Wednesday January 30, 2013

Last Thursday a report was released by two consulting firms hired to run the numbers for Vermont's universal health care system, Green Mountain Care (GMC), to begin in 2017. It marks the beginning of a new era in Vermont health care reform.

The 156 page document, titled "Health Care Reform Financing Plan," submitted by Secretary of Administration Jeb Spaulding and Director of Health Care Reform Robin Lunge, includes the consultants' report. New numbers relating to Vermont's version of single payer are revealed.

The state report notes that, "Overall, GMC is estimated to save $281 million over the first three years, even with these enhancements to coverage, elimination of the uninsured, and a reduction in out-of-pocket costs for Vermonters. GMC is estimated to cost approximately $3.5 billion, but only $1.61 billion would need to be financed due to federal contributions for the remaining amount. In 2013, individuals and employers will contribute approximately $3 billion between private insurance costs and out-of-pocket costs, so overall the costs to Vermonters are reduced under Green Mountain Care."

The savings are significant, but the $281 million three year savings is chump change compared to the overall savings that would be realized by Vermonters when you consider the overall program costs. What this means is that under our current non-system individuals and employers pay $3 billion a year for health care. As a result of all of the pieces of federal support available to the state as it moves forward, Vermonters will pay $1.


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4 billion less each year than they do now to finance a single payer system.

Opponents of single payer will use the $1.61 billion figure without providing context and they will hope that will scare enough people into the realm of uninformed, knee-jerk reaction.

Vermonters must be educated about what the new system would mean to them financially and that will be the job of the governor and his team. There is talk of plans being made to create an initiative to provide Vermonters with facts to help defuse the heated rhetoric.

Keep in mind this critically important fact about single payer. The plan will cover all Vermonters with a comprehensive benefits package. No more uninsured. No more underinsured.

You will hear all sorts of remarks about how we can't afford new taxes to pay for this new system. The numbers and the moral imperative of covering everyone now clearly show that we cannot afford not to adopt this new system because it is the only way most Vermonters will be able to continue to afford health insurance and health care.

There will have to be a new tax dedicated to pay for the new system and finding that mechanism is at the center of most political criticism. People say they want to know the funding mechanism. That will be the next step. Now that we know the cost, creating the funding plan will be a matter of who wins the day in the political philosophy arena fight.

The inside players on both sides have always known what the financing options are. Some are using the lack of a plan as a way to discredit a process that has been deliberate and thoughtful. No matter what side of the debate, everyone knows that financing will have to be done through payroll taxes, income taxes, dedicated health care taxes or some combination of all three.

The actual financing plan is not as important as critics make it out to be because they are not talking about the trim and slim elephant in the room. No matter how the single payer system is financed, all of us will be paying less for health care.

Yes, we will see some sort of new taxes. The amount of that tax will be less than what Vermonters are now paying for health insurance. The new report makes that clear.

In simple terms, it means that health insurance will become more affordable for more Vermonters. That means that as more people find they can make more of an effort to stay healthy, all of us will eventually start to see less of a rise in health care costs.

Hopefully, facts and not lies and half-truths will fuel discussion of health care reform as we provide a model for the rest of the country.

Richard Davis is a registered nurse and executive director of Vermont Citizens Campaign for Health. He writes from Guilford and welcomes comments at rbdav@comcast.net.