by Estella Leach
The single payer policy being proposed by this committee and Dr. Hsaio is the antithesis of my existence as a free Vermonter and American. It is the exact opposite of the values of my upbringing and the values upon which Vermont was founded: fierce individualism, work ethic, freedom and dignity.
Vermont has metamorphosed into a State whose direction and values I no longer recognize as remotely similar to my own. The State has encouraged its people to become co-dependent on a government that has overstepped its purpose, and single payer will only exacerbate the co-dependency on government and drive up the cost of medical services while lowering the quality.
….And of course, there will be waivers and exceptions from single payer and the political favors , of which I am sure there will be many, leaving a few of us to hold the bag, likely very small business and sole proprietors.
As well, State government simply does not have the capacity nor should it to manage and oversee such an undertaking. I do not want my health care drenched in politics any more than it currently is.
I am so much opposed to your single payer health care as a solution in Vermont that I must seriously consider my future as a Vermonter. You may refer to the map of immigration (note: Washington, Warren and Saratoga Counties, NY) recently released by Forbes: http://www.forbes.com/2010/06/04/migration-moving-wealthy-interactive-counties-map.html.
When I drive in New York (groceries, doctors, Target, movies, events), I see Vermont license plates everywhere. Many Vermonters work in New York from my area, and the road to Manchester, Vermont from Granville, NY (Route 30) carries hundreds of people to work every day. How do you propose to ‘capture’ (your word not mine, ‘capture’ what an ominous undertaking) the people who work out of Vermont or who live in another state and work in Vermont? Will New Yorkers or any other non-Vermonters working in Vermont lose health care coverage?
We are not a desert island. We are a geographically small state who depends on this workforce and this money. You cannot fence people in and out to accomplish your utopian vision.
I live on the border of NY State and receive all medical care in New York State. I pay for my own health insurance through our family -owned and operated business, and I hold a high deductible policy with an HSA account as does my husband. It is not inexpensive, but I like being in control of my own life.
I am free to choose whatever policy is currently available in the State (limited in Vermont). My medical service providers in New York accept it, and I am prompted to ask how much something is going to cost before I make the purchase, by the way, not many are asking, because there is quite a scramble to get the price agreed upon between the provider and the insurer (it’s not that difficult; it just isn’t done). I encourage you to try it.
This tells me consumers of health care are completely disconnected from health care costs. As long as consumers have the impression someone else is paying, they will not start asking what it costs.
Currently, I have a direct connection between how much I am willing to spend for premiums (deductibles), and must prioritize my health care spending and make a decision based on how I use the health care system (It’s like leasing a car for $200, driving 45,000 miles a year and wondering why you have a big payment at the end of the lease). I make these choices for everything else: food, rent, housing, autos. It is nonsensical that I can be trusted by the government to negotiate the price of an auto but not to find out the real price of a medication, an operation, an MRI, x-ray, or lab test….completely illogical.
Single payer will not reduce medical costs. Regulation has never reduced the price of anything, airline fare, medical services or septic systems. The prices always go up when government meddles in the people’s affairs, and when prices go up low income earners get hurt the worst and more people fall off the cliff of self-sustainability and get sucked into the system, often directly at odds with political rhetoric.
On the other hand, the price of Lasix, way down; shopping for eyeglasses (lots of price ranges), cosmetic surgery (look at the innovation and the competition), all because most policies don’t cover these procedures.
Instead of leaping off a cliff and attempting to imprison (‘capture’) the whole population, why don’t you start with baby steps? I think the smartest thing to do would be to cut the employer-employee ties to health care policies, and let individuals buy their own policy and let the employer provide that benefit as cash with proof of a policy-after all, employers do want healthy employees.
Consumers of health care will shop to pocket as much savings as possible, creating competition; they will start asking the price of things; they will stop going to the doctor for hangnails; perhaps there will be less reliance on the coding game to get coverage for something that really is questionable (now you won’t go for the nose job disguised as a possible deviated septum because you may have to pay the first thousand bucks). Employers will be free of hours of arduous paperwork, and may spend the money on jobs, innovation and growth (you will cut the costs of compliance).
Finally, I have a friend who lived in South Korea until she was 29 years old. She immigrated to New York State. She has told me about South Korean health services: waiting in long lines with her father; back-door dealing for people with cash to pay. She does not understand why anyone would want this, and I don’t want this.
She thinks we are crazy. I think she is right.
161 Forrest Farm Road
Pawlet, Vermont 05761