Home Commentary Opinion OPINION: Health Care Costs: Another View 10.9.14

OPINION: Health Care Costs: Another View 10.9.14


by Peter Sterling

agree with the main point made by Blue Cross and Blue Shield of Vermont’s Don George (p.26): that the way we currently pay for health care is unfair to businesses and health-care providers, and that that ultimately and unnecessarily increases the cost of health care.

Unfortunately, the solution isn’t the one Mr. George proposes. Simply throwing away more of our tax dollars on increased payments to health-care providers is like painting over the rusty spots on your car so it can pass inspection: It may look good for a very short time but it’s not fixing the root cause of the problem.

But, thanks to the leadership of Governor Peter Shumlin and the Legislature, Vermont is now on a path to controlling the cost of care while making sure everyone has insurance. It’s called Green Mountain Care and it’s a single, taxpayer-funded plan that every Vermonter will be eligible for.

Under Green Mountain Care, set to begin in 2017, every Vermont resident will be automatically enrolled in the same plan with the same high-quality benefits. No more waiting periods or getting coverage dropped because you missed a premium payment. Your health care will be paid for the same way you pay for schools, the police, and fire protection.

Imagine calling the police to report a break-in, only to be told they can’t come to your house because you couldn’t pay your police premium. That’s essentially what we’re doing now with people’s health-care needs.

The basic numbers for Green Mountain Care add up to real savings for all Vermonters. We as a state are currently spending about $2.6 billion yearly on health care. The Shumlin administration’s projection is that we can replace this with a tax package of approximately $2 billion to pay for Green Mountain Care—a savings of roughly half a billion dollars.

We’ll be spending less money to get better results because, in contrast to the current, broken system, everyone will get coverage. It won’t matter if you lose your job, you finish college, your employer offers coverage, or you work for someone that doesn’t offer health benefits: Green Mountain Care will cover you. And that’s very good news for all of us, especially the roughly 40,000 Vermonters that go uninsured every year.

It’s important to remember what got us into the situation we face today—how we ended up with our current, broken system. For decades we’ve relied on a health-care system based on competition between insurance companies, with the government covering the people the private market didn’t find profitable—the poor (Medicaid) and the elderly (Medicare). While the private market is very effective at driving down the cost of consumer goods like televisions, it really doesn’t work for delivering health care to sick people. If your wife is having a stroke, you don’t comparison-shop for emergency-room prices. You just want the closest ER to save her life.

In the health-care “marketplace,” competition has not simply failed to decrease medical bills; it has in fact led to the opposite—skyrocketing costs. With multiple insurers come various plans and different deductibles, co-pays, provider rates and so forth—which adds layers of complexity and cost that we all end up paying for. One basic fact highlights this: Government programs spend significantly less on administration than do private programs—about five cents of every dollar under Medicare, as opposed to the 10 to 12 cents per dollar spent by private insurers.

Vermont has an exceptional track record for getting people enrolled in Dr. Dynasaur, which very much resembles the proposed Green Mountain Care. Dr. Dynasaur is a single-payer plan, entirely publicly financed, that is open to every child under a certain household income level. Its 97 percent enrollment rate is largely due to its low cost—there are no deductibles or co-pays for its services—and to the high quality of care that enrollees receive.

While it’s very easy to get confused and feel your eyes glaze over at all the numbers being thrown about regarding health-care reform, one idea, embraced by every other industrialized country in the world, always seems to float to the top: The only way to guarantee that everyone has access to affordable, high-quality health care is through a universal, publicly financed system such as Green Mountain Care.

Peter Sterling is the director of Vermont Leads, which advocates a single-payer health care system. He lives in Montpelier.