http://www.workerscenter.org/b…
Happy St. Paddy’s Day!
While Congressional healthcare reform dominates national headlines, things are heating up in Montpelier for Vermont to lead the way for more fundamental change to truly fix the broken system.
Yesterday, the Vermont Senate Appropriations Committee took testimony from Sen. Doug Racine and the Senate Committee on Health & Welfare about S.88. In case you missed it, this is the bill their committee passed out unanimously (6-0) last Friday which would set up a commission to hire experts to design implementation plans for an overhaul of the healthcare system to be enacted in 2011 (see more here:.
The Appropriations committee room was packed, including six members of the Healthcare Is A Human Right Campaign. Everyone on both committees seemed to be in agreement that the current healthcare system is broken, that the work that Vermont is currently doing won’t fix the problem and that soaring healthcare costs are unsustainable, especially for the State Budget.
There was lots of discussion about whether the new version of S.88 bill, that Sen. Racine and his committee was asking for $400K would help us get to where we need to go. Since the moment this bill passed out of committee, the discussion that has been the discussion outside the statehouse as well. Leaders throughout the healthcare reform movement , including leaders of the Healthcare Is A Human Right Campaign are not unified on what might happen if the bill passes. There are concerns about the language of the goals of the commission in its current form and our Policy Committee has made a list of ways the bill needs to be strengthened.
Some groups and individual single-payer healthcare advocates have called for the new bill to be completely replaced with the old language. But it is highly unlikely given that the bill passed 6-0 out of the Senate healthcare committee, and four of those six were original sponsors of S.88. So what should we do? I think its clear we must strengthen and pass this bill in the Senate and the House. There’s a bunch of ways to do that. I know I could sleep a whole lot better at night if the Governor only had one appointee on the Commission as in the original bill…
… or maybe as Rep. Paul Poirier (I-Barre City), told our members on Monday night, that its possible to find a way to get rid of the commission all together and just order the work done by architects. (A lot of folks think we might have a perfect candidate you can join us to hear from tomorrow. Dr. William Hsiao, who has experience designing healthcare systems around the world, will be speaking before Joint Healthcare Committees tomorrow at 2pm at the Statehouse in Room 11).
The Senate Health & Welfare Committee did not pass exactly what we wanted. With the help of Con Hogan (see See VWC Blog on Feb 23 ) they tried to put a bill together that would be a “consensus bill” to get bipartisan support on. That is why the bill calls for the design of three options, one of which is a single-payer and all of which need to meet the principles and goals (including our human right principles). We think its unnecessary and only more costly to have three options but I think we can live with them, if it helps get legislators behind a bill that has at least one option design a implementation plan that will make healthcare be able to be treated as a public good.
A crew of our Chittenden County members were at the Statehouse and met with Sen. Hinda Miller (D-Chittenden) yesterday. When we talked about how we wanted to strengthen the bill, she said beware that “the perfect does not become the enemy of the good.” That is a real danger. Now, our mission is to make sure healthcare is treated as a human right by holding public policy up to human rights standards and calling for a overhaul of the healthcare system to meet those standards. So the question has been how can we get this to be improved to make sure it accomplishes what we need it to, that is, it designs the plan to implement next year. We need to find amendments to strengthen it so we are sure it will do that and let’s work to get the members of the Senate Health & Welfare Committee to support those amendments.
In today’s Times Argus/Rutland Herald story they quoted me as saying “This will move us forward.” When asked about the bill as we left the Appropriations Committee room what I actually said was “we need to make it stronger, but we must move forward”.
Let’s make amendments to it that can strengthen it in ways that we can get broad support for it so it CAN pass. After it passes, our work will certainly still need to be done. There is no way we can pass anything that the new Governor and Legislature could not totally undo. So we need to continue momentum through the end of the legislative session. We need to fight to pass this bill and let’s organize a huge rally on May 1st at the Statehouse. Then we will continue organizing all Summer and Fall to keep the pressure up and make sure people running for office know what our mandate is. And then as one of our leaders from Rutland said yesterday, “Our job will be to make sure “our” option is selected by the next Legislature in 2011.”
Let’s make it happen.
James Haslam is the Director of the Vermont Workers’ Center who launched the Healthcare Is A Human Right Campaign in 2008. see www.workerscenter.org
“James,
Thank you for your call yesterday. As you requested, following are some of my perspectives on the issue of how to reach true health care reform and how it relates to current events.
I have become convinced, as have many, over the years that a ‘single payer’ health care is the best bet we have to provide high quality care to all Vermonters and control costs. However, at the same time we all know how hard it is to get there.
Advocates play an essential and important role in getting there. At their best they can do the following. They can raise public awareness about the issue. They can educate the public about fundamentals of single payer cost benefit. They can confront a reluctant political establishment. Toward these ends the single payer advocates in Vermont, regardless of the organization, have done a steady and solid job over the years to the point where things are lined up again for some possible progress.
However, single payer advocates alone cannot make it happen. There needs to be a broader based coalition of a variety of interests to truly move things forward. Original S.88 is a good example. S.88, in my judgment was not going to move forward in its original form. S.88 is a statement of faith that single payer is the only way to go without any kind of comparative analysis. In that mode, S.88 could not have garnered the more broad based political support to move forward. This level of health care reform would truly be historic for Vermont and an example to the nation, but it cannot be rammed through by single payer advocates alone. It needs allies. And it needs a broadened process in addition to clear content.
That is why the revised S.88 was created, namely to broaden the process and content of the bill to bring others into the fold. A primary ally would have to be the business community, which with some exception, has remained on the sidelines regarding health care reform.
The idea of having several options to analyze and compare is the way that business makes decisions. Business looks at the numbers of the status quo, and then invariably invites a set of proposals from which to decide and move forward. Businesses that by and large make their decisions based on hunches and dogma are often not long for this world. That is the spirit within which the comparative ideas behind S.88 2.2 was developed. That revision is clear in that a comparative analysis of the status quo, vs. a single payer system, vs. at least two other options is the key to gaining the broader base of support needed to achieve reform. It is that kind of approach that could draw business, and many legislators who have also remained on the sidelines to support a broadened process.
But now, at a key time, it appears that the advocacy community may be becoming fragmented. And if that is so, it is a death knell for a bill. ‘All or none now’ can only bring disappointment as it is a signal that the very groups that got it this far don’t know how to move it further. Any kind of confusion at this point in the process is deadly.
It is true that S.88 2.2 has flaws, some of them substantial. But they can be fixed while retaining the essence of the bill, the comparative analysis feature.
For example, much of the prescriptive language about delivery systems needs to be dropped, so that the focus on comparative numbers becomes enhanced. The broadened health care board needs to be carefully looked at to prevent mischief in the appointments to the board. But these kind of things are fixable, and actually would enhance the opportunity to simplify the bill and, in the process, incrementally draw more support for the bill’s movement.
James, thank you for phone call yesterday, and I was encouraged by your comments in the newspaper this morning. Feel free to use this in any way that is helpful.
Con