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Senate Candidates Speak on Single-Payer


by Joyce Kahn

On November 4, Washington County voters will elect three state senators. Incumbents Bill Doyle (R), Anthony Pollina (P-D) and Ann Cummings (D) will appear on the ballot along with challengers Sandra Gaffney (P-D), Pat McDonald (R) and Dexter Lefavour (R). The Bridge is posing three questions to the candidates on critical issues. Candidate responses to the question “What is your position on health care and single-payer?” appear below.  In our last issue, the candidates offered their views on education costs; in our next issue they will address ways to keep our youth in Vermont.

Question: What is your position on health care and single-payer?

Ann Cummings, Montpelier, Democrat:

Before we start talking about health care and single-payer, I think it would be helpful to remember how we got here. All the problems surrounding the exchange seem to have overshadowed the reason we are doing anything—the present system wasn’t working for a growing number of Vermonters and it wasn’t sustainable in the long run. With annual double-digit inflation in the cost of health insurance, fewer and fewer people and employers were able to afford it. Health care is literally a necessity of life. Without it, people die. We have to find a way to curb the cost spiral in health care and to make insurance affordable to everyone. Single-payer, which does away with much of the paperwork and the need for large corporate profits, seems promising. It is the model that has been chosen in one form or another by the rest of the industrialized world and I have been a long-time supporter.

That is the short answer. The long answer is that it’s more complicated than that. There are hundreds of moving parts. There are competing interests and there are a host of unknowns. Logically, single-payer should work, but we won’t know that until all the issues are on the table. I won’t vote for any system that is not financially sustainable or does not provide high-quality health care to every Vermonter. I believe a single-payer system can do that, but people’s lives are at stake. We have to make sure we get it right the first time.

Bill Doyle, Montpelier, Republican:

Health care is surely one of the very major issues for the upcoming legislative session. For a considerable amount of time, the Legislature has been waiting for the administration’s health-care proposal. Specifically, the Legislature has been waiting to find out the cost of the health plan and how will it be paid for.

I will keep an open mind on the proposal that will come to us. But before I vote, I would want to know the proposed cost of the program, and who will pay for it.

Sandra Gaffney, Berlin, Progressive-Democrat:

As Vermonters, we weighed in on how we feel about health care when our legislature passed Act 48. This says that we are providing our own health-care system for every Vermonter to have the health care we need when we need it.

There are some who would have us scared away from doing what’s right and good for everyone by creating a faux logic that a systemic change in health care will be economic ruin for Vermont.

The guidelines in Act 48 state that our health- care system will be equitable, accountable, transparent, universal, and open to participation by our communities where we are not only heard but heeded. In the current system, driven by profits, our own residents of Vermont are being priced out of access to health care and are left to fend for themselves in an economy that makes it extremely difficult to make choices. No matter what it is called—single-payer, universal health care, health care with a conscience, or any other future name down the road—this is what our Vermont, people who live here, has worked hard to create in law. We are ready to work together and fight whatever battles are ahead so we will have our own well-thought-out, equitable, transparent, accountable, easily accessible health-care system. The question is, Who wouldn’t want that?

Dexter Lefavour. Middlesex, Republican

The state of Vermont has clearly proven its inability to administer a large-scale health insurance program over the past few months. Vermonters are exceptional people that take good care of themselves and neighbors, and this means that is it important that we all receive the health care we need. Ninety-two percent of Vermonters were insured before Green Mountain Care, and the number of insured is dwindling because insurance has become too expensive, and access to insurance more difficult. Small employers and individuals have lost health insurance options like health savings accounts and self-insurance programs with incentives to being healthy and not unnecessarily using the health-care system. The new options are more expensive and less flexible. This is not progress. We need options for procuring health care and more freedom of choice in health care choice. This can be done while ensuring that those who need health care but can’t afford it are protected.

Pat McDonald, Berlin, Republican

I believe most Vermonters want a health-care system that takes care of all Vermonters at an appropriate and affordable cost, and keeps doctors and patients in charge. But Vermont is a small state with limited resources.

It puzzles me why we insist upon being first with health care. With “first” comes many mistakes because of the inevitable trial-and-error period, which [has] costs in time and money. For example, we have already spent $70 million on a contract with CGI for the problem-plagued online Vermont Health Connect system, complete with security concerns.

Taking a page from Senator Joe Benning’s article “Governor, It’s Time for a Plan ‘A,’” here is what I think we should do, remembering that “the original plan was to make health care universal, make it affordable and disconnect it from employment.” We should “run the exchange the way the Obama administration intended. Form a NE regional partnership to keep costs down through competition. Keep the Green Mountain Care Board to oversee expenditures. Resurrect Catamount for those who fall through the cracks.” We require car insurance, don’t we? Why not health insurance?

Remember the administration still hasn’t confirmed how much our new health system will cost, who will pay and what will be covered, going well beyond legislative mandated timelines. There must be a better way! This is a tough problem that can only be tackled by strong leadership. I will bring my experience and leadership to Montpelier to bring about a better solution.

Anthony Pollina, Middlesex, Progressive-Democrat

There is good reason most of the world uses a single-payer-type health care system. It is the most efficient, cost-effective way to provide universal care; it eliminates aggravating, costly paperwork and for-profit insurance companies; and, compared to the United States, provides better health outcomes at lower cost—the goal, of course.

The question is, given the challenges, how to design a system that works for Vermont. I suggest looking at existing models we might build on. The Vermont state employees’ health plan is one. It is a large self-insurance plan administered by a single payer (currently Blue Cross). It provides comprehensive benefits with stable, reasonable rates.

Any new system must provide care to all, reduce costs, be financed equitably based on ability to pay, and enhance economic development in Vermont. Rather than building a new system from scratch, I think we should consider building on or replicating an existing single-payer-type system that already serves Vermonters—at least some Vermonters—well.