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Burlington Free Press (Vermont)

Vermont Senate Gives Initial Approval to Single Payer Care

Nancy Remsen

MONTPELIER — Sen. Peter Galbraith, D-Windham, ran for the state Senate to be able to support a bill setting Vermont on a course toward a more consolidated health care system guaranteeing coverage to every Vermonter, he said Monday.

“This is a historic day,” Galbraith declared just before he joined 20 other senators to give preliminary approval to the health reform bill.

The 21-8 vote split largely along party lines. One Republican — Sen. Kevin Mullin, R-Rutland — voted with the Democrats and two Democrat/Progressives to support the bill, which Mullin helped write as a member of the Senate Health and Welfare Committee.

One Democrat — Sen. Robert Starr, D-Essex/Orleans — joined the seven Republicans who voted against the measure.

Senators continue debate on the legislation this morning with the final vote expected by the end of the day.

The contrasting political views regarding the bill were spelled out during the debate by Sen. Claire Ayer, D-Addison, who has shepherded the bill through the Senate as chairwoman of the Senate Health and Welfare Committee, and Sen. Joe Benning, R-Caledonia.

They agreed only on the fact that the current health-care system is broken.

“Doing nothing is not an option,” Ayer argued.

“Change is needed because the present system cannot be financially sustained,” Benning said. “The issue that divides us is how that change should be made.”

Ayer described the bill, a version of which the House already has passed, as a “business plan for unified and universal health care in Vermont.” The bill outlines a process that will unfold over several years, she noted. The Legislature will have future opportunities to decide whether it’s feasible to move to Green Mountain Care, the government-run health coverage program the bill envisions.

Benning disputed Ayer’s characterization.

“This bill is being sold to us as just a road map to see where we should take health care,” he said. “Respectfully, I must disagree, because this bill establishes protocols and gives specific directions, which are marching us toward doubling our state budget. I have grave reservations.”

Sen. Randy Brock, R-Franklin, used more vivid language, likening the bill to a cattle ramp at a slaughterhouse. Despite supporters’ contention that there were checkpoints throughout the process, he said, “I’m worried there is a point when we won’t be able to turn around.”

Ayer argued there is an urgency to do something about the health care system.
“While some ask, ‘Why rush?’ more ask why we dawdle,” she said. She cited the escalating cost of health care in Vermont as reason to act now.

“Health care in Vermont costs us over 18 percent — almost one-fifth — of our entire domestic product and is growing,” Ayer said. “Over 200,000 Vermonters are un- or under-insured. Many of them are a broken arm away from homelessness or worse, and their numbers also grow by the day.”

The pending bill, Ayer said, was the remedy for the ailing system.

Benning countered that the bill fell far short of solving the state’s health-care ills.

“It is irresponsible to promise or imply that all citizens will be covered for all their health-care needs in a comprehensive plan when we cannot afford to do that,” Benning said. He criticized the bill for, he said, failing to answer critical questions such as what the health benefit package would be, how much it would cost or how to pay for it.

Ayer answered that the bill called for an exploration of “the options, the pitfalls, the benefits and the possibilities of health care for all Vermonters.” She listed the principles in the bill that would guide the proposed Green Mountain Care Board and the Legislature in analyzing the responses to the questions Benning and other critics have raised. The principle include:

• Vermonters have the right to see their own doctors.

• The health-care system would respect the primacy of the professional judgment of health-care providers and the informed decisions of patients.
• All Vermonters will contribute to the fiscal sustainability of the system.

• Vermonters would take responsibility for their health and use of resources.

• Providers and hospitals would be paid at a level that ensures their work is sustainable and their jobs, attractive.

Senators proposed nearly a dozen amendments to the 74-page bill. As afternoon became evening, and decisions had been made regarding only a handful, sponsors of numerous amendments agreed to delay presenting their proposals until today.

Once the Senate finishes its deliberations on the bill and votes, the revised version goes back to the House, which could accept the changes or call for negotiations. Negotiations are expected.

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