Editor’s note: This op-ed is by Dr. Deb Richter, a proponent of a single-payer health care system. She lives in Montpelier.
Last week’s presentation of three health care systems designs is a victory for the forces of health care reform.
Is it premature to declare victory? It is if you mean that health care reform is all but complete.Because of course it isn’t. The victory, though, consists of a change in thinking.
Until now every politician, and even special interests opposed to reform paid lip service to a public good. Their formula was “high quality, affordable health care for all.” But that describes a public good. A single payer health care system is a shorthand way of talking about a public good.
The goal is to create a system of health care that acts as a public good, which in effect means it ensures all Vermonters high-quality, affordable health care.The same thing that has been talked about all along but toward which no practical steps were ever taken.
When it came to taking practical steps toward health care as a public good these same politicians and spokespersons backed off. The Douglas Administration was a perfect example of this.
Now it’s different. We have a governor who ran on single-payer and has stuck to his guns. He was party to bringing the respected Harvard health economist William Hsiao to Vermont to design three system options for the Legislature to act on.
Key legislators have come around to thinking of health care as a public good. They don’t have a lot of choice because years of postponing systemic reform have allowed costs to double and contributed hugely to the state’s own deficit that has lawmakers so worried.
Now that Dr. Hsiao has presented and described his three system designs the Legislature decides which is the most practical approach under current circumstances and within that approach, what are the first practical steps toward the goal.
The goal is to create a system of health care that acts as a public good, which in effect means it ensures all Vermonters high-quality, affordable health care.The same thing that has been talked about all along but toward which no practical steps were ever taken.
If everyone sticks to their guns – Gov. Shumlin, legislative leaders, those of us acting in the public interest not self interest -the first practical steps in a process that will stretch for years will be taken. Why years? Because we’ve allowed health care to fall into such a tangled mess and it take years to untangle.
But if the first steps are knitted together under the system goal as a guiding principle then even early steps will benefit everyone.
Real health care reform doesn’t arrive as a plug-and-play system. Assembly is required. And that assembly calls for time and patience, and a good idea of what promises to be practical now and to remain practical in the steps ahead.
We will use a side-by-side comparison chart to each of the three plans against an abbreviated set of criteria spelled out in Act 128. Stay tuned.
