by Rob Roper
Vermont Digger recently chronicled an exchange between Governor Peter Shumlin and a physician/single payer healthcare advocate, David Himmelstein. Himmelstein was critical of the idea that Vermont’s pending reforms would actually lead to a single payer system because separate programs such as Tricare for veterans and Medicare for seniors would also continue to exist, inevitably leaving a multi-payer system (and many costly inefficiencies) in place.
Shumlin dismissed Himmelstien’s criticism, saying, “Yeah we are [implementing a single payer system], and insisting, “if you help me get rid of those Tea Party nuts in 2014, I’ll get it done.”
Now, throughout the process of moving toward single payer in Vermont, seniors and have been promised that nothing will happen to their care. However, Act 48 states in black and white,
The director, in collaboration with the agency of human services, SHALL obtain waivers, exemptions, agreements, legislation, or a combination thereof to ensure that, to the extent possible under federal law, ALL FEDERAL PAYMENTS PROVIDED WITHIN THE STATE FOR HEALTH SERVICES ARE PAID DIRECTLY TO GREEN MOUNTAIN CARE. GREEN MOUNTAIN CARE SHALL ASSUME RESPONSIBILITY FOR THE BENEFITS AND SERVICES PREVIOUSLY PAID FOR BY the federal programs, including Medicaid, MEDICARE, and, after implementation, the Vermont health benefit exchange. (Page 12)
The agency SHALL SEEK PERMISSION from the Centers for Medicare and Medicaid Services TO BE THE ADMINSTRATOR FOR THE MEDICARE PROGRAM IN VERMONT. (Page 85) [All Caps added]
It is the desire and the intention of the Shumlin Administration and the legislators who voted in favor of Act 48 to incorporate Medicare into Green Mountain Care. They gave themselves the legal authority, and indeed the legal obligation, to try to “the extent possible.” What Shumlin is hoping for is a national Progressive wave that will carry into office the kind of people who will be willing to grant Vermont the federal wavers necessary to fulfill the vision. The only thing standing in the way of a Vermont takeover of Medicare at this point, at least according to Shumlin’s comments, is the TEA Party.
Perhaps the question Vermont’s roughly 100,000 senior citizens should be asking today is if you like your Medicare can you keep it, “period”? Or is it, if you like your Medicare you can keep it, “asterisk”, see pages 12 and 85 of Act 48.
– Rob Roper, president of the Ethan Allen Institute