by Rob Roper
Vermonters’ anxiety over the many unanswered questions regarding healthcare legislation has been growing ever since the legislature passed Act 48 at the end of the 2011 legislative session. The fact that the politicians who passed the law want to delay providing those answers until after the 2012 elections only serves to fuel suspicion that the impact of this law will not be pleasant.
Governor Shumlin hosted an event in Rutland to quell some of the public rumblings of discontent, but left his audience more frustrated than they were before.
“The governor ran off and would not take any questions,” wrote an exasperated constituent of Rep. Jim Eckhardt (R-Chittenden). Shumlin did indeed dash off quickly after delivering his prepared remarks, leaving the Q&A to Anya Rader Wallack, Special Assistant to the Governor for Health Care, and Cassandra Gekas, Health Care Advocate from VPIRG. “I brought up the fact that the State couldn’t/wouldn’t control education costs and raised taxes two to three fold, so how could they possibly expect to manage health care reform cost reductions. I asked if tort reform was part of the package, and also questioned if the Feds would likely consider granting waivers in view of there Obamacare program to take over health care. Needless to say the answers I got back were not convincing.”
Shumlin admits that anxiety is warranted. Echoing comments he has made repeatedly, the governor said, “For those who mistrust what we’re doing, I say, I don’t blame you. I don’t blame you, because, as I argue, government has gotten health care reform wrong every single time. That people much smarter than me – Bill Clinton, Hilary Clinton, Barack Obama, Howard Dean back here at home to name a few who can out think me and out move me – didn’t get it quite right. Here’s what they got wrong. We confuse access with cost containment.”
However, despite Shumlin’s assurances, grassroots advocates for a single payer healthcare system seem more interested in the expansion of coverage and benefits than they do about cost containment. In addition, cost containment was a stated goal of other states’ and national healthcare reform initiatives. They just couldn’t deliver.
Shumlin also repeated a promise to abort the plan if cost containment is not attainable. “We will only go ahead if we’re convinced together as a state, that the system is better than what we have, that it costs less, it’s going to help create jobs, and we’ve got the cost containment system right. If we can’t do that, we’ll take our marbles and go home.”
But, even taking Shumlin at his word that he would kill his single payer initiative in Vermont if costs could not be controlled, questions remain. How will he measure “cost containment” when determining whether or not to pull the plug? Will the five-member panel charged with determining the financial feasibility of Green Mountain Care be willing to terminate their own jobs by declaring the plan unworkable? Is he promising to create net new jobs for the state, or just create a few new jobs while killing many existing ones?
The most confusion still remains over how a single payer system would be paid for. The Hsiao Report, which formed the basis for Act 48, recommended a payroll tax. However, Anya Radar Wallek indicated that the scheme would ultimately be funded with a blend of different revenue sources–payroll tax, income tax and others revenue.
Rutland City Treasurer, Wendy Wilton, who has spent many hours of her personal time trying to understand the numbers of the single payer initiative, sat in on the Rutland presentation. Wilton summed up the evening, “This event was not a win for the governor… When they finally got to questions, they could not answer them, and people left frustrated and angry.”
Jeff Bartley contributed to this article