by Kurt Staudter
While We Were Sleeping
“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.” While We Were Sleeping… May 2006
Catamount Health is DEAD! I just hate being in the position to tell you so, but there it is. Governor Shumlin, who was on a brief hiatus from the legislature when the Catamount Health scheme was hatched between Governor Douglas and Speaker Symington, never liked the plan calling it “financially unsustainable,” proposed to have the 12,500 folks in the program rolled into the state run Vermont Health Access Program. The administration projects about $5 million in savings from this move, and it was also proposed that Catamount customers would see their deductibles go from $500 to $1,200 per year.
As you might expect, MVP and Blue Cross Blue Shield, the private insurance companies that now profit from Catamount Health, were “disappointed.” The more than doubling of the deductable isn’t sitting well with the folks in the program. And finally, the medical community isn’t happy because VHAP doesn’t pay for services as well as the insurance companies.
However, that is what happens when you shake up the status quo – There are winners and there are losers. I know we are all in agreement that business as usual is no longer an option, so let’s all get to work to find an uniquely Vermont solution to this problem. Now no one can say that Governor Shumlin is dragging his feet on getting the ball rolling – The ink wasn’t even dry on the Hsiao report before he supported a House bill. FYI: Keep your eyes peeled this week for some more from Dr. Hsiao when he makes his final report on February 17.
The House Bill H.202 and the companion Senate Bill S.57 has the backing of Governor Shumlin and will be one of the hottest topics in the biennium. Already powerful forces are being marshaled to kill these bills, but the stage is set and all we need is the will of the people to be the first in the nation to address the healthcare crisis. Our Washington delegation is already hard at work getting us the exemptions we’ll need to move forward, and there is a sense among lawmakers that now is the time to get this done.
As you may have heard, there are three options that are being proposed in the Hsiao report: Option 1, a single payer government run system; Option 2, includes a public option that would compete with private insurance; and Option 3, a single payer system that would be administered by the private sector. It is this third option that is being discussed as the path we need to take.
Many questions come to mind right off the bat, but we should wait until the final report is delivered because there are bound to be some changes. What we can comment on right now is the proposed legislation now under consideration.
The bill as it stands now is walking a tight rope and juggling a lot of different issues. On one hand Obamacare has set certain rules that need to be followed by the states. So the bill jumps through those hoops. Also, we are trying to modify our existing health programs to make them more cost effective. Finally, and this is all but unheard of in most healthcare legislation, it tries to look well into the future.
Under Obamacare states are permitted to set up insurance “exchanges.” These are where insurance companies would be pit against one another in order for the consumer to shop for the best deal. With this legislation that is being proposed, Vermont would have a public option in the exchange. Eventually, by 2014 one would hope that the single payer public option would dominate the exchange, finally leaving nothing but the single payer system. This is an ambitious plan, but they forgot one thing: Unlike the Hsiao plans that call for a payroll tax to pay for the new program, these bills in the legislature have no funding mechanism. Governor Shumlin wants to get the provider payments side of the equation under control before he takes on the thornier question of how to fund it. I don’t know about this – Sounds fishy.
Shumlin has his work cut out to sell this whole idea to the public. One would hope that too much time doesn’t elapse before citizens see tangible results. It’s one thing to set up a new system, make us pay for it, and not really get anything out of it: I for one what to see what this means for me and my out-of-state employer. So far there are more questions than answers.
There will be an opportunity to ask those questions at a public hearing on the bills on March 7 from 6pm to 8pm. You can testify at any of the Vermont Interactive Television sites around the state. Sites near us include Springfield, White River Junction and Randolph Center. Check out: www.vitlink.org
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Let The Healthcare Games Begin!
by Kurt Staudter