The national news media has not paid attention to it, but the Vermont Legislature has spent the winter and spring debating the merits of universal health care.
It’s a debate worth having. Vermonters spend $3.5 billion on health care each year, about $5,700 for every man, woman and child, sick or healthy. Those costs are rising at the rate of $350 million per year – almost a million dollars a day for the state as a whole or $550 per person, per year. Our Medicaid deficit for next year is projected to be $80 million. The worst part about this is that one-quarter to one-third of this money is spent on administration – red tape that makes no one healthier.
Someone has to pay for that. Employers find their overhead costs rising, employees have less take-home pay as they are asked (or forced) to pay for a share (or larger share) of their health care costs, taxes go up to pay for school and municipal employees’ rising premiums and the cost of every Vermont-made product – from ice cream to computer chips to ski lift passes – goes up.
Last week, the Democrat-dominated lower chamber of the legislature passed a bill to provide universal health care for all Vermonters, with the state acting as intermediary between citizens and the health-care system. The bill calls for the state to provide universal access to primary and hospital care by 2007 and all essential health care services by 2009.
The House of Representatives bill is a bold and necessary first step in what needs to be national action on health care. There are people of good conscience in Vermont who oppose the House bill. They have some arguments on their side; a big one is cost. There’s general agreement that a state-run system will be cheaper and more efficient than what we’ve got now. (The most ardent free-marketeer is loathe to defend America’s health-care boondoggle.) The challenge is to make the transition from health care system A to health care system B without incurring enormous duplication of payments for the transition years. The insurance companies, who stand to be the big losers in this, have no incentive to cooperate in their own demise.
Vermont’s executive branch, unfortunately, is not much friendlier to universal health care than insurance executives. Our Republican governor, Jim Douglas, does not want to lead the nation toward what his party calls “socialized medicine.” His top bureaucrat calls the House bill “a catastrophe” and Mr. Douglas has promised to veto the bill in its current form.
To no one’s surprise (or delight), politics will play as large (or larger) a role as policy in determining the future of health care in Vermont. The entire legislature and the governor run for election in every even-numbered year; electoral politics are always close at hand. Our state Senate, like the House, is controlled by Democrats, but in this chamber the majority is huge (two-thirds). On the other hand, the Senate’s president pro tem is widely held to harbor gubernatorial ambitions and is reluctant to offend any group of potential supporters. Thus the version of the health care bill considered by the Senate is more incremental than the House bill and would phase in state-managed health coverage, starting with employers that don’t offer coverage and employees (including self-employees) that don’t have it. Gov. Douglas has suggested the Senate bill might be something he will sign.
Any law that moves any state away from our current health care disaster would be welcome, but obstacles remain. Vermont is confronting an issue that should properly be addressed by the national legislature. If we unilaterally offer our citizens universal health care, we run the risk of triggering an influx of sickly, uninsured people who move here solely for the health care. One can’t fault sick people for seeking treatment, nor can one fault Vermonters for wanting to avoid being charity hospital to the nation. If it came to that, I’d rather get stuck paying for health care for a few out-of-staters than have my money go toward year-end bonuses for insurance company executives.
There are people in Vermont who don’t like the idea of universal health care. They have reasons, but with health care costs going up one million dollars a day, how long can any of us wait to act?
A Million Dollars a Day
The national news media has not paid attention to it, but the Vermont Legislature has spent the winter and spring debating the merits of universal health care.
It’s a debate worth having. Vermonters spend $3.5 billion on health care each year, about $5,700 for every man, woman and child, sick or healthy. Those costs are rising at the rate of $350 million per year – almost a million dollars a day for the state as a whole or $550 per person, per year. Our Medicaid deficit for next year is projected to be $80 million. The worst part about this is that one-quarter to one-third of this money is spent on administration – red tape that makes no one healthier.
Someone has to pay for that. Employers find their overhead costs rising, employees have less take-home pay as they are asked (or forced) to pay for a share (or larger share) of their health care costs, taxes go up to pay for school and municipal employees’ rising premiums and the cost of every Vermont-made product – from ice cream to computer chips to ski lift passes – goes up.
Last week, the Democrat-dominated lower chamber of the legislature passed a bill to provide universal health care for all Vermonters, with the state acting as intermediary between citizens and the health-care system. The bill calls for the state to provide universal access to primary and hospital care by 2007 and all essential health care services by 2009.
The House of Representatives bill is a bold and necessary first step in what needs to be national action on health care. There are people of good conscience in Vermont who oppose the House bill. They have some arguments on their side; a big one is cost. There’s general agreement that a state-run system will be cheaper and more efficient than what we’ve got now. (The most ardent free-marketeer is loathe to defend America’s health-care boondoggle.) The challenge is to make the transition from health care system A to health care system B without incurring enormous duplication of payments for the transition years. The insurance companies, who stand to be the big losers in this, have no incentive to cooperate in their own demise.
Vermont’s executive branch, unfortunately, is not much friendlier to universal health care than insurance executives. Our Republican governor, Jim Douglas, does not want to lead the nation toward what his party calls “socialized medicine.” His top bureaucrat calls the House bill “a catastrophe” and Mr. Douglas has promised to veto the bill in its current form.
To no one’s surprise (or delight), politics will play as large (or larger) a role as policy in determining the future of health care in Vermont. The entire legislature and the governor run for election in every even-numbered year; electoral politics are always close at hand. Our state Senate, like the House, is controlled by Democrats, but in this chamber the majority is huge (two-thirds). On the other hand, the Senate’s president pro tem is widely held to harbor gubernatorial ambitions and is reluctant to offend any group of potential supporters. Thus the version of the health care bill considered by the Senate is more incremental than the House bill and would phase in state-managed health coverage, starting with employers that don’t offer coverage and employees (including self-employees) that don’t have it. Gov. Douglas has suggested the Senate bill might be something he will sign.
Any law that moves any state away from our current health care disaster would be welcome, but obstacles remain. Vermont is confronting an issue that should properly be addressed by the national legislature. If we unilaterally offer our citizens universal health care, we run the risk of triggering an influx of sickly, uninsured people who move here solely for the health care. One can’t fault sick people for seeking treatment, nor can one fault Vermonters for wanting to avoid being charity hospital to the nation. If it came to that, I’d rather get stuck paying for health care for a few out-of-staters than have my money go toward year-end bonuses for insurance company executives.
There are people in Vermont who don’t like the idea of universal health care. They have reasons, but with health care costs going up one million dollars a day, how long can any of us wait to act?
© Mark Floegel, 2005