Editor’s note: This commentary is by Lee Russ, of Bennington, who was the lead author/editor of the third edition of “Couch on Insurance,” and is a member of the Healthcare is a Human Right campaign.
There are many people who have persistently and vocally opposed Vermont’s efforts to implement a publicly financed universal health care system, to be known as Green Mountain Care, since the day the proposal was passed by the Legislature in 2011. When Gov. Shumlin abruptly announced last month that it’s “not the right time” for publicly financed universal health care, those who had relentlessly attacked Green Mountain Care immediately began taking figurative victory laps all over the state, crowing that “single payer has failed” as they all knew it would.
Ignoring the fact that Green Mountain Care did not fail in operation, since it was never allowed to operate, what exactly is it that the opponents of Green Mountain Care are so happy about? What does the abandonment of Green Mountain Care leave us with? The undeniable answer is “the status quo.”
And what a “status” it is: fractured, expensive, confusing, and, far too often, inadequate to protect our citizens from health and/or economic disaster. Its inadequacy is clearly evident and, indeed, is what drove the push for publicly financed universal care in the first place. Yet I don’t hear any Green Mountain Care critics crowing that this is the “status” to which we have been consigned.
Here is what we have been left with for a health care “system” that is a system in name only.
A large but shrinking portion of the population remains covered by commercial health insurance provided by employers. For these people, employers require that they contribute an ever-higher portion of the premiums, the premiums keep rising, and the insurance policies impose ever larger deductibles and co-pays. According to the recently published Commonwealth Fund report “State Trends in the Cost of Employer Health Insurance Coverage, 2003–2013” employees experienced a 93 percent increase in the annual amounts they paid toward health insurance premiums, at the same time that the average per-person deductible for employer health plans more than doubled, increasing by 146 percent from 2003 to 2013. [the report is available online here.
Unless your income is low enough to qualify for major subsidies, you will find monthly premiums of hundreds of dollars, accompanied by high deductibles and co-pay requirements.
The commercial insurance available through the Affordable Care Act? Unless your income is low enough to qualify for major subsidies, you will find monthly premiums of hundreds of dollars, accompanied by high deductibles and co-pay requirements.
We have a growing segment of the population on Medicaid, which under-compensates medical providers, making them reluctant to accept Medicaid patients. The financial costs are borne by all taxpayers. The health and mental costs of being unable to find a doctor are borne by the people on Medicaid.
We have another large and growing segment of the population on Medicare which, contrary to the image of many that this provides “free” health care for seniors, is actually quite expensive and also frequently under-compensates medical care providers. For a single person, the premium cost is at least $1,200 per year, and is really useless unless you also buy a commercial supplement policy for at least another $1,200 per year. Prescription drug coverage would require still another commercial policy for several hundred dollars a year. Want decent Medicare coverage? Expect to fork over at least $2,750 per person, $5,500 for a couple.
Smaller segments of the population are covered by the VA health system or the federal government’s Tri-Care.
How many people technically have insurance but simply can’t afford to pay the medical expenses required to meet the deductible, leaving them without access to care? How many people do pay the deductibles, but have to forgo food, clothes, fuel, etc., in order to do so? How many people are prevented from attending college, from having their kids attend college, or from looking for a better job, by this nightmare of medical costs? How many people manage to scrape through at the moment, but constantly worry that the slightest change in their income and/or health will sink them at any moment?
I don’t know. I also don’t know how you put a dollar value on that. And that’s one of the real problems of deciding if Green Mountain Care is “affordable.” The analysis never takes these kinds of costs into account.
So, where does that leave us? And why, exactly, are so many Green Mountain Care opponents so happy about leaving us there?
