Vermonters for Health Care Freedom Health Care Reform Newsletter #29
Vermonters for Health Care Freedom continues our newsletter series on Vermont’s health care reform efforts. Our aim is to provide useful information to our client businesses and newsletter recipients, to inform our readers about the efforts toward a “single payer” health care system in Vermont and the problems inherent in such a system, and to address other related health care matters at both the federal and state levels.
Quote of the Week: “At each stage of the project Shumlin and Mark Larson, the commissioner of health care access, have sounded cheery notes about progress even when they knew about numerous problems.” Barre-Montpelier Times Argus editorial, “Horses Midstream”, 2/19/2014
In This Issue:
- Let’s Not Lose Sight of Accountability
- Another Look At the NEA “Single Payer” Poll
- VHCF Press Release: “NEA Poll Shows Single Payer in Trouble”
- Voices Again Call on the Governor to Delay Exchange Enrollment
- Independent Review of Vermont Health Connect?
- Vermonters’ Health Care Advocate Budget Slashed
Let’s Not Lose Sight of Accountability
As the Shumlin administration hurtles toward a “single payer” government-run health care system for Vermonters, it is important to review their legal obligations under Act 48, and how well they are being held accountable by our elected representatives.
Section 9 of Act 48 reads in part:
(a) The secretary of administration or designee shall recommend two plans for sustainable financing to the house committees on health care and on ways and means, and the senate committees on health and welfare and on finance no later than January 15, 2013.
(1) One plan shall recommend the amounts and necessary mechanisms to finance any initiatives which must be implemented by January 2014 in order to provide coverage to all Vermonters in the absence of a waiver from certain federal health reform provisions established in the (Affordable Care Act).
(2) The second plan shall recommend the amounts and necessary mechanisms to finance Green Mountain Care and any systems improvements needed to achieve a public-private universal health care system.
The results so far? It is nearly March 2014. Vermonters still do not have the financing details the Governor was required by law to provide by January 15, 2013. His $300,000 UMass study did not comply with the law. At the study’s end, the Shumlin administration unilaterally directed UMass not to include the financial detail required by Act 48.
UMASS’s gross estimate of $1,600,000,000 was understated. We now know Vermonters’ share of the cost to be $1,800,000,000 to $2,300,000,000. But most important and missing from the detail are “the amounts and necessary mechanisms…..in order to provide coverage to all Vermonters in the absence of a waiver from certain federal health reform provisions”. This is the true cost of “single payer” if the Feds do not provide Medicaid and Medicare waivers that would roll those funds into Green Mountain Care. Absent those funds, the true total cost is closer to $6,000,000,000.
Vermonters will pay dearly for this “single payer” scheme if it is allowed to occur. But the Governor believes that it is acceptable not to provide legally required financial information until it is politically feasible for him to do so. And our elected representatives apparently do not believe that they have the responsibility on our behalf, to require compliance with the law they created and passed.
Let’s make governmental transparency and legislative accountability the major issues this fall when we talk with our legislators. Vermonters have been ignored long enough.
Another Look at the NEA “Single Payer” Poll
In a surprising move last week, the Vermont National Education Association (NEA) opted to come out in support of Vermont’s “single payer” initiative. The teachers’ union said it made its decision after conducting a poll to measure public support for Green Mountain Care. The poll queried 502 Vermonters using randomized phone numbers and screening for registered voters.
“Single payer” advocates have described the poll results as favorable toward “single payer”. However, a closer examination reveals a different result. Here are some of the findings:
· To Question #16, “Are you inclined to favor or oppose a single-payer system for Vermont or do you feel you don’t know enough about it yet to have a firm opinion?”
Only 24% favor. 25% oppose and 51% don’t know enough yet.
· Question #27 gave a very positive sounding description and rationale for “single payer”, including the following phrases: “health care will be expanded to include all Vermonters”; “the state will pay all health care bills”; “insurance companies will no longer be involved”; “the overall cost of health care under this approach will be lower than it is now even though it will cover everyone”; “(will) provide all Vermonters with the same or better health care benefits”.
Even this euphoric description only garnered a 55% favorable response, with 42% saying they opposed single payer and 3% were not sure.
VHCF notes that a more accurate description would be, “Federal employees will not be covered”; “the state will not pay all health care bills if there is insufficient funding or if a procedure falls outside the parameters set by the Green Mountain Care Board which has total autonomy”; “an insurance company (Blue Cross Blue Shield) will most likely be involved”; “there is no proof, guarantee or certainty that the overall cost of health care will be lower under this approach, and it will not cover everyone”; “single payer will not provide all Vermonters with the same or better health care benefits. Some may get more but some will get less generous benefits than they have now. In future years there may be cutbacks to covered services based on available funding”.
· Question #36 responses showed that currently Vermonters’ biggest worries include cost, higher taxes, how we fund/pay for it, and that the state will do a poor job running it. These are all very legitimate concerns. Lower on the list are concerns about how the plan will be implemented, what is covered, patient choice/limited options, access to care will suffer, and businesses will leave/hurt the economy.
So far the administration has tried to keep the focus off the details of the proposed health plan. It is worth noting, however, that Act 48 provides for individuals to maintain supplemental health insurance if they so choose, that there will be cost-sharing by individuals and that prior authorization of health services can be required. Not exactly “the state will pay all health care bills” or “insurance companies will no longer be involved”. VHCF predicts that these coverage issues will become hot ticket items sooner rather than later.
· Question #47 responses show that Vermonters would be more likely to approve of “single payer” if health care services could never be denied because of a pre-existing conditions, and if deductibles and co-payments were as low as or lower than they pay now. The expectation of more for less is inherent here.
· Questions #49 – #55 responses were very interesting. The poll presents a series of statements and shows the percentage of respondents who found the statements convincing. Statements are paraphrased for brevity.
1. “Everyone will get all the benefits to which they are entitled, without having to worry about insurance companies denying needed treatment.” Only 40% found the statement convincing even though GMC purports to do away with all insurance companies! When adjusted for those who don’t believe it, the score goes down to 28%.
2. “All Vermonters will have access to quality, affordable health care – everybody in, nobody out”. Only 39% believed that and when adjusted for non-believers, the score drops to 34%.
3. “By streamlining the system and greatly reducing administrative costs, GMC will save Vermonters hundreds of millions in health costs in the years ahead”. Only 26% believed that, and when adjusted for non-believers the score drops to 2%.
· Lastly, Question #57 asked whether voters would be more or less inclined to vote for a legislator who supports “single payer”. Only 36% said more inclined, while 24% said less inclined and 39% said no difference.
All in all, these poll results are not the ringing endorsement of “single payer” touted by the NEA. Peter Sterling, Director of Vermont Leads, the NEA’s single payer advocacy group, has stated, “I think there’s always concern that super PACs are going to drop unlimited dollars to run a disinformation campaign on universal health care”.
VHCF believes that the Shumlin administration is already running a disinformation campaign on universal health care and has been for years. The grandiose statements and promises “everyone will get all the health care they want or need”, “millions of dollars in health care savings” simply don’t hold up to critical analysis.
How can a thinking electorate support a non-existent health care scheme? This situation reminds us of a cross between “The Wizard of Oz” and “The Emperor Has No Clothes”.
Voices Again Call on the Governor to Delay Exchange Enrollment
On February 19, 2014 the House Republican leadership along with Lt. Governor Phil Scott again called on Governor Shumlin to grant a two year delay to small businesses and individuals from mandatory enrollment in Vermont Health Connect.
With the March 15th enrollment deadline rapidly approaching, the system still does not work for small businesses to enroll. Vermonters can enroll directly with either Blue Cross or MVP. However the expected crush of applicants had caused Blue Cross to lower the number of health plans available to small businesses from 18 to 3, saying they simply cannot handle a large number of plan choices with manual enrollments.
To date, 48% of people eligible for coverage have not yet signed up. If they do not sign up by March 15, they will not be able to get coverage until next January 1.
VHCF and House Republicans have called on the Governor to delay Vermont Health Connect as the President has done, and to allow Vermont’s Exchange to be voluntary. VHCF further calls on Governor Shumlin to scrap his single payer scheme.
Independent Review of Vermont Health Connect?
When Governor Shumlin announced in January 2014 that he would commission an “independent” review of the massive rollout problems with Vermont Health Connect, few really believed that the review would be independent. And so it is.
The new “independent” reviewer, BerryDunn, is the same firm that performed the initial review, even though the bid went out to four companies. Richard Boes, state chief information officer, who selected the firm, reports to the Governor. And although Republicans in the legislature asked to have a role in the vendor selection, they were turned down. So there you have it. Independence.
Vermonters’ Health Care Advocate Budget Slashed
The office of the Vermont Health Care Advocate was set up to ensure that Vermonters have a voice in health care decisions promulgated by the Green Mountain Care Board, as this Board expands its regulatory authority. The office used to be the “health care ombudsman” through Vermont Legal Aid. But its responsibilities have grown considerably with the advent of Green Mountain Care, and it is serving many more Vermonters with their health care needs.
Now for the second year in a row, the Advocate’s office is being underfunded. With nearly $171,000,000 in federal health care grants, the Shumlin administration can certainly afford to fully fund the office’s $157,000 shortfall for 2015. But the message seems to be, “Let them eat cake”. In response, Robin Lunge, Shumlin’s director of health care reform, said, “Like all other nonprofits, they can seek funding from other sources like private donations”. Private donations? Really?