by Alice Dubenetsky
How far are the proponents of forcing Vermonters into a single payer health care system willing to go to see their dreams of a Socialist utopia realized?
Representative Jim Condon (D-Colchester) was one of only three House Democrats to vote against Act 48. As a member of the Ways and Means Committee, Condon says he has serious reservations about the measure.
Act 48, known as Green Mountain Care, is a sweeping piece of legislation that purports to make health care in Vermont less expensive and more equitable by establishing a single payer, Canadian-style system in one of the country’s least populous states. While Condon has serious concerns about the legislation, he does not underestimate the determination of many of his colleagues to realize their long-held dream of single-payer health care. Condon, like many Vermonters’, is puzzled about how they propose to pay for it. “Until they admit what their funding will be, the bill is in trouble,” says Condon.
The cost of GMC is estimated at $1.6 billion, and it is scheduled to take effect in 2017, meaning the legislature has until then to identify and implement a funding process that doesn’t bankrupt the state as it sends businesses and high- income earners fleeing.
The fact that the pool of potential funders for this undertaking is so small might seem to be lost on it’s supporters, except for the fact that at passage no funding mechanism was established, leading one to believe that they knew then that the costs will be exorbitant, and will place serious burden on businesses and taxpayers alike in our small state.
It is further indefensible that the report the state commissioned from UMass (at a cost of $300,000) to make recommendations on the implementation of GMC also did not include funding recommendations, even though it was initially contractually bound to do so. At best, the state is practicing budgetary malfeasance by its refusal to make public any financing plans and thus refusing to engage in a frank dialogue with Vermonters about the feasibility of GMC.
Green Mountain Care is based on an “Everybody In” theory, meaning that in order to function properly everyone will pay into a single pool. However, there are approximately 100,000 employees in Vermont who may not be included in the mix. Many work for self-insured businesses and are protected by the Federal Employment Retirement and Income Security Act (ERISA) and are not subject to state authority or state insurance regulations. Under ERISA IBM, GE., and a number of other businesses would be exempt from GMC.
In an article published in the on-line blog Heartland Magazine, Bruce Shields, for President of the Ethan Allen Institute, discussed the topic of exemptions from GMC. “Once you start going through ERISA exemptions, you find that about 50,000 cannot be covered by the Vermont plan. Then there is the teachers union, which represents about 10,000 people. They preferred the insurance they already had and decided not to participate in the Vermont plan. Lastly, the full-scale Medicare beneficiaries will be exempt,” said Shields. “So it begins to look like only half of the state could even apply for the Vermont plan.” So, it now looks like is some people in, and a lot of people out.
Vermont’s Director of Health Care Robin Lunge was so concerned about the ERISA problem that three days before the UMass report was due to be released she emailed UMass consultants Katharine London and requested the deletion of a paragraph in the report because it raised ERISA concerns.
The 2013 Town Meeting Days have come and gone and still Vermont legislators have not seriously broached the topic of funding GMC with their constituents – although it is hard to give credence to the idea that they honestly don’t have any idea what this undertaking will cost the average Vermonter.
It’s beginning to look like the magical pipe dream of single payer in Vermont has the potential to turn into a nightmare. Right now we have an unfunded plan to sweep Vermonters into an unknown system, thereby dismantling the health care system we already have, which, while expensive and imperfect, is at least functioning on most levels. Hopefully, cooler, more mature thinking will somehow find it’s way into the State House chambers of health care reform – before we all find ourselves wide awake in a living health care nightmare.