When I was a kid my mom had the uncanny knack of timing her “wake up for school” call in the middle of some of my best adolescent dreams. Glory and stardom were rudely interrupted by the frightening reality of another day in algebra class. Sorry, Vermont, but the dream of a money-saving, single-payer, universal, state-run health care system is about to experience a similar rude awakening.
It’s taken long enough. I was afraid we were going to sleep and dream through our 2017 appointment.
Thankfully, our governor, appearing recently at a Democratic Senate caucus meeting, urged that caucus to “plow the ground” for Green Mountain Care. Yes, he was passing a buck that he himself was responsible for, but no matter, we’re on our way.
First, let’s dispel any leftover dreams. Green Mountain Care was passed on the premise that we would be saving many millions of dollars. Those savings were predicted by William Hsiao, who warned us not to heed the political winds that would blow his planned savings apart. We didn’t listen. His predicted cost savings are no longer reality.
Second, let’s identify the remaining mission: Provide quality health care for every Vermonter with a state-funded system by 2017. We’ve yet to develop a working IT network, define services, mandate service requirements for care providers and contractually agreed-to provider payments.
We also need a figure to work with. Sketchy numbers right now call for a figure of about $2.2 billion. I say “sketchy” because our population in need of services continues to rise, meaning we are likely to need around $3 billion by the time 2017 rolls around. Whatever the number, we’ll need to understand that figure will be competing for money needed for everything else we do as a state.
Next we need to decide who’s going to pay for that and how. Enter courageous Sen. Peter Galbraith. He just introduced Senate bill 252 with no co-sponsors, a financing scheme for Green Mountain Care. I say “courageous” because this lone senator’s bill will finally force discussion of an issue his party has been trying to avoid for three years.
A smooth transition between what we have now (or should have had by now) and services provided through government by 2017 means we will need money rolling in and a workable delivery system in place by 2016. This all requires legislation. That leaves the 2014 and 2015 legislative sessions, roughly eight months in real Vermont time, to accomplish the task.
I remain convinced Vermont needs to go in a different direction. I share in the wish for a system that is disconnected from employment, provides universal coverage, and is less expensively paid for through a streamlined approach, only I’d do it with a national plan. But getting there will require further discussion. Unfortunately, a determined donkey is firmly hitched to the plow tilling the nightmarish ground of Green Mountain Care. Whatever we end up with, as one Democratic senator prophetically observed, Vermonters won’t be pinning that tail to an elephant.
Sen. Joe Benning, a Republican, represents the Caledonia-Orange district.
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