz.
    http://vermontbiz.com/news/march/homes-sales-vermont-prices-down
    Only 11 more houses were sold, but the inventory went up almost 2,000 units (that is a lot for our small state) while the median price went down almost 15.4%. We did much worse than the rest of New England.
    Just looking at real estate on http://www.zillow.com for Vt is quite discouraging. Zillow is only a projected estimate, but a lot of people do utilize it when purchasing a home in and out of this state.

    This was also not encouraging information.
    “Report: Fewer newcomers call Vermont home”
    “…In 2010, however, that changed. Vermont saw a net loss of income for the first time since the IRS began to publish this data. According to the latest report, 13,422 people moved into Vermont in 2010. Their total adjusted gross income was $353.9 million. The same year, 14,071 Vermonters moved away. Their income added up to a bit more: $356.3 million.” I hope that this is not the beginning of a downward trend.
    http://vermontbiz.com/news/january/report-fewer-newcomers-call-vermont-home

    I do not think that the cost of health care will be taken off the businesses as I am almost certain that a lot of the taxes will be in payroll taxes and possibly gross revenue taxes to pay for Green Mountain Care. Dr. Hsaio put high payroll taxes in his report. Whatever the mix of taxation devised to support GMC, it will likely be high, based on Hsiao’s assessment. We need to address the issue of taxation for GMC sooner, rather than later as I am concerned with seeing both those Vermont Biz articles above. Prolonged uncertainty is not good for our state.

    We will have to agree to disagree and have the right to our own opinion. I feel very strongly that freedom of choice is being usurped for the businesses with under 50 employees that are being FORCED into the exchange! Again I emphasize that VT is the only state forcing anyone into the exchange! No freedom of choice for those business owners and their employees!

  29. walter carpenter :

    “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 enough of a salary to afford a $400-$600 monthly premium (individual plans) with a deductible of anywhere from $2,500-$5,000, paying roughly $10,000 before they can use the insurance. If they are even luckier and deemed income eligible they might be able to get onto catamount, but they have to watch their income. $10 over and they get thrown off. Choice depends on income. Good luck.

    An employee will have more choices within the exchange. They can choose what plan they want from the menu. They can move around They will not be tied to an employer’s plan. If they are laid off or their job is eliminated they do not lose their health insurance like they do now. This happened to me once during a highly life-threatening illness and I needed an operation, but did not have any insurance because my job had been eliminated. Try that and see how it feels.

    And, in this situation, try getting insurance and see how far you get. To help employees pay for insurance on the exchanges there are tax credits and federal subsidies that have come in. One can argue, of course, the merits of this, but the real problem is that our market-based health insurance is impossibly expensive for what we get for it. As for premiums rising by 18%, that is rather small considering that 20-30% premium raises is not uncommon. In California 50% rate hikes have been in vogue. Health insurance companies, in Vermont and elsewhere, are doing quite well. Even in the height of the recession they could afford to drop a million a day of our premium money to channel the health care reform effort like they did.

    As for employers losing choice with the exchanges, they also gain the freedom of not having to be insurance agents. As one small business man told me recently, “we’re business people, not insurance agents.” Small business people (if they can afford to offer insurance) will no longer have to swallow offering some employees insurance, but not others. I know business people who do their damnedest to insure their employees, but are uninsured themselves. Bob has a point when he said “I see taking the cost of insurance off business as a way to make business more competitive.” A small business that does offer insurance to its employees cannot compete with a business that does not.

  30. Karen McCauliffe :

    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 very good product in Vt where preventative care is covered at the first dollar and at 100%. But Walter the issue is since you are so concerned about the employees ,let the employees look at the coverage that their employer is offering out of the exchange and then if they want jump into the exchange.

    I posted a comment before Walter to see the issue that we are addressing here.

    Fortunately, in the great US ,we do have liberty and freedom of choice to move to other states if we think that we are being discriminated against in anyway. Vt is the only state in the entire US forcing any group into the exchange! In fact, a neighboring state did not even set up an exchange!(also in that neighboring state their 2011 Small Business Survival Index was 33rd instead of 48th..(best to worst) http://www.sbecouncil.org/survivalindex2011/
    Live free or die,I like that motto!

    • Craig Powers :

      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 does not like the HSA concept because he feels that health care should be cheap and plentiful. It reminds me of that quote:

      “If You Think Healthcare is Expensive Now, Just Wait Until it’s Free!”

  31. Walter Carpenter :

    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 plans outside the exchange are better, thereby throwing the sicker ones into the exchange and spreading the costs unequally, and weakening the exchanges. Then, of course, the private costs will go way up too. A hunch.

    You say that in the great USA we can move to any state we want. You are both right and wrong. Right, of course, in that we can move to any state. Wrong in the realm of health care since the states are unequal here. I have a significant medical past behind me. If I wanted to move to another state and get health insurance, my freedom of choice is restricted to those states with a fairly enlightened health insurance system — like Massachusetts, Oregon, or Vermont for example. I am not including any special circumstances here, as if I were doing it on my own. If I wanted to move to New Hampshire, for example, I would probably be refused for insurance and then there is nothing else for me unless I could qualify for medicaid.

    If I were retired it would be diffierent Then I would have a national health program called Medicare, where I could retire to any state that I wished.

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