By PATRICK ARMSTRONG,
Brattleboro Reformer Staff
Friday, December 13, 2002
BRATTLEBORO — Concerns, suggestions and possible solutions to the goal of obtaining a universal health-care system in Vermont were the topic of discussion at the second annual meeting of Vermont Citizens Campaign for Health Thursday night.
Virtually everyone present agreed that the current health-care system in the United States and Vermont does not work, including the three panelist speakers.
“It’s clear that the health-care system in this country is crumbling,” said panelist Rep. Carolyn Partridge, D-Windham. “I passionately believe we have to do something about it, but I’m afraid the system will really have to crumble and a disaster happen before we are able to make a change.”
“The disaster’s already here,” said VCCH board member Richard Davis later in the meeting. “It’s just a matter of how it gets portrayed.”
Panelist Dr. Chris Meyer, a doctor at Brattleboro Memorial Hospital and member of Physicians for National Health, told those in attendance that the United States pays far more than other industrialized countries for health care, and that Americans receive less health care for more money, primarily because of a prodigious amount of money spent on medical bureaucracy. In addition, there are substantial portions of the population that do not have insurance or are underinsured, said Meyer.
“There is an inherent conflict between what is best for business and what is best for us, the patients,” he added. “What is best for business is saving money, and business saves money by not delivering health care.”
“I don’t think it is morally right for people to make money off the sicknesses of other people,” said Rep. Michael Obuchowski, D-Rockingham.
Meyer said that he believed single-payer health care was the solution to the health-care situation, and suggested that the first step would be to draw up a budget, based on how much is currently paid per capita on health care, to let officials know how much money that budget would need. The best way to pay for health care would be to convert everything already paid — such as premiums, co-payments and prescription prices — and convert it to a tax, such as a payroll tax.
People would ask if this would be the government controlling health care, Meyer said. “No more, and probably much less, than the insurance companies do,” he said, adding that the government would only act as the payer for a single-payer system, and the current medical system would remain in place. Competition would still exist as well, Meyer said, because people would be able to choose their health-care provider based upon the quality of care given.
Partridge said that a payroll tax, such as having an employer pay 6 percent of an employee’s income and the employee paying 3 percent, would be much less than what most companies pay now. Many insurance packages cost as much as $8,000, said Partridge.
Using a 5 percent employer contribution as a model, VCCH board member Michael Daly said that an employee would have to be making $160,000 per year in order for a 5 percent contribution to equal the cost of an $8,000 insurance policy.
“We shouldn’t be scared of the numbers,” Daly said. “It is just amazing how they can scare us when the numbers show such great savings.”
Because companies would pay less, Partridge said, this could be used as an enticement for economic development, attracting businesses to Vermont because they would be paying less for health-care costs. A lower employer contribution would also mean property tax relief, as taxpayers would not be paying for high health insurance costs for municipal, state and school employees, she added.
Shoshana Rihn, a VCCH board member, said that small business owners had voiced concerns to her that a payroll tax could penalize employers who pay their employees well. Rihn said that it was important to include businesses in the discussion about single-payer health care, which Partridge agreed to.
“If it’s not a payroll tax, that’s fine with me, as long as it’s the most cost effective way of doing it,” Partridge added.
Marty Jezer said that a single-payer system is a complex issue that, to him, is still an abstraction. Jezer emphasized the need to find out how a single-payer system would work.
“I suggest over the next two years we have time until (Obuchowski) is governor, or someone else is governor, to do our homework,” said Jezer. He suggested bringing together people to write down all the options, send them out to businesses and health-care providers for their input, and in 2004 giving all the information to lawmakers.
“For God’s sake, let’s stop talking about single-payer as an abstraction and get it on paper,” Jezer added.
However, both Obuchowski and Partridge warned against getting into too much detail in single-payer legislation, and suggested that broader legislation would work better.
Obuchowski admitted that the status quo is “politically comfortable,” and that the biggest question is coming up with reasons to shake up the status quo. There is a lack of political will, Obuchowski said, but the way to get the political will to enact universal health care is for citizens to contact elected officials.