A new poll shows support for Gov. Peter Shumlin’s decision not to pursue a single payer health care system in Vermont this legislative session.
Two months after the governor announced that the state’s economy was not strong enough to support the idea, a VTDigger/Castleton Polling Institute survey shows that nearly two-thirds of respondents agree.
The poll of 700 Vermonters was conducted Feb. 9-24 (see sidebar for methodology).
Sixty-four percent of poll respondents said they supported the governor’s decision to abandon single payer at this time, while only 20 percent said they were opposed and 10 percent saying they were unsure. Among Democrats, 54 percent said they supported the governor’s decision.
Keith Brunner, a spokesman for the Health Care Is a Human Right campaign, said that’s likely because of confusion about what single payer is, or would mean for the public.
“There’s just a lot of confusion around health care reform. People sometimes conflate the exchange with publicly financed universal health care and the negative experiences people have had,” Brunner said.
But his grassroots organization still consistently hears from the public that getting insurance and accessing medical services when they need them is difficult and frequently prohibitively expensive, Brunner said.
“That crisis is still there, and I think that’s something that hasn’t changed,” he added.
Hamilton Davis, a longtime journalist and close observer of health care reform, said he agrees with Brunner’s assessment.
“My instinct would be that the public has been inundated with negative coverage of single payer,” he said.
As Vox’s Sarah Kliff points out, and as the governor ultimately acknowledged, the largest obstacle for single payer is that medical care is too expensive in Vermont and the United States as a whole. That makes paying for health care with public money a tall order.
Shumlin critic Darcie Johnston, with Vermonters for Health Care Freedom, says that’s why Vermonters are right to conflate the Vermont Health Connect exchange with the push toward single payer.
“A number of Vermonters saw a huge increase in what they pay for health care because of the exchange, and I think many would say Vermont’s policies over the last three years have hurt the economy,” she said. The looming possibility of “government controlled health care” put a damper on the outlook of businesses as they contemplated what it would take to pay for health care with taxes.
Much of the work in health reform — driving costs out of the system and changing how doctors, hospitals and clinics are paid for providing medical services — is taking place at the regulatory Green Mountain Care Board, Davis said. Their work is much less visible to the public, and people often don’t see its connection to a public health coverage program like single payer, he said.
Some experts say that publicly financed health care is only possible if providers can make the shift away from a fee for service payment system that compensates hospitals and doctors for the volume of services to a system that compensates providers based on keeping patients healthy.
Davis said he sees no possibility for movement on a public program during the 2015 legislative session, despite the ongoing efforts of groups such as the Health Care Is a Human Right campaign, which recently introduced its own, more progressive public financing concept. That group maintains the program is viable now, if large businesses and wealthy individuals were asked to pay a greater share than Shumlin was willing to ask.
If the administration is serious about making single payer happen in the future, Davis said, it will take the coming year to highlight the board’s work and try to change attitudes toward its viability.
