Mary Gerisch: Single payer myths

Editor’s note: This commentary is by Mary Gerisch, of Bennington, who is a retired civil rights attorney. She is an active leader and board member of Rights & Democracy and is also on the board of the National Center for Law and Economic Justice.

Let’s clear up a few myths about Vermont’s efforts to enact universal — so-called single-payer — health care.

Myth #1: Single-payer health care failed in Vermont. You can’t fail at something you didn’t actually start. Vermont never enacted single-payer health care, even though a report at the time said that it could work. The only failure was that of a single politician who ignored both the overwhelming popular political mandate from his constituents and the well-researched report that showed that a publicly funded, statewide universal health care system could, in fact, succeed and save money in the first seven years. In fact, then-Gov. Peter Shumlin never delivered three financing plans to the Legislature to finance the enacted law, simply saying it “is not the right time” and stopped debate before it could even begin.

Would a doctor claim to say that a medication failed to treat a patient if, in fact, the patient never even filled their prescription? I think we all know the answer is no.

Myth #2: Vermont has abandoned single-payer health care and progress on health care reform has come to a halt. The fact is that Vermont passed a universal health care law in 2011 – known as Act 48 – which is still the law that governs any health care reform efforts unfolding in the state. Most importantly, the governing principles guiding our efforts are ones that should be considered when evaluating any reform effort nationally. Those principles include designing a system that provides universal access, equitable and sustainable funding, transparency in budgeting and the cost of services, freedom for consumers to choose their providers, and prioritization of the provider-patient relationship, among others.

Improvements and proposals to change Vermont’s health care system have been ongoing since 2011 and continue today. In contrast to other states with similar exchanges where premiums have risen astronomically, the Vermont health care exchange that enrolls people into various plans under the Affordable Care Act — and helps with providing premium assistance — has seen substantially lower rate increases. Additionally, a movement to pass universal primary care which includes mental health and substance abuse treatment has flourished in recent years with a bill in the Statehouse that has significant Democratic and Progressive Party (who together make up Vermont’s legislative majority) support and a good shot of passing this upcoming session.

Myth #3: Green Mountain Care was too expensive. Every analysis showed that it was less expensive than the status quo, and the conservative estimate is that it would have saved Vermonters $378 million in the first four years. The fact that the governor didn’t feel comfortable with the financing plan is different than claiming that single payer was too expensive. In fact, today the toll of medical debt and bankruptcies due to medical bills, as well as the rising cost of premiums and deductibles, makes Green Mountain Care as relevant today as it was in 2011.

These examples indicate that Vermont’s health care reform efforts are both ongoing and successful.

Another positive development out of Act 48 is the Green Mountain Care Board itself. While there’s more that could be hoped for about its decisions and tamping down rate increases, it has created a greater emphasis on the public good and public transparency for rate reviews and hospital budgets – especially when compared with other states.

A lot of attention is placed on Vermont, and rightly so, for being a leader in bringing forward a national discussion on universal health care — whether you call it single-payer, Medicare for All, or Health Care as a Human Right.

From the earliest efforts under former Gov. Madeleine Kunin to expand health care coverage to all Vermont children, to several efforts in the past 30 years to bring about a universal system that covers all Vermonters, this little state has long understood the social, economic and moral reasoning to provide health care to all of its residents.

Now, we have U.S. Sen. Bernie Sanders leading a national discussion with his Medicare for All legislation just introduced in the Senate — along with 16 Democratic co-sponsors.

Gov. Shumlin is no spokesman for the efforts to make single payer a reality in Vermont. Gov. Shumlin, rather, is the poster child for what happens when you abandon a promise to move a bold idea like single-payer health care and then go back on your word: You become an ex-governor giving speeches on the topic of failure.

Perhaps that’s a lesson he can remind his fellow Democrats, and other politicians, who fail to get behind, or try to block, a national plan to enact universal health care.

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