Editor’s note: This commentary is by Walter Carpenter of Montpelier.
[M]r. Randy Brock’s parable “You Can’t Get There from Here,” (VTDigger 09/04/14) is a fairy tale employing the stereotypical “old Vermonter at the country store” telling newcomers how they “can’t get there from here” in buying health insurance in Vermont. A striking irony about Mr. Brock’s parable is what has been omitted: The Old Vermonter is probably on Medicare, the publicly funded single-payer program for seniors. He or she no longer has to worry about purchasing health insurance. It is always there for them.
“Just keep on ‘til you come to what’s left of the old Free Market,” the Old Vermonter (on Medicare) tells them. “It’s pretty much boarded up and out-of-business now … since most of the insurance companies got run out of town.” Perhaps this Old Vermonter’s memory has faded; the insurance companies were not exactly “run out of town.” Many left of their own volition when a street named Guaranteed Issue, was built to help curtail the old free market’s habit of cherry-picking. With the guaranteed issue, the Old Free Market could no longer refuse health insurance to one person or sell to another based on criteria designed to enhance the insurer’s profit.
How about High Deductible Road? Although easy on the premium side, it had huge expenses on the payment side if the driver had the misfortune to need the insurance. It was hard to avoid the turn onto Claim Denial Street, where the driver had to fight an insurer’s refusal to pay despite all the years of premiums.
If the newcomers missed the turns onto High Deductible Way or Bankruptcy Road they were forced onto the No Insurance Highway. Most took this route after losing their jobs or being unable to afford private insurance.
High Deductible Road splits off into Medical Debt Way or Bankruptcy Street, byways to be avoided. Perennially in debt to the old free market for the bad luck of getting sick, the only exit was often via bankruptcy court. Many of those on Bankruptcy Street or Medical Debt Way lost their homes to unpaid medical expenses.
If the newcomers missed the turns onto High Deductible Way or Bankruptcy Road they were forced onto the No Insurance Highway. Most took this route after losing their jobs or being unable to afford private insurance. The exit tolls are heavy. One is called “your money or your life.” The attendant in this tollbooth could not tell them exactly what the toll was; he probably didn’t know. You just had to keep pouring money into the basket to save your life or die.
The old Vermonter pauses, then smiles.
“Somethin’ new’s coming up that way,” the Old Vermonter tells the newcomer.
This is referring to single-payer, which will replace the former Bankruptcy or Medical Debt streets with streets like Guaranteed Access, Universal Care and No Medical Debt. Health insurance here is not a for-profit business; it is for the public good. This is not some newfangled Vermont scheme. Every other democratic nation has closed its Medical Debt Street and No Insurance Highway. They keep administrative costs low and provide hassle-free access to care, without worries about losing it.
“Come to think of it,” the Old Vermonter tells the newcomers, “you can get there from here.”
