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.