Home Columns Opinion OPINION: An “Exchange on Steroids” Helps No One

OPINION: An “Exchange on Steroids” Helps No One

by Peter Sterling
The visionaries who founded our country did not give women the right to vote. Nor did they outlaw one of the most heinous of all crimes: slavery. Proof positive that even brilliant people sometimes come up with bad ideas, just like the rest of us. And Vermont’s own history has a few such ideas as well, such as the plan to build a road across the top of our Green Mountains. Looking back, one can only ask, “What were they thinking?”
Were it to become law, I believe history will similarly view the current plan floating around the Vermont legislature to abandon the creation of Green Mountain Care—Vermont’s publicly funded, universal health care plan. This proposal keeps us shackled to the current system responsible for runaway health care costs and 120,000 underinsured Vermonters burdened with high deductibles that keep them from getting affordable medical care when they need it most.
Prepared by a consultant to the Vermont legislature, Ken Thorpe, the plan builds upon Vermont’s existing health care exchange (aka Obamacare). As a navigator who has enrolled many people in the exchange, there are numerous reasons that using it as the foundation of reform will never result in affordable health care for all Vermonters—just one example is that the eligibility and application processes mandated by federal law are just too complex and administratively burdensome.
And, instead of Vermonters collectively saving $500 million in health care costs from moving to Green Mountain Care, Thorpe’s proposal for an “exchange on steroids,” adds another tax (rumored to be around $200 million a year) to Vermonters’ bills. Again, we’re going to be asked to pay a higher tax bill to prop up the current system that has so thoroughly failed to either control health care costs or provide affordable health care. As they say, “You can put lipstick on a pig but it’s still a pig underneath.” And that’s what the exchange is always going to be: the pig constantly at the trough gobbling up more and more of our tax dollars for subsidies for Vermonters to buy health insurance plans from Blue Cross Blue Shield and MVP.
The exchange is pretty much the mirror opposite of Green Mountain Care where every Vermonter will have access to a single health care plan that is completely publicly funded. Think of a Dr. Dynasaur for all types of programs—little or no deductibles, comprehensive benefits, no open enrollment periods or other barriers to getting coverage and widely embraced by Vermont’s hospitals and doctors. We already know that public plans like Medicare and Dr. Dynasaur provide excellent coverage at a fraction of the cost of private insurance plans. This happens in large part because of their efficiency: only 5 percent of Medicare dollars go towards administrative costs, while private insurance requires 10–12 percent of every health care dollar for administrative purposes.
The essence of Green Mountain Care is to change the way we pay for health care, not the way we receive it—Vermont hospitals and doctors will largely go about their business as they do now but with an important difference. No longer will health care providers have to deal with multiple insurance companies imposing multiple coverage rules or claims reimbursement rates. Finally, doctors and nurses will be able to spend more time treating patients and less time dealing with paperwork.
I appreciate the legislature’s work to “kick the tires” on the governor’s proposal for Green Mountain Care. It’s the appropriate role for our elected officials to ask hard questions, think of alternatives and vet them thoroughly. But, everyday we get closer to showing the rest of the nation that it’s possible to create a system ensuring that everyone has access to affordable, publicly funded health care. Our legislature would be performing a grave disservice to the health and financial well-being of Vermonters were it to abandon these laudable goals of Green Mountain Care.
Peter Sterling is the director of Vermont Leads, a nonprofit organization working to create a universal, publicly funded health care system in Vermont.