Dr. Deb Richter has been the leading advocate for a single payer health care system in Vermont. According to the website workerscenter.org, Richter is the one responsible for bringing Dr. William Hsiao, architect of Taiwan’s single payer system, to Vermont. On Thursday, Richter led a group of doctors under the banner Physicians for a National Health Program () to Montpelier to tell their stories.
The sales pitch for the group is ironic. A business card on the table had the slogan, “Single Payer: The most fiscally conservative way to cover all Vermonters.” Liberals, it seems, have to make themselves sound like conservatives to get things passed.
The conference began with Richter directing the doctors and other health professionals, most wearing white lab coats and stethoscopes draped around their necks, to line up at the front of the room while she called the speakers, many of them psychiatrists, to testify.
Donna Kiley, a psychiatrist at Central Vermont Substance Abuse, lamented that psychiatric conditions accompanying substance abuse, like depression, were not “billable” in Vermont and caused clinics to lose money. Although coverage for services at her clinic is provided partly by private insurance and partly by the State of Vermont, Kiley said, “neither funding source allows for the agency to bill for my services in the treatment of co-current psychiatric conditions.”
“[Patients] are so embarrassed to have to come for free medical care,” remarked Wendy Manganiello, a Registered Nurse employed at Dartmouth and volunteer at a free clinic. She told the story of a woman who delayed care for two years because she was “too embarrassed” to come to the free clinic for what she assumed was a tonsil problem. It turned out to be throat cancer. Manganiello used this illustration to outline the “need” for a single payer system, but under Dr. Hsaio’s plan, low-income Vermonters wouldn’t have to pay into the healthcare system and would therefore receive ‘free’ healthcare.
Speaker after speaker complained about the current healthcare system and cited various insurance-related “horror stories” for more than an hour.
A table nearby contained pamphlets promoting single payer healthcare. One of the pamphlets was a fact sheet for Act 128, the legislation passed last year that authorized Dr. Hsaio’s healthcare system study. “All Vermonters will have access to health care and none will go broke due to health care expenses,” the paper claimed. This statement, and the overall tone of the doctors’ desire for access to more money to provide better care, is in contrast to Governor Shumlin’s claim during his press conference that reform is all about cost containment.
Single payer advocates argue that with their system, administrative costs will be curbed due to less paperwork, making more money available for healthcare. Not all medical care providers in Vermont agree.
Jane Combs, an LPN who works as a Minimum Data Set Coordinator at Burlington Health and Rehabilitation Center, disagrees. “My personal belief is, if there’s more government involved, there’s more rules and regulations,” she says. “That means more time filling out paperwork rather than helping patients. [It means] much more red rape, policy and procedure, and bureaucracy.”
Marianne Danis, a Pharmacy Technician in Burlington with thirty years experience in the healthcare field, points out that Medicare applies the same cost-cutting measures that single-payer advocates complain private insurance companies inflict on patients. “Medicare has a lot of rules and regulations, and it seems like they change them every day,” Danis commented. “They’ll tell me something is covered and then it’s not.”
When asked what she sees wrong with the proposed single-payer system, Danis replied, “Competition. You can go to one company and they’ll quote you a price and you can negotiate. That’s what capitalism is about. I think the private sector is a little more accountable, they have stockholders and others keeping an eye on them,” Danis said. “With the government it’s not what you know, it’s who you know.”