Brock releases market based health care framework as counter to Shumlin’s single-payer proposal

Senator Randy Brock. VTD/Josh Larkin

Senator Randy Brock. VTD/Josh Larkin

Republican gubernatorial candidate Randy Brock released his vision on Friday for a “patient-centered” health care system that he said is fundamentally different from the single-payer proposal by the Shumlin administration.

The first line of the six-page document, however, could be a line from Gov. Peter Shumlin’s health care reform initiative. Brock wrote:  “As Governor, one of my highest priorities will be to ensure that every Vermonter – 100% – has access to quality health care at an affordable cost.”

From there, Brock describes two paths through the forest of health care choices that are fundamentally different: Shumlin’s, he wrote, leads to a government-run system with the specter of higher taxes and rationing; the other, his approach, takes the state toward a system, similar to the one we have now, in which “the power of individual consumers and the free market can drive the transformational change needed, just as they have done in every other aspect of the American economy.”

Brock says his reforms would keep health care costs under control through “prudent regulation, free choice and abundant competition.”

The state senator from Franklin County said his health care plan would place an emphasis on “patient-directed” care, a stronger safety net, competition and personal responsibility.

Brock consulted with health care, public policy and insurance experts on the plan, but no single health policy “czar” helped draft the document. He drew inspiration for the plan from policy initiatives in the states of Maine, Idaho and Indiana.

The proposal contains concrete qualitative proposals, from allowing Vermonters to buy insurance from licensed insurers throughout New England, to introducing patient smart cards and allowing health plan discounts for healthy lifestyles.

Much of the white paper, however, is dedicated to a direct attack on Shumlin’s single-payer initiative.

Brock says the governor’s reforms “will lead to rationing through global budgets, will drive up the cost of medical care, discourage physicians and dentists from moving to Vermont, make it difficult for businesses to add jobs and put critical health care decisions in the hands of five unaccountable government appointees (the Green Mountain Care Board).”

On the other hand, medical tourism could become an industry in Vermont, he said, for cosmetic surgery and orthopedics specifically, if revenue caps were lifted from providers under Shumlin’s plan. VPIRG sniped at that idea in a statement: “This is hardly the kind of health care reform that most Vermonters have in mind…They are not likely to be satisfied by having Vermont become the destination du jour for tummy tucks, facelifts and breast implants.”

Brock’s health care agenda receiving a mixed reception from experts and political activists.

Critics said Brock’s proposal contained little detail, wasn’t realistic politically, and would likely undo the progress the state has made toward affordable health care.

Alex MacLean, Shumlin’s campaign manager, said Brock wanted to return to a pre-1991 “broken system,” in which “the elderly, the sick, and those Vermonters with pre-existing conditions were often denied coverage.”

MacLean argued that Vermonters could see their health care costs rise dramatically, by up to 300 percent, if Brock’s recommendations for modifying Vermont’s community ratings were carried through.

Brock defended his vision by first attacking Shumlin’s alternative as “schlerotic,” but he said he believed that reinsurance pools funded by taxes on health insurance could increase affordability, and that a competitive and free health care market would bring down costs.

Brock called such concerns about the lack of detail in the plan as an “utterly disingenuous” critique from those in the single payer camp. Under the governor’s plan, he said, “you don’t know what’s going to be covered, who’s going to be covered, where you’re going to get it from: you know absolutely nothing.”

“My plan is more detailed than the single payer plan, and they spent a year and a half, $100 million and 100 people on theirs,” insisted Brock.

Donna Sutton Fay, policy director for the Vermont Campaign for Health Care Security Education Fund, said that bringing more health insurance firms into the state to increase competition hadn’t worked in the past.

Fay felt that Brock’s criticisms of Shumlin’s plan, sprinkled throughout his proposal, were not particularly informed. These include the claim that under Shumlin’s proposal, quality of care would worsen.

It would also be “a huge reverse of course” politically, said Fay. “I just don’t think the Legislature is going to undo all the work it’s done in terms of moving to single payer. I don’t see that as a reality as all.”

Brock said the changes he suggests would be incremental and could be politically cumbersome.

Prominent conservative John McClaughry, vice president of the Ethan Allen Institute think tank, rattled off some sentiments he agreed with while skimming through Brock’s proposal.

“Consumer choice, a crucial ingredient in any such plan … personal responsibility, absolutely … Robust choice, yes …” murmured McClaughry. He prefaced his remarks by saying that health care is a huge topic, where “a six-page paper isn’t going to do justice to the complications.”

In a phone interview, Brock emphasized that his plan was a broad framework. He lacked the needed funding, he said, of up to $300,000, to produce a detailed policy proposal.


Nat Rudarakanchana

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71 Comments on "Brock releases market based health care framework as counter to Shumlin’s single-payer proposal"

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walter carpenter
3 years 11 months ago
“Shumlin’s, he wrote, leads to a government-run system with the specter of higher taxes and rationing.” Rationing? How can we ration more efficiently than we already do now? And government-run means that it is run by us. Why do we want it run by the insurance cartels? “reinsurance pools funded by taxes on health insurance could increase affordability, and that a competitive and free health care market would bring down costs.” Competition has never reduced costs before. Why will it work now? It also has the added benefit of excluding people who need care. I suppose that under this scheme… Read more »
3 years 11 months ago

Here’s an exercise: go to your nearest favorite internet search engine and search on the following: “us insurance companies exempt from antitrust laws”.

Then ask yourself just what competition is Mr. Brock talking about?

ruth sproull
3 years 11 months ago
Market-driven health care is just a rallying cry employed by demagogues with a specific ideology about how EVERYTHING should work economically. It doesn’t work with health care because health is too unpredictable and things like drive, initiative, creativity and personal responsibility often have little effect on one’s ability to keep healthy. Often it’s just the crap shoot of genetics, environment and yes some personal choices but the mix just boils down to whether or not you’re lucky. Therefore, this is an area where the “rugged individualism” model employed by the right is completely out of step with the reality of… Read more »
Kelly Cummings
3 years 11 months ago
It is telling that Randy Brock seems adamant about protecting the insurance company’s profits. This is kind of like trickle down economics….it didn’t work then and it won’t work now. Let’s face it, if it did….there would be more jobs than people and everybody would be healthy! There would be no preventable deaths, no medical debt, no bankruptcy. Right…. “This is hardly the kind of health care reform that most Vermonters have in mind…They are not likely to be satisfied by having Vermont become the destination du jour for tummy tucks, facelifts and breast implants.” Really Randy? You belittle yourself… Read more »
Kelly Cummings
3 years 11 months ago
VPIRG sniped at that idea in a statement: “This is hardly the kind of health care reform that most Vermonters have in mind…They are not likely to be satisfied by having Vermont become the destination du jour for tummy tucks, facelifts and breast implants.” It was kindly brought to my attention that I had mis-read the above and that it was not Randy Brock who made this statement. So my apologies to you Mr. Brock. Instead, if I now have it correct, you said: “On the other hand, medical tourism could become an industry in Vermont, he said, for cosmetic… Read more »
Dan McCauliffe
3 years 11 months ago
Vermont’s current single payer plan of developing a government administered single payer system that utilizes global budgets to ratchet down health care costs, is very similar to Canada’s single payer health care system. Gubernatorial candidate Randy Brock’s health reform plan develops a universal access system that is much more similar to Switzerland’s mixed payer health care system. Switzerland’s health care system is considered to be one of the best in the world while Canada’s system is not highly rated. In a 2010 Commonwealth Fund study Canada ranked dead last in terms of timeliness of access to care and quality of… Read more »
Craig Powers
3 years 11 months ago
Well researched and well written, Dan! We can create the necessary reforms if all points of view are considered. The British, Taiwanese and Canadian systems are going broke, so clearly those systems will not survive much longer than our current US model. To keep ignoring that simple fact will only further drive costs upward and dumb-down quality. The argument that the outcomes are better and that everyone is covered might hold a little water right now, but that argument will not hold true for long because the single payer system is as economically unsustainable as the present system.
Dan McCauliffe
3 years 11 months ago
Michael, Why has Shumlin and the Vermont legislature chosen a Canadian type system over the Swiss type system, when the Swiss type mixed payer system is superior to the Canadian single payer system? Shumlin and many single payer advocates have not realized that the vast majority of European countries do not have the Canadian type single payer systems. Many European countries have mixed payer systems, and the better systems usually follow the Bismarck model, like the Swiss system. Randy Brock is proposing a mixed payer system that offers universal access to health care for all Vermonters. A mixed payer system… Read more »
walter carpenter
3 years 11 months ago
For one, who says that Vermont is copying the Canadian system? Perhaps we may incorporate some facets of it, but maybe not all of the canadian system, the key word being system here versus the confusing hash we have. For the record, Canadians have private insurance too. And it is in your eyes that the Canadians system is failing. It is undergoing changes, like all health care systems do, but it is not failing. The conservative Harper administration is trying to put more of it out to privitization, as a Montreal family told me. They are running into much resistance.… Read more »
Karen McCauliffe
3 years 11 months ago
Walter, You question “who says that Vermont is copying the Canadian system?” Answer: William Hsaio, the professor who developed Vermont’s single payer plan said that Vermont’s system would resemble the Canadian single payer system. He also helped devise the Taiwan single payer system, modeled after the Canadian system. The Taiwan system is having significant problems, including financial difficulties, overworked and demoralized health care workers, and a shortage of doctors. Walter once again you leave the same misleading comment that I previously corrected you on, in another post: Here is my previous response to your comment that “Canadians have private insurance… Read more »
walter carpenter
3 years 11 months ago
“He also helped devise the Taiwan single payer system, modeled after the Canadian system.” Karen: This is completely incorrect. While Dr.Hsiao does admire the british/canadian systems, he did not incorporate them into his designing of taiwan’s system. He used elements of them, but he did not model taiwan’s system after either of them. Instead, he used what was already in place in Taiwan and worked from there. Taiwan is a public-private type system. Its problems stem from a reluctance of the politics to increase the low rate of spending on health care that they enjoy for fear of igniting a… Read more »
Patricia Crocker
3 years 11 months ago
Walter, you say, “Compare it, however, to the millions of Americans who cannot get colonoscopies because they lack the access to care, and how many that die because of it.” Please cite your reference to this number. Hospitals are obligated to provide services to anyone who walks throught the door. If someone cannot pay for a colonoscopy, they can still get it. I have not read any study that talks about widespread deaths, as you state, from cancer because people cannot pay for a colonoscopy. I have, however, read something about people dying because they avoided getting colonoscapies because of… Read more »
walter carpenter
3 years 11 months ago
“Hospitals are obligated to provide services to anyone who walks throught the door. If someone cannot pay for a colonoscopy, they can still get it.” Patricia. Are you sure about that? I know, for example, that hospitals are required by law to stabilize and tend anyone who walks through the door, but not to cure them. I did not know that you could walk in and still get a colonoscopy if they cannot pay for it. And if a colonoscopy, who is it that pays for it if they cannot? Us. Have you tried being uninsured and trying to get… Read more »
Paula Schramm
3 years 11 months ago
Dan McCauliffe states: “Randy Brock’s health reform plan develops a universal access system that is much more similar to Switzerland’s mixed payer health care system”. He has not paid attention to his research at all. There is NO basic similarity ,that I can tell through this article, with what Randy Brock is proposing , and the Swiss system, as others have pointed out in these comments. His plan is based on the plans of Maine, Iowa and Indiana, which as far as I know do not mandate that everyone buys health care insurance as the Swiss system does, and do… Read more »
Dan McCauliffe
3 years 11 months ago
Paula, You say, “His plan is based on the plans of Maine, Iowa and Indiana, which as far as I know do not mandate that everyone buys health care insurance as the Swiss system does” Starting in 2014 everyone will have to purchase health insurance, under the ACA (ObamaCare) law. It is a given that Brock’s plan will have to be in compliance with the federal law. There is also a federal mandate for a basic level of health care coverage, that again, Brock’s plan will have to be in compliance with. If Romney gets elected and the ACA law… Read more »
David Bell
3 years 11 months ago

Dan,

Brock’s plan is nothing, and I must stress again, nothing remotely similar to the Swiss system. In order for Brock’s plan to resemble the Swiss system, it must actually incorporate most of the significant elements of the Swiss system. Elements like mandates, subsidies and regulations; none of which are present in Brock’s plan.

The insurance mandates under federal law are a separate issue.
Just by being in a country that has incorporated an element of the Swiss system (mandates) does not, in any way, mean Brock’s plan resembles the Swiss system.

It’s not a difficult distinction.

Dan McCauliffe
3 years 11 months ago
David, The point I have been trying to make is that the best health care systems in the world that offer universal coverage are mixed payer systems, not single payer systems like Canada. I mention the Swiss system, as an example of one of these highly rated systems. My original post said that Shumlin’s single payer plan was more like the Canadian system and Brock’s plan was more like the Swiss system. I did not say Brock’s plan would be identical too, or very similar to the Swiss system. His emphasis on consumer driven plans to constrain health care costs,… Read more »
David Bell
3 years 11 months ago
Dan, You have falsely claimed that Brock’s plan is like the Swiss system. I have pointed out it is not. Furthermore, Brock’s emphasis of “market based solutions” could, charitably, bear a great deal of resemblance to the Texas healthcare reforms that have left more people without affordable insurance. While I believe many of us do want “universal and timely access to high quality and affordable health care”, your obfuscations and inability to acknowledge that the Swiss system is based on subsidies, mandates and regulations demonstrates you are not one of this group. You simply seem to want less government involvement… Read more »
Paula Schramm
3 years 11 months ago
Dan McCauliffe – David Bell & Deb Richter have made many points in answer to your repeated attempts to find similarities between Brock’s plan and the Swiss health care system, so I will let my statement stand that there ARE no basic similarities. I would just like to clarify something else. In your reply to me you mention the ACA, or Obamacare, as a mandate to buy health insurance with which Brock’s plan would have to comply. That of course is not the same as in the Swiss system. Their mandate works so that everyone does end up with health… Read more »
David Bell
3 years 11 months ago
Karen, I find it ironic that you provide a number of misleading statements after calling Walter’s comment misleading. Hsaio states that Vermont’s system would resemble Canada’s, resembling a system and copying it are two very different things. Furthermore, despite your repetition of the tired canard that Canadians are ulcerating to eliminate their healthcare system and replace it with private insurance, actual evidence shows that Canadian approval of their healthcare system is significantly higher than approval by US citizens for our healthcare system (http://www.webmd.com/healthy-aging/news/20041029/us-health-care-satisfaction-trails-others, http://scienceblogs.com/denialism/2009/05/22/are-patients-in-universal-heal/). No system is perfect, which is why it is very simple to point to an example… Read more »
Karen McCauliffe
3 years 11 months ago
David, I am not arguing for the status quo. I am arguing that we should look at other systems than the single payer systems due to the problems with the single payer systems. I have never said the Canadians are envious of the US system. Read the link I posted above…Depending on the outcome of the Canadian Supreme Court, Canadians may end up with a mixed payer system like most of Europe. That is what I am advocating for, a system like the Swiss system that is not as problem prone as the single payer systems. We can quibble about… Read more »
David Bell
3 years 11 months ago
Karen, Again, you are making false assertions regarding Brock’s plan. Randy Brock’s plan does not, as you claim “call for universal access for all Vermonters to health care, via a mixed payer system, like the highly rated Swiss system”. Randy Brock’s plan calls for nothing more or less than the magic market solution that has been used in Texas for the past decade. This system has utterly failed to provide universal healthcare, make healthcare more affordable or do anything that bears even the faintest, most remote resemblance to Swiss healthcare. Swiss healthcare is a combination of healthcare mandates, subsides based… Read more »
walter carpenter
3 years 11 months ago
David: Thanks so much for your post. I had not seen it when I replied to Karen’s criticisms of my earlier post. You covered much and I would have quoted from it, but did not see it until after I had posted my reply to Karen. Thanks again. You are right about the Canadian system in that they are not about to adopt what we have. In fact, the Canadians I meet (and I meet a lot of them) have told me that they are amazed that we tolerate what goes on down here. They are stunned. While their system… Read more »
David Bell
3 years 11 months ago

Walter,

Good to hear from you as well.

I imagine Douglas had to put up with the same naysayers in his day; can’t let it get you down.

3 years 11 months ago

Mr McCauliffe- I think most of us would be happy enough if we had a system similar to any other system in the industrialized world…including the Swiss system. I rather doubt that Senator Brock is endorsing a Swiss system where they enforce heavy regulation of their private insurance companies, have uniform benefits, uniform reimbursement and their tertiary care is for the most part publicly financed. Is that your interpretation of what Senator Brock is advocating?

Dan McCauliffe
3 years 11 months ago
Dr. Richter you deserve much credit for pushing Vermont forward toward the development of a single payer health care system. You and other single payer activists lobbied Montpelier and encouraged Peter Shumlin to hire single payer advocate Dr. William Hsiao to make a proposal. Dr. Hsaio offered three options (2 single payer options, and a public option). He endorsed one of the single payer plans that became the foundation of Act 48, our single payer health care law. However, Dr. Hsaio never offered us a Swiss style option. I wish he had. I was once a proponent of single payer… Read more »
Dan McCauliffe
3 years 11 months ago
Michael, As I previously mentioned to Paula earlier, starting in 2014 everyone will have to purchase health insurance, under the ACA (ObamaCare) law. It is a given that Brock’s plan will have to be in compliance with the federal law. You do not need a public option to achieve universal coverage. The Swiss system has no public option. Brock’s plan is to cover 100% of Vermonters, and that means universal access. Read his plan at the link in this article above. “Brock emphasized that his plan was a broad framework. He lacked the needed funding, he said, of up to… Read more »
Ross Laffan
3 years 11 months ago
Marving Malek used cite the example of the state of Texas where they have large numbers of insurers but, also, the largest number of uninsured in the country. Is that still the case? According to the Washington Post 26 percent of Texans are uninsured. In the end, what we have now is unacceptable. What would happen if the United States adopted a single payer style health care system? For decades, we have operated with a system that allows for tens of millions of uninsured. Would single payer be worse than that? Why isn’t it possible for this country to figure… Read more »
Allison Costa
3 years 11 months ago
One group understands individuality and the health of competition. Another group wants to hand something over and consolidate, but at what price? “government-run means that it is run by us” – you mean, like the ex-public, now government schools? I think individuality matters in education and in health care. I keep seeing the “individualist” camp hunkering down and being willing to work toward their goals. I keep seeing the “one world/we are all in this together/let’s share the misery and the joy/socialist” camp believing in, what? So far all I can see are hand-outs. If you haven’t, please read your… Read more »
3 years 11 months ago

I guess if you don’t participate in the running of your local public schools then governance is indeed a distant thing – on the other hand if you avail yourself of the many opportunities open to Vermonters and local school districts then governance is at the kitchen table each and every day.

Your choice.

David Bell
3 years 11 months ago
Allison, We have a system of healthcare designed by the “individualist” camp; and it shows a belief in profits to the rich put ahead of healthcare for the poor, medical bankruptcies and constant misery shared by the poor in order to line the pockets of the rich. The “socialists” in Vermont do not want “handouts”, they want a system of healthcare that is affordable for all, that protects societies most vulnerable and is run by the people and for the people. You suggest we “read history”, perhaps you should try looking at the effectiveness of healthcare systems by country. The… Read more »
Patricia Crocker
3 years 11 months ago
Jeffrey Wennberg and Bob Gaydos did an unscientific study of “medical bankruptcies” in Vermont by surveying law practices who deal in bankruptcy law. They found no evidence of “medical bankruptcies” by anecdotal reports from these law practices. What they did find was that people were bankrupt because they lacked disability insurance and their disability prevented them from earning a wage to pay bills, including mortgages. Bob Gaydos whose company deals with medical insurance, tells people (to the detriment of his own income) that if they cannot afford both, they should purchase disability insurance, NOT medical insurance, because they can still… Read more »
Patricia Crocker
3 years 11 months ago
you also state, “he “socialists” have us beat by most significant metrics; in the US we spend more for worse results.” What is your source for this statement? First of all, the US spends more money because we can. Many people pay more for private rooms in the hospital, and they also pay for elective procedures such as cosmetic surgery. Did you know that if you take into account accidents and homicide, that the US actually has the highest life expectancy? Did you know that the infant mortality rate is higher in the US because we bring more high risk… Read more »
Patricia Crocker
3 years 11 months ago
David Bell
3 years 11 months ago
My source for our high cost/low quality healthcare system: “The findings make clear that despite high costs, quality in the U.S. health care system is variable and not notably superior to the far less expensive systems in the other study countries,” (http://www.politico.com/news/stories/0512/75851.html#ixzz264VYKWNw” You ask ” Did you know that if you take into account accidents and homicide, that the US actually has the highest life expectancy?” I know right wing fanatics repeat this lie to other right wing fanatics; I also know this claim has been thoroughly disproved (http://theincidentaleconomist.com/wordpress/how-flawed-is-life-expectancy/). In summary, we spend more money, not because we can, but… Read more »
Allison Costa
3 years 11 months ago

I am thinking the answer is a balance of the two: individual choice and competition to keep costs down, and a social contract to aid those who ask for it.

Paula Schramm
3 years 11 months ago

Allison Costa – What you are describing here:

“I am thinking the answer is a balance of the two: individual choice and competition to keep costs down, and a social contract to aid those who ask for it ”

sounds to me a lot like our complex collection of (non-)systems that the U.S. now has , and which has become so expensive, while not giving everyone access to adequate health care.
As long as there is the profit motive driving insurance companies, they will continue to make money by denying care….there has got to be another way !

Paula Schramm
3 years 11 months ago
“One group understands individuality and the health of competition.” They don’t seem to understand that “health of competition” has brought us an extremely flawed , inequitable health care situation where insurance premiums skyrocket at much greater than the rate of inflation, half the individual bankruptcies are due to health care bills and 81 million Americans are under- or uninsured. And we spend nearly twice as much as all other industrialized countries, and with worse over-all outcomes. The individuals getting killed are literally the 40,000 people who die every year in our country from lack of access to health care. When… Read more »
Patricia Crocker
3 years 11 months ago

Please provide references to your statistics.

Paula Schramm
3 years 11 months ago
Patricia Crocker – you wrote at the start of your earlier very glowing description of the strengths of health care in the U.S. , asking someone else in reference to their post : ” the “socialists” have us beat by most significant metrics; in the US we spend more for worse results.” What is your source for this statement?” I would like to recommend reading T.R. Reid’s book “The Healing of America- a global quest for better,cheaper, and fairer health care.” It is full of facts, figures & comparative studies, with plenty of footnotes. It is also much more than… Read more »
Paula Schramm
3 years 11 months ago

That’s 700,000 people that go bankrupt because of medical bills EVERY YEAR.
( Since this figure is from a study done before the 2008 economic collapse, I would guess that the figure is much higher now .)

Walter Carpenter
3 years 11 months ago

“Why are you willing to kill the individual in order to amass a large group of basically dead (powerless) people?”

Alison, what makes you so sure that we will be dead and powerless under a single-payer type system versus being completely dead and powerless under the market-based system that we have now? Ever have to fight a denied claim against a private insurance company bureaucracy? And why is it killing individuality? What is individuality, anyway, without the group to support it?

Allison Costa
3 years 11 months ago

Individuality is not ever, ever defined by a group.

David Bell
3 years 11 months ago

Isn’t that the choice of the individuals?

What gives you the right to speak for other people as to how they define individuality?

Patricia Crocker
3 years 11 months ago

Depends on what your definition of “is” is.

Allison Costa
3 years 11 months ago

Was not trying to speak for other people! Just giving my understanding on what appears to me as an absolute. 🙂

3 years 11 months ago
Mr. Brock’s plan of unrestricted proliferation of out of state insurance companies in spite of past predatory practices as a solution for health care reform is no reform at all and is why we have community rating. It would guarantee making a bad situation worse for the 190,000+ Vermonters that are now uninsured or underinsured. His mantra of “free market health insurance” advocacy makes him a more suitable candidate for president of AHIP (American Health Insurance Plans), the insurance trade association and lobby group than for state wide office. Maybe this position is required to secure financing from the insurance… Read more »
Patricia Crocker
3 years 11 months ago

“contained little detail, wasn’t realistic politically, and would likely undo the progress the state has made toward affordable health care”

Was there sufficient detail in the plan that our Legislature passed (Act 48) when they headed us in the direction of single payer? They gave no specifics about what was to be covered
and how much it would cost. They essentially said, “let’s pass this bill so we can find out later what’s in it”. Seems to me I’ve heard that story before.

David Bell
3 years 11 months ago

I assume you mean the Republican party’s promise to tell us what their tax plan is after they get elected.

If you are referring to the sad, pathetic, provable false statement that Nancy Pelosi and the Democrats passed the ACA without reading it, then it’s time to turn off the Fox News; not only was the ACA thoroughly debated before the vote, it was available online to anyone who bothered to read it.

Which I am guessing did not include you.

Patricia Crocker
3 years 11 months ago
How can anyone read 2000 plus pages of a document filled with legal jargon? I’m guessing you read the whole thing David? It has been stated by a majority of our legislators that they could not read the document before the voted for it, simply because they would have had to be certified speed readers to fit it in between the time it was released and when it was voted on? To this day, we are now finding things in this bill, that no one knew anything about (even the people who wrote the bill)and the unintended consequences that were… Read more »
Patricia Crocker
3 years 11 months ago

ACA summarized in one sentence, http://www.youtube.com/watch?v=DRGq5ZSJ3Ys

David Bell
3 years 11 months ago

I will turn your mantra around on you.

Please cite source proving that the majority of legislators did not in fact read the bill before voting on it.

Furthermore, please prove that “we” are still finding out what is in the ACA.

And use actual evidence, rather than youtube videos.

Karen McCauliffe
3 years 11 months ago
“Is Brock going to provide subsidies based on income levels to insure that everyone can afford healthcare? Will he pass laws requiring every citizen to purchase healthcare?” (Michael Stevens’ questions above) Here is from Randy Brock’s more depth analysis that I found at his website… “Ensure that the Health Insurance Exchange, established under the federal health care law, is easy to use, clear and has an abundance of choices.” So yes, Randy would have the insurance exchange go forward and as long as the federal subsidies keep coming into the state of VT. To address the question, “Will Randy Brock… Read more »
Jason Farrell
3 years 11 months ago
Check out this bullet from Mr. Brock’s “Plan” “Gradually reduce and eventually eliminate the vicious cycle of the cost shift under which government programs (Medicaid, VHAP, Dr. Dinosaur, Catamount) systematically underpay providers, who in turn shift the uncompensated costs to private insurance customers. This shift makes private insurance less affordable, creating more uninsured people, and driving more people into underfunded government health care programs. Providers would need to agree to reduce the present cost shift to private insurance by the approximate amount of the increased state payments.” This gem is hidden under the heading “PROTECT PATIENTS WITH REASONABLE RULES” on… Read more »
Dave Bellini
3 years 11 months ago
I hope whatever the future is, that it provides Vermonters who need medical care to receive it and without going broke. I’m less certain an all government system is the best solution at a state level. It could be a system that meets the needs of all Vermonters, but will it? What guarantee is there, that promises made today will be kept? What happens if Vermonters elects another conservative Governor? Do people really trust that a new health plan model would be left alone? I can tell you from 34 years experience in state government that state programs are political… Read more »
Paula Schramm
3 years 11 months ago
“the power of individual consumers and the free market can drive the transformational change needed, just as they have done in every other aspect of the American economy.” This quotation from Randy Brock just stopped me in my tracks. The 2007 economic disaster, caused in considerable part by the Wall Street titans of our “free market” system, is still so heavy on my mind – because the middle class has as a result lost 40% of its net worth ! That just might not be the best model to “drive the transformational change needed” for universal health care, since it… Read more »
3 years 11 months ago
This remark by Walter Carpenter caught my eye: “Taiwan is a public-private type system. Its problems stem from a reluctance of the politics [sic] to increase the low rate of spending on health care that they enjoy for fear of igniting a revolution:)” Yes! There is nowadays no practical limit on the amount and expense of health care that the public can consume. Under single payer (Green Mountain Care), the Vermont public will be given as much health care as the GMC Board can persuade the legislature to pay for with ever increasing taxes. In fact, the single payer advocates… Read more »
3 years 11 months ago
I was struck by this line from Walter Carpenter: “Taiwan is a public-private type system. Its problems stem from a reluctance of the politics [sic] to increase the low rate of spending on health care that they enjoy for fear of igniting a revolution:)” Yes! Nowadays there is no practical limit on how much health care services a public wants. There is a very practical limit on how much legislatures will vote in increased taxes to support a single payer system. That’s why the UK, Taiwan and Quebec health systems are chronically “underfunded”, producing the usual results of demoralized providers,… Read more »
David Bell
3 years 11 months ago

Yes, the crash was all about dastardly regulators forcing the poor, innocent banksters to give loans to deadbeat minorities.

The free market simply can do no wring.

HA!

Read the Big Short by Michael Lewis, it details the rather obvious fact that the crash was caused by the most criminally irresponsible private financial services sector since the 1920’s; you know the last big crash that occurred when a President declared “we need less government in business and more business in government” (Herbert Hover).

walter carpenter
3 years 11 months ago
“That’s why the UK, Taiwan and Quebec health systems are chronically “underfunded”, producing the usual results of demoralized providers, shabby facilities, technological retrogression, and government rationing of costly services while offering inexpensive services (with lengthy waiting) to hold public discontent in check.” John: I am glad that my comment struck you. But if you read between the lines of that remark, which came to mind after reading about the Taiwanese system (for the fifth time or so) it suggests that the people of those countries would in no way accept what we have had to deal with here — the… Read more »
Steve Merrill
3 years 11 months ago
Why should a profit motivated company be allowed to make life and death decisions? Why are people taking 5-15 “medications” daily? Ask your pharmacist what the “average” person takes for med’s, and from how many doctors? Insurance is a business and we once allowed human slaves to be sold in the “free market” barely 150 years ago, it was just a business. Pharma’s a business, hospitals, even non-profits, are businesses now when they used to be a communal responsibility and the revolving door at the FDA, along with the massive drug recalls, show the inherent problems with the “free” market.… Read more »
Christian Noll
3 years 11 months ago
My family physician recommended that I see a “Specialist.” So I did. It cost me a $50. copay and a half a day off work. My visit consisted of a twenty minute conversation which was awkward at best. The “Specialist’s” office charged my premium (most expensive/best) Cigna insurance $295. for the twenty minute visit. So that’s 50 + $295 = $345 x 3 = $1035 an hour. This doesn’t count my unpaid time off work and visit was in my mind totally useless other than understanding that the “Specialist” didn’t care if I were to die right there on her… Read more »
Karen McCauliffe
3 years 11 months ago
Christian, thanks for your comment. The $295 is only what your doctor’s office billed and is not what your “specialist” got paid for by your insurance company. Transparency is needed in the health industry. If your specialist was at a hospital then MVP will pay an additional “facility fee” for your office visit. Also the amount that MVP would reimburse is at a higher rate to an academic medical center. So irregardless if you are using a private practice office, a physician based in a hospital or a physician based in an academic medical center, what is charged and/or billed… Read more »
Christian Noll
3 years 11 months ago
Thank you Karen and I suspected as much. FYI, I don’t have MVP (do they still exist?) I have Cigna and its the most expensive and highest quality option my part time employer offers. Also sorry for the early morning math ! I’ve asked vtdigger to either delete the post or correct my math but I’ll just go ahead and mention that; $50 + $295 = $345 and NOT $245! Sorry. So 3 x $345 for one hour = $1035 and as Karen makes mention, this is not a complete cost analysis. Maybe if I took better care of myself,… Read more »
3 years 11 months ago

Your earlier post has been corrected.

Christian Noll
3 years 11 months ago

Thank you Cate !

Paula Schramm
3 years 11 months ago
A similar, perhaps more trivial short story- no insurance provider involved, so I know exactly what my specialist was paid : In early 1980’s, I crushed my finger at work, and being self-employed and uninsured I went to the emergency room at my local VT hospital. They looked it over and bandaged it up ( $300 ….not a small sum in those days). But they weren’t sure about the ligaments in the finger and told me to go to a specialist the next day. It took half my work day to see him. When he came in to check me,… Read more »
Christian Noll
3 years 11 months ago

Whats the record for the most posts to a vtdigger article?

Seems like this might be it!

It takes my computer for ever just to load the page!

Not just posts, but a lot of good content and well thought out responses also!

Way to go Nat !

Karen McCauliffe
3 years 11 months ago
Christian, We are out of space in our earlier discussion, so I will just post a comment to you here. (anyone new to the discussion, please see Christian’s post and my earlier post) Just to add for clarification as my main point was missed yesterday. What a doctor’s office, hospital, provider etc bills is not what they are reimbursed. So your specialist billed MVP $295, it does not mean that they will get paid that. You need to look at your MVP explanation when your bill is paid by MVP to see what has actually been paid. MVP may only… Read more »
Paula Schramm
3 years 11 months ago
Patricia Crocker asked for sources for my statistics on number of preventable deaths/year in the U.S. caused by lack of access to health care. I gave the figure of 40,000. See below: Despite slight drop in uninsured, last year’s figure points to 48,000 preventable deaths: health expert Persistence of large numbers of uninsured and related deaths shows urgency of enacting an improved-Medicare-for-all system, physician says The Census Bureau’s official estimate that 48.6 million Americans lacked health insurance in 2011 means approximately 48,000 people died needlessly last year because they couldn’t get access to timely and appropriate care, a health policy… Read more »
David Cadran
3 years 10 months ago

Want a good example of government run health care? The VA. A 100% government run healthcare institution.

While the VA has had some problems in the past, it does provide great care a majority of the time to our nations veterans.

All I can say is that the system we have now (which Brock proposes to expand) is clearly no working. It’s time to try a new direction.

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