By Kevin Joseph Ryan
Green Mountain Health Care (Act 48), was passed into law in 2011, establishing though the Vermont Legislature that the state will begin integrating all of its public health care programs, including Vermont Health Care Access (VHAP), Catamount Health, Medicaid and the Children’s Health Care Program (CHIP) into a single unified group. In recent debates in the statewide governor’s race, this and other health care proposals have been a major bone of contention between current Governor Peter Shumlin and Republican candidate Senator Randy Brock.
“Actually, if it were as simple as having an advanced degree in health care policy, it would only be one level of baffling,” said Jeff Wennberg, Director of Vermonters for Health Care Freedom, in describing the labyrinth twists and turns upcoming in the debate. However, Wennberg points out that given the uncertainty of the costs and particulars of the plan, it is even more difficult to ascertain exactly what the plan means to Vermont’s health and financial future. He was quick to point that in replacing Vermont’s current system, which covers more than 90% of the population, we are “blowing up the bridges” in the process.
So why even do it? According to Governor Shumlin, “It’s what we know that should scare us.” The Governor points out that currently, Vermonters spend 5 billion dollars on health care and if the costs are not brought under control, by 2020 those costs will balloon to 10 billion. “Where’s the money going to come from?” is the question Shumlin has been asking on the campaign trail this season. Wennberg disagrees with the presumption. “The rate of increase the Governor has been using is four years out of date.” When asked what the increase would be at current inflation, Wennberg said closer to about 6 billion.
Annual premiums for family health insurance provided by employers nationally rose about 4% to $15,745 in 2012, according to a survey by the Kaiser Family Foundation and Health Research and Educational Trust. Governor Shumlin’s numbers presume the same rates of increase seen in previous years, such as 2009, when the Vermont Joint Fiscal Office and Department of Banking, Insurance, Securities and Health Care Administration (BISHCA), put that previous number at closer to 7%.
In general, it should be noted that without reducing payment rates to medical practitioners, the Green Mountain Care law, as passed, could not reduce medical costs without capping payments, and at best would reduce the cost of insurance coverage. Some have pointed out that without other states moving to the same plan, reducing payment rates to health providers may increase scarcity of medical care in Vermont.
Governor Shumlin’s opponent, Republican Senator Randy Brock would prefer to avoid Green Mountain Care before it goes any further. Brock blames state meddling for the high health care costs and premiums. He has been telling Vermont audiences at campaign stops and debates, “We haven’t had a free market in health care in over fifty years thanks to government intervention.”
Brock further notes that elective medical procedures not subject to government interferance, such as Lasik eye and cosmetic surgery, “Follow the law of economics. Prices go down with completion.” Brock would like to see a pilot reform program that could be revoked if it is not successful, instead of a wholesale rewrite of Vermont’s insurance and health regulation system.
The Governor has rebuked the idea of more limited reforms. He makes the claim, If the free market worked in health care, we wouldn’t be in the mess were in.” Specifically, in debates this year, he has told opponent Brock, “I know it’s your job is to spread fear in this campaign.” For Brock’s part, he responds by saying, “I refer to it as telling Vermonters the truth.”