Governor, it's time for 'Plan A'
Governor Shumlin, I'll give you credit for raising the discussion of health care to a level not seen before. And I'm old enough to remember the titanic battles over this issue in the 1990's. Even though Act 48 was just an abstract concept (a "path" to single-payer) you've kept a sizable portion of Vermont's population clinging to that concept through four years and two election cycles.
But this abstract concept has become a perfect storm. Experts making predictions on savings that we now know will not come true, relying on an influx of primary care providers who haven't materialized. Missed deadlines in blatant violation of law and contract. Navigators thwarted by an IT system that has left thousands exasperated and some without coverage. Untold millions spent. An out-of-state law firm hired for contract work. Contractors hired to oversee contractors. A new state bureaucracy.
And the abstract concept is still, well, abstract! As I asked during the Senate debate in 2011, "What is the benefit package? What is the cost? How are we going to pay for it?" OK, we do have an estimate of cost, which you yourself recently stated could be as high as $2.6 billion. But considering Vermont's entire current budget is just over 5 billion, that's just another dark cloud in this perfect storm.
As Hamilton E. Davis recently wrote on VPR: "Passing the financing plan for single payer will be the biggest challenge that any legislature ever has faced." And we still have no clue on whether we can secure the federal waivers necessary to complete the task, while we become more heavily reliant on federal money that could disappear in an instant.
How about returning to Plan A? The original plan was to make health care universal, make it affordable, and disconnect it from employment. I suspect most Vermonters can unite around such a plan. I also suspect most Vermonters don't care how it is paid for so long as it is affordable. So here are some suggestions.
First, declare this "path" financially unsustainable and run the Exchange the way the Obama administration intended. Form a regional partnership (New England, New Yoark and New Jersey) that attracts as many insurance companies as possible, keeping costs down through competition. Keep the GMC board to oversee expenditures. Resurrect Catamount for those who fall through the cracks.
Second, for those committed to government healthcare, put our federal delegation to work devising a national plan that uses Medicare as its platform. Expand Medicare in increments until it covers the entire population; everybody in, nobody out. Propose a national sales tax to pay for it, so that rich and poor alike pay their proportional fair share. This will take the discussion out of our legislature, which has other obligations to deal with.
Third, fire CGI immediately and sue them for breach of contract. Hire a Vermont company to register people on the Exchange. (If Dealer.com can run a global operation, surely there is a Vermont company that can design a registration system for our tiny population.)
I won't pretend these steps provide all the answers, but we desperately need a new direction for this conversation. We're all getting tired of arguing over an abstract concept that has brought us nothing but grief.
Sen. Joe Benning, R, represents the Caledonia-Orange District in Vermont.
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