Will Vermont pass the most radical health-care reform in American history?

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HEALTH - Will Vermont pass the most

radical health-care " reform " in American history?

 

 

 

WALL STREET JOURNAL

Canada South

Will Vermont pass the most radical health-care " reform " in American

history?

 

BY JOHN MCCLAUGHRY

Friday, May 6, 2005 12:01 a.m.

 

CONCORD, Vt.--The real political news in Vermont has been buried under

recent headlines announcing the retirement of Sen. Jim Jeffords: The

Vermont House has approved the most radical health care proposal ever

to gain majority support in a state legislative chamber.

 

In its early days in the Union--after 14 years as an independent

republic--Vermont was a bastion of 18th-century radicalism dedicated

to principles of " liberty and property. " But shaped by the state's

traditional town-meeting democracy, succeeding generations of

Vermonters tempered this radical individualism. Until recently,

however, Vermonters had steadfastly resisted big-government collectivism.

 

This great leap forward into socialized medicine can be traced to the

governorship of Madeleine M. Kunin (1985-90). She was committed to a

Canada-style single-payer system. But her plan faded as revenues

declined, and she ultimately settled for providing health services to

needy children age 6 and under. But the single-payer concept would

rise again.

 

In August 1991, when Gov. Kunin's Republican successor Richard

Snelling died in office, part-time lieutenant governor and physician

Howard Dean suddenly found himself Vermont's chief executive. Gov.

Dean quickly distanced himself from the single-payer idea he had

supported, favoring instead something called " regulated multipayer. "

Translation: Hillarycare.

 

47d1b34.jpgGov. Dean convinced the 1992 legislature to create a Health

Care Authority to come up with two proposals: a single-payer plan and

a regulated multipayer plan. But when it came time for a House vote in

1994, political support for a big-government solution had evaporated.

Health care " reform " died ignominiously after a 7-0 vote in the Senate

Finance Committee, and the Health Care Authority was abolished in 1996.

 

 

From 1995 until late 2004, health care " reform " in Vermont

consisted of Gov. Dean's constant expansion of Medicaid to higher

income workers, known as the Vermont Health Access Plan. Since the

plan's costs rose much faster than the revenues assigned to pay for

it, Gov. Dean financed the expansion by progressively underpaying

doctors, dentists, hospitals and nursing homes. His successor,

moderate Republican Jim Douglas, ruefully announced in his 2005

inaugural address that the state was headed for a $270 million

Medicaid shortfall by 2007.

 

But the new, exceptionally left-wing legislature elected with him

was eager to implement their platform pledge of a single-payer health

system. House Democrats, with a working majority of 89-60, elected the

very liberal Rep. Gaye Symington as speaker.

 

Rep. John Tracy, chairman of a new committee on health care

reform, drove his committee hard to come up with a plan. The eventual

bill declared that Vermont had no " clearly defined, integrated health

care 'system,' " but instead, a patchwork of programs, inequitably

financed, leaving some 60,000 Vermonters without access to care. The

proposed solution was universal coverage for " essential " services as

defined by legislative committee. The state's 12 hospitals would be

subjected to a binding " global budget. " Doctors and other providers

would be compensated on a " reasonable " and " sufficient " basis, in

light of bureaucratically established " cost containment targets. "

Private health insurance for essential services would be abolished.

The new system would be paid for by $2 billion in new payroll and

income taxes.

 

The plan overlooked a few sticky considerations. Many Vermonters

go to hospitals in neighboring states: How could those hospitals be

forced to accept Vermont's government payment rates? What about sick

people migrating into Vermont to gain the benefit of the universal

care? How could the state have " single payer " efficiency when

Medicare, Medicaid and Veterans Administration care existed side by

side with " Green Mountain Health " ? The final version of the bill,

which appeared on the House floor on April 20, didn't settle these

questions.

 

Nonetheless, the House passed the single-payer plan on a vote of

86-58. Gov. Douglas attacked the measure as potentially " devastating

to our economy. " " They are asking Vermonters to pay more taxes, but

get less health care, " he said.

 

 

The business community largely ignored the problem for the last 10

years. Then, on the eve of House passage of " Green Mountain Health, "

business organizations finally united in opposition to the

single-payer plan, but they still couldn't agree on a strong

alternative proposal. The Retailers and Grocers associations came up

with a plan whereby the group insurance market would remain the same,

but the individual (nongroup) market would be converted into a

government-run Vermont Health Security Plan. Those not otherwise

covered would be required to buy insurance from this plan.

 

Democratic Senate leader Peter Welch, though a longtime

single-payer advocate, quickly sidetracked the radical House proposal.

A proposal for more modest reform would avoid a certain veto battle,

and the negative fallout for the liberal legislators who strayed

beyond what even liberal Vermont voters want. The current Senate

version features a new payroll tax to be paid by employers that do not

offer health coverage and by their employees. Its price tag is only

$40 million, a far cry from the House plan's $2 billion.

 

Sen. Welch is a likely candidate for governor when Gov. Douglas

vacates that office. Many believe that he does not want to be viewed

by the business community as the champion of socialized medicine in a

future statewide campaign.

 

All of this would seem to be a tempest in a very small teapot, but

for one thing: Over the past 30 years, Vermont, with a liberal

majority, a hive of activist left-wing organizations, and a press

corps largely hostile to anything smacking of conservatism, has become

the nation's premier blue-state testing ground for virtually every

imaginable liberal proposal. Putting single-payer health care in place

in Vermont would be an enormous breakthrough for the left. This year

its advocates are closer to victory than ever before. If they

ultimately succeed, the reverberations will be felt from coast to coast.

 

Mr. McClaughry, a former state senator, is president of the Ethan

Allen Institute.

http://www.opinionjournal.com/cc/?id=110006652