Vermonts 3 plans to ensure health care for all Vermonters

[Guest guest]

Editorial: Health care study bill is a logical step forward

April 11, 2010 page C6 of Sunday's Burlington Free Press

The health care bill passed by the state Senate is a cautious but pragmatic step

forward, and a testament to the dogged pursuit of the issue by those who believe

Vermont can lead the nation in pursuing universal coverage.

The bill directs the state Health Care Reform Commission to produce three plans

-- including a publicly financed option -- for implementing universal health

care in Vermont starting July 2012. This is a far more realistic course than

rushing headlong into creating a new health care access system -- the original

intent of the legislation -- overtaking the rollout of the plan passed by

Congress.

Supporters of the bill were up against leaders in both houses -- Senate

President Pro Tempore Shumlin and House Speaker Shap -- who at the

start of the session dismissed chances of passing a health care reform bill this

year, especially with the impact of federal health care reform still to be

sorted out.

Sen. Doug Racine, a Democrat from Chittenden County, was an early and ardent

advocate for advancing universal coverage this session. The Vermont Workers'

Center did the legwork in keeping the issue local amid the national health care

debate by holding numerous " Health Care Is a Human Right " forums around the

state.

Any state reform efforts must negotiate the mandates of the new health care law

and seek to improve on the federal plan to make up for its shortcomings rather

than start from scratch to build an alternative. The Legislature must only

consider plans that pass the tests of increased access and improved

affordability.

The bill also caps rate increases for the 14 Vermont hospitals collectively at 4

percent for each of the next two years. While an arbitrary cap is hardly the

first choice for controlling spending, this is an experiment worth trying given

that nothing else seems to slow the rising cost of health care. Having hospitals

craft budgets with a specific spending limit in mind, instead of having them

justify their budgets before state regulators, could be a useful exercise in

efficiency and cost-cutting. The key is for regulators to keep a close watch on

the quality of care during this period.

Far from being a policy graveyard, the Legislature has used these kinds of

studies on controversial issues as a springboard for tackling serious

legislation. The short timeline for executing a plan mandated by the bill says

that health care reform and universal coverage will remain a priority in the

next Legislature.

The passage of the bill this session also means that health care will likely be

an issue in this year's election, at least in the Democratic primary. The upper

house includes four gubernatorial hopefuls -- Democrats Racine, Shumlin and

Bartlett, and Republican Lt. Gov. Dubie, who is president of the

Senate.

The goal of any health care reform effort -- be it federal or state -- is better

quality, improved access and lower costs, or at least slower cost increases.

With Congress having given reform its best shot, the idea that the state can do

health care better than Washington is worth exploring.

http://www.burlingtonfreepress.com/article/201004110600/OPINION01/4110301

Vermont House panel to vote on health reform bill

By Remsen, Free Press Staff Report • Thursday, April 15, 2010

This story appeared on page B1 of Thursday's Burlington Free Press

MONTPELIER — The House Health Care Committee votes this morning on a bill that

would maintain Vermont's momentum reforming health care despite the financial

constraints caused by the recession.

" Every year since 2006, the Legislature has significantly enhanced

health-care-reform efforts, " said Jim Hester, director of the Legislature's

Health Care Reform Commission. " This is another step forward in that journey. "

The bill calls for:

• Statewide expansion of the Blueprint for Health, a program, tested in a few

pilot sites, that uses care teams and payment changes to help primary-care

doctors deliver more preventive medicine and better management of chronic

conditions.

• Recommendations about how the state can ensure there will be enough

primary-care professionals to treat Vermonters as health coverage expands and

the focus of medical care changes.

• Hiring of experts to write three sets of plans for how universal health

coverage could be achieved, including a government-run, publicly funded option.

• Two insurance-coverage mandates — one for tobacco-cessation treatment and the

other for anesthesia for children and some adults undergoing dental procedures.

• Targets to encourage hospitals to restrict budget growth.

In a straw vote late Wednesday, a majority of the committee indicated support

for the package — welcome news for representatives of Health Care as a Human

Right who sat through hours of deliberations.

" We're really excited, " said Peggy Franzen of Montpelier. Many lawmakers had

advised the organization that health care reform wouldn't happen this year. She

said the bill that will emerge today contains much she and others can support.

She wasn't even that upset that neither the House nor Senate versions contains

the words " health care is a human right. " The concept is established in the

principles listed for health care reform, she said.

The bill has a modest price tag, $339,000, with most of the money required for

the research and design of health-system options.

Still, in a session when lawmakers are grappling with how to make up for a

looming $154 million revenue shortfall, even this amount concerned some on the

Health Care Committee.

" I'm having a hard time going to the floor with this bill, asking for an

increased appropriation, " said Rep. Anne O'Brien, D-Richmond. She didn't declare

how she would vote today.

Rep. Morley, R-Barton, was the sole committee member prepared to say

Wednesday he wouldn't support the bill, and money was his reason. He questioned

where the Legislature intended to find the funding.

Morley also suggested it would be premature to invest money and time in

exploring health-reform options before really understanding the impacts of the

recently enacted federal health-reform legislation. " Let's just hold off, " he

said.

http://www.burlingtonfreepress.com/article/20100415/NEWS03/100414033/Vermont-Hou\

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Senate wants 3 plans that ensure health care for all Vermonters

Experts to provide options for universal coverage

By Remsen, Free Press Staff Writer • Thursday, April 8, 2010

MONTPELIER — Dr. Deb Richter is accustomed to the slow pace of progress toward

the health reform she favors, but she comes back to the Statehouse again and

again to push for change. She was on hand Wednesday when senators took another

small step.

The Senate voted 28-2 to give preliminary approval to a bill that directs the

Legislature's Health Care Reform Commission to hire experts to write three sets

of plans that would implement a universal health care system in Vermont

beginning in July 2012. One of the options must be a government-administered,

publicly financed health benefits system.

" It is a good bill. It will get the ball rolling, " said Richter, an advocate of

a single-payer system she sometimes describes as " Medicare for all. " Medicare is

a federal health insurance program that covers all Americans over age 65.

Richter is sure the design for a single-payer system will show it to be " the

most fiscally conservative way to cover everybody. "

The Senate's health reform bill wouldn't commit the state to change, said Senate

Health and Welfare Committee Chairman Doug Racine, D-Chittenden. Rather, it

would give next year's Legislature and new governor detailed information to help

them make decisions about the next steps they could take to achieve universal

access and better affordability.

Racine said the design process " is a necessary step to make change. "

The bill senators endorsed Wednesday was a political compromise among three

Democratic gubernatorial candidates. Racine, Senate Appropriations Chairwoman

Bartlett and Senate President Pro Tempore Shumlin are among five

Democrats running for governor. Initially, they disagreed about who should

coordinate the planning called for in the bill.

" I believe now we are one big happy family, " Racine reported as he asked

senators to substitute the compromise bill for his committee's original version.

Rather than create a new board to oversee the planning process, the bill calls

for using an existing commission. The panel's membership would change to include

two more nonlegislative members and two fewer lawmakers.

Another change proved more controversial — although not among the gubernatorial

candidates. It would cap growth in the collective rate increase for the state's

14 hospitals at 4 percent for each of the next two years.

Appropriations Vice Chairwoman Jane Kitchel, D-Caledonia, explained that this

would address the mushrooming cost of health care until policymakers have made

reform decisions.

Health care expenditures in Vermont are predicted to hit $5.9 billion by 2012,

and hospitals account for 42 percent of total expenditures, Kitchel said.

Sen. Mullin, R-Rutland, said officials at Rutland Regional Medical Center

warned him the cap would create serious financial problems. He wouldn't support

it, he said.

http://www.burlingtonfreepress.com/article/20100408/NEWS03/100407029/Senate-want\

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