Here’s a commentary I got from the Vermont Progressive Party. It’s by Kurt Staudter and I think it expresses some of the dissatisfaction that many of us have with the Legislature’s deal on health care.
Health Care Commentary:
Historic Health Care Reform?
By Kurt Staudter
“The politics of health care reform in Vermont and in the nation will remain the politics of the center for the foreseeable future. In the case of Vermont – and I suspect the nation as well – it will take a coalition of the left (who after all wants something, as opposed to those on the extreme right who want either nothing or something so minor as to be inconsequential) and the center to enact reform. This will mean that single-payer advocates will have to reconcile themselves to the fact that they may not get all they want immediately.” Howard M. Leichter, Winter 1994 issue of Health Affairs
That was written more than a decade ago after our last attempt at historic health care reform. Meanwhile, the costs have gone out of control, the quality of care has deteriorated, the number of people uninsured or under-insured is climbing to record levels, and we haven’t a clue as to how we are going to pay for this dysfunctional system. Yet, after intense negotiations, and in the dark of night, a deal was brokered between Governor Douglas and the Democrats in the legislature. A deal for which both sides are now claiming victory. With all of the back-slapping and self-congratulatory speech making going on, one would have to believe that maybe the state has finally gotten their act together and passed historic systemic healthcare reform. I wish that I could tell you that were true, but the reality is actually quite different.
For those that have been working on the issue of healthcare justice for more than three decades, the work done last year in the legislature was the source of great hope at the end of a long fight. The fact that Governor Douglas wasn’t going to buy into a plan that would represent true systemic reform really wasn’t that surprising, but after his veto, I was stunned by the behavior of Senator Jim Leddy and Rep. John Tracy as they pointed the finger at you and me for not being more outraged at the governor. This somehow justified for these legislative leaders to move the whole discourse to the right, and despite what has been reported in the news, Catamount Health is neither historic nor reform.
As precious time ticks away we are now going into the next round of waiting for the latest scheme to work, and the problem is that we can’t afford another four year delay to solve the crisis. However that is what we now have, and because we will all dutifully wait a see if Catamount works, during the next two election cycles the issue won’t even be on the table. Incidentally, even Karl Rove couldn’t have manufactured a more effective scuttling of Scudder Parker’s campaign for Governor. Before the deal Scudder said on the steps of the Statehouse, “If I were governor we would be talking about a very different bill,” then adding, “Jim Douglas just doesn’t get it… Jim Douglas thinks voters will just throw up their hands and think nothing can be done.” Governor Douglas is no fool, and as the week wore on he saw that he was clearly seen as the one unwilling to compromise, and after gutting any sort of true reform from the bill, he was ready to sign on. And Scudder Parker might as well pack it in and enjoy the summer.
This is of course the problem when the right/center coalition is permitted to write healthcare reform legislation. We ended up with yet another version of the employer benefit/insurance company model that has led to the crisis in the first place. Did we uncouple the financial link between employment and health insurance coverage? No. In fact Catamount forces a greater link between employment and health care by encouraging employers to carry their employees on their insurance, and if they don’t, then they will be forced into the Catamount pool. I will say that charging employers a piece of the cost of public programs is a step in the right direction. However, any way you slice this, the cost of the employer based benefit system is not sustainable and will eventually collapse of the shear weight of the costs.
Add to this the fact that families will have to pony up to $1,600 that they can’t afford to buy into the program. We’ve just moved the bar a little for low-income Vermonters for a program that will remain unaffordable. Then one of the parts of the backroom deal capped the state involvement in Catamount to only cover the first 25,000 of the 60,000 uninsured. I guess those that get neglected can just suck it up. And nothing is done for the rest of us that are being crushed under the weight of unaffordable insurance, and nothing is going to be done to reign in the out of control costs of our inefficient system.
Perhaps what disgusted me the most about Catamount is that it is just another insurance company product. The new program is going to be offered through the insurance companies, and we all know that if they can’t make a profit on Catamount, they’ll just have to make up the difference with rate increases in our already too high premiums. Here we go again with private sector gatekeepers whose job is to limit care and maximize profits. The whole point was to move beyond the employer/insurance company model to a program that actually took care of our healthcare needs in a way that was effective and efficient. Catamount does neither, and 4 years from now we will realize that we have to start all over again. Let’s hope it’s not too late. But for those of us that didn’t get timely affordable care during that time, sadly, it will be.
Kurt Staudter appears regularly in the Springfield Reporter and Vermont
Standard