Several hundred health care activists packed into the Cedar Creek Room, the ceremonial salon of the Vermont Statehouse, on Wednesday to demand that lawmakers act on health care reform this legislative session.
The rally, led by the Burlington-based Vermont Workers’ Center as part of its “Health Care is a Human Right” campaign, included speeches from health professionals, teachers’ union representatives from the Vermont NEA, the Vermont Center for Independent Living and Democratic legislators.
The Vermont Workers’ Center is pushing for passage of health reform bills S.88 and H.100. These bills “propose to establish the goal of universal access to essential health care services in Vermont through a publicly financed, integrated, regional health care delivery system; provide mechanisms for cost containment in the system; and provide a framework, schedule and process to achieve that goal.”
The advocates say 66,000 Vermonters don’t have health insurance coverage and that those who have insurance plans are not adequately covered for a severe illness or a disabling accident. They talked about how expensive premiums and high medical care costs make adequate health care inaccessible for Vermonters.
Jennifer Henry, a registered nurse and president of the nurse’s union at Fletcher Allen Health Care in Burlington, described patients who have insurance plans, but fear they don’t have enough coverage to absorb the costs of their hospital stays and ensuing treatment at home.
Henry implored lawmakers to pass a health reform bill this session: “We can no longer tolerate excuses. We will measure legislators by their can-do attitude.”
Other speakers talked about the pervasive lack of access to adequate care.
Martha Allen, president of the Vermont NEA, said medical insurance problems affect student performance. The teacher’s union has adopted a reform policy statement declaring that health care reform should be a fundamental right of citizenship.
“When children don’t have good health care, they don’t come ready to learn, they can’t do their best and they can’t achieve the standards we set for them,” Allen said.
For Susan Lucas, president of the Vermont Workers Center, the issue boils down to treating health care as a public good.
“Health care is not a commodity but a public good,” said Lucas. “We look at health care somehow separately. We look at our schools as a public good and we look at our police and our fire departments as a public good. Why is it we can’t look at health care in the same way? No one should have to beg for health care.”
Lucas, who has worked as a nurse for 30 years and is now president of the Copley Hospital nurses’ union, says “corrupting influences” are to blame for political inaction on reform.
The effects of high cost care has a significant impact on Vermont companies, Lucas said. Most businesses in Vermont are self-insured, she said, and for many “it’s a hardship.” She recounted a story about a large company that had to drop its health insurance plan for employees because after one worker had a catastrophic medical problem, their new rates became unaffordable.
Lucas invited Democrats Peter Shumlin, Shap Smith, Doug Racine and Steve Maier to speak during the rally.
Shumlin, who is the Senate president and a candidate for governor, said he will be sponsoring S.88. “I’ve been a sponsor of bills like this for a long time, but I think what’s changing is most Vermonters understand the race to the bottom is not only going to cripple our health, it is going to cripple our economy.”
Doug Racine, who is running for governor and serves as chairman of the Senate Health and Welfare Committee, said despite the Legislature’s best efforts, the system remains broken. Racine said nationally, health care costs make up 16 percent to 18 percent of gross domestic product.
“There’s still a lot of uninsured Vermonters,” Racine said. “There’s still a lot of underinsured Vermonters who don’t even know it yet because they haven’t had to … use their health care plans. Then they find out their plans weren’t as good as they thought they were.”
Racine said he and Maier would hold hearings to listen to Vermonters’ concerns about health care accessibility.
The Vermont Senate Health & Welfare Committee and House Committee on Healthcare will be holding joint hearings on S.88 and H.100 from 6-8 p.m., Tuesday, Jan. 12.
Overview of S.88 and H.100, as published on the Vermont Workers’ Center Web site.
These bills “propose to establish the goal of universal access to essential health care services in Vermont through a publicly financed, integrated, regional health care delivery system; provide mechanism for cost containment in the system; and provide a framework, schedule and process to achieve that goal.”
The bill begins with findings, in five parts, as follows.
1. The healthcare infrastructure (and services) are public goods that are threatened in the current healthcare system. In particular, economic incentives distort the provision of quality care, and multiple payers create excessive administrative waste.â¨
2. The current healthcare system cannot contain costs and is therefore unsustainable.â¨
3. The costs of the current healthcare system are unfairly distributed.â¨
4. The current healthcare system is not accessible to all who need care.â¨
5. The quality of healthcare in Vermont could be improved by a better system.
The bill creates a new plan, VermontCare, (analogous to Medicare) to pay for essential healthcare services in Vermont. It would utilize the existing network of healthcare providers (doctors & hospitals) but would eliminate private insurance for essential healthcare services and replace the current multiple payers with a single public fund financed by a system of broad-based taxes. Insurance premiums (and, therefore, deductibles) and out-of-pocket payments (“co-pays”) would be eliminated. All residents of Vermont would be eligible for VermontCare, simply by virtue of residence. The bill would merge three existing government divisions into a new department, Health Care Administration, and create a new three-member board, the Vermont Health Care Board, each with specific mandates, guidelines and timelines for designing, implementing and managing theservices included in VermontCare. (Specifically: the Board would propose [to the general assembly] a package of essential health services to be covered by VermontCare and subsequently act in a quasi-judicial capacity to hear complaints and amend established reimbursement rates. The Department of Health Care Administration would administer payments and establish a drug formulary, which would be used to negotiate discounts from manufacturers and establish uniform state-wide prescription practices, along with several other administrative duties related to VermontCare.)
The bill also calls on the general assembly to create regional community health boards to assess, prioritize and define community health needs, as well as to develop budget recommendations and provide regional oversight and evaluation regarding the delivery of care in their regions. Under VermontCare, providers would be compensated based on best practices and healthcare outcomes rather than for individual services. Hospitals would negotiate annual “global” budgets instead of being paid for individual services.
H.100 sponsors: Michael Obuchowski, Bill Botzow, Alison Clarkson, David Deen, Michael Fisher, Patsy French, Mary Hooper, William Lippert, Terrence Macaig, Michael Mrowicki, Betty Nuovo, Carolyn Partridge, Paul Poirier, Ernest Shand, David Sharpe, Ira Trombley, John Zenie, David Zuckerman
S.88 sponsors: Ed Flanagan, Timothy Ashe, Claire Ayer, John Campbell, Matthew Choate, Ann Cummings, Harold Giard, Robert Hartwell, Sara Kittell, Virginia “Ginny” Lyons, Mark MacDonald, Peter Shumlin, Robert Starr, Jeanette White, Richard McCormack
