by Rob Roper
Not surprisingly, the health care bill, H.202, passed the Senate on Tuesday. It will go back to the House as changes in the bill by the senate as passed need to be reconciled by the former chamber. (See the roll call vote HERE.)
One of the changes made by the senate came through an amendment by Senator Kevin Mullin (R-Rutland), which would require that the Green Mountain Health Care board determine before requesting a waver that, among other points, “cost-containment efforts will result in a reduction in Vermont’s per-capita health care spending as compared to the national rate of increase of health costs.”
I asked Senator Mullin a question I’ve been asking about alleged cost containment since the session began: will this calculation include the cost of wrap around policies purchased above the state provided benefit?
He replied, “Per capita spending is simply the total cost of all healthcare [emphasis added] divided by the number of Vermonters. The rate of growth per capita has been growing faster in Vermont than the US average. The good news is our spending per capita is less than the national average but we are catching up. I believe this is one of the most important benchmarks for measuring cost containment.”
If the board actually follows this requirement, it will pose a difficult barrier for single payer to overcome because ERISA members, if forced to pay twice, will likewise register twice on the cost containment meter. If unions bargain for wrap around policies to maintain their current levels of coverage, the per capita costs will go up accordingly.
As Dr. Hsiao pointed out in his report, if Vermonters all receive comprehensive health insurance packages, there is no cost containment. In fact, costs explode. Therefore, if Governor Peter Shumlin honors his pledge not to sign a bill that doesn’t contain costs, and the Board follows the law (assuming the Mullin amendment makes it through the process), this provision could kill single payer.
However, those are two big ifs. (See the following article.)