Blog#193-3/8/24
VERMONT TRIES AGAIN
By Richard Davis
December of 2014 marked the end of the campaign for single payer health care in Vermont. Governor Peter Shumlin had been onboard with the effort during his tenure in office and he worked hard to support efforts to move in that direction. But in the end, when he had to look at the real cost of the plan, he declared that single payer in Vermont was dead because the cost would have been too much for small businesses.
We now have a new effort in the form of H. 156, a bill that would, “… implement Green Mountain Care, a publicly financed health care program for all Vermont residents, over time, starting with primary care in the first year, adding preventive dental and vision care in the second year, and incorporating additional health care services in later years. It would establish the Universal Health Care Advisory Group at the Green Mountain Care Board to provide recommendations to the General Assembly regarding the sequencing of and financing for the health care services to be added in the third through tenth years of Green Mountain Care’s implementation. The bill would also express legislative intent regarding funding sources for Green Mountain Care and would prohibit health insurance plans and rates from reflecting duplication of the coverage provided by Green Mountain Care.”
It is an ambitious bill and something that needs to happen. The problem is that I don’t think this effort is going to get too far right now. I spent over 25 years working on single payer and although the people I worked with felt defeated, we never really gave up. We held out hope that more people would come to their senses and realize that what we were proposing made a lot of sense and that it would save a lot of money and improve people’s lives.
We did studies and we held public forums and we engaged lawmakers and policy wonks and we did everything that activists do to push their cause. We knew the plan would have to be promoted by the Governor and he was with us, until he wasn’t. We did feel a sense of betrayal at the time but we had to realize that he had a lot more people to please than just the health care activists.
This push for single payer by Shumlin was probably one of the reasons that his popularity seemed to wane. There were other issues. Even though some us felt he threw us under the bus we did not publicly trash him and we found little ways to keep the movement alive.
H. 156 seems to be the newest effort at creating a more universal health care system in Vermont. There have been other bills over the years that have tinkered around the edges but this bill has huge implications, meaning that it would cost a lost of money.
As far as I can tell this bill is stalled in the House Health Care Committee. I am not in touch with the legislature as much as I used to be and it looks to me that the bill didn’t make crossover, which means it is dead for this session. I may be wrong.
There were lessons from 2014 that activists and those pushing health care reform should have learned. No matter how well intentioned and no matter how many studies and charts and statistics that you throw out there, no matter if you get people to tell heart-breaking stories in committee rooms, you will get nowhere unless you show people the numbers up front.
H. 156 would rely on a combination of payroll and income taxes, but it does not show the real numbers. In order for any costly health care reform bill to gain support from legislators and the public they first need to see real numbers. The rest of the discussion is meaningless unless you can convince the public and legislators that the cost is affordable without causing great harm. Until that happens there will be no successful major health care reform in Vermont.
