1. Universal publicly financed primary care would reduce the need for expensive hospitalizations and emergency room visits by preventing disease and treating conditions earlier.
2. It would lower health care premiums for all! (Vermont law does not allow premium rates to reflect services private insurers do not pay for).
3. Primary care could be financed for relatively little. A state 2016 study estimated it would cost under $175 million per year, and this would include both substance abuse and out patient mental health. That is not much more than the cost of a proposed new hospital building at Fletcher Allen.
4. Financing for the bills would be taken up next session, but these bills would create a road map to universal publicly financed primary care. They would keep us on the road to health care as a public good set out in Act 48.
5. If we don’t invest in primary care, it won’t be there ten years from now. We will be left with specialists, and this will not only be bad for public health, but also vastly increase costs!
6. Over 1/3 of all Vermonters under age 65 are now underinsured (36%). This number continues to rise. Underinsurance means people do not access care when they need it due to financial barriers. Primary care for all with no fees at point of service would help ensure access to care.
7. Of Vermonters who went to the doctor once in the previous 12 months, most (61.6%) did not visit a specialist at all. Primary care is where most of us access care most of the time!
8. Only about 10% of privately insured Vermonters get their insurance through the Exchange. So, even if we bolster the Exchange, this does nothing for almost 90% of privately insured Vermonters, a substantial number of whom are underinsured, and who would typically access the health care system through primary care.
59 House members have introduced H156! It creates a clear roadmap for publicly financed health care for all Vermonters! (A companion bill S74 has also been introduced in the Senate).
These bills phase in a universal health care system, starting with Universal Primary Care, including outpatient mental health and substance use disorder treatment. The bills propose adding preventive dental and vision care in the second year, and incorporating additional health care services in later years until we have universal access for all sectors of care.
In the first phase of implementation, every Vermonter would be entitled to free primary care with no barriers. Accessible primary care has been shown in numerous studies to be the single best step to improving population health. Click here for talking points, and here for a more detailed FAQ. Please contact House Health Care Committee and the Senate Health and Welfare Committee. Let these committees know you would like this bill considered and passed out of their committee.
The bill will also:
We will keep you up to date on specific actions you can take to help us pass publicly financed health care for all Vermonters.
Use the legislative finder below to automatically connect you to your representatives and senators. Ask them to support universal publicly financed health care, with universal primary care as the first step. Health care should be a right, and not a private commodity.
Every Vermonter needs guaranteed health care for the simple reason that every Vermonter to one degree or another is at risk for being left out by our dysfunctional healthcare system.
Universal health care is also critical to health care justice, especially in addressing lack of access to health care for disabled, low-income (yet not qualifying for Medicaid), black, indigenous, people of color and other marginalized populations.
Use the form below to find and contact your state legislators and demand that they support legislation to make health care available for every Vermonter without cost, independent of private insurance, employment or income, starting with universal primary care. Here are talking points on why we should implement universal health care starting with universal primary care. (Click here for a useful handout on lack of access and affordability in our current system).
Tell your legislators they need to take action!
Support Universal Primary Care (H.129)! Write to your own representative and house leadership and ask them to take up this bill in the next session. Health care should not be a back burner issue in Vermont.
Download our information card on universal primary care here. Please help spread the word! Click here for more talking points!
Our goal is to have at least one letter supporting universal publicly financed health care in each paper every week. The letter to the editor section is one of the most highly read parts of the paper. We’ve made it really easy for you to write a letter including providing some important facts and the address to send it to. Click here to write a letter to your paper today. Click here to read what other Vermonters are writing about Single Payer. Click here to read answers to the latest myths about single payer!
What Burton Actually Said (BFP)
There he goes again. Burton’s decision to move its manufacturing jobs to Austria led the governor to say that taxes need to be rolled back. But the CEO said nothing about state taxes, which are a very small component of business costs (and of course we have no idea how much Burton pays, although we do know they received $1.8 million in EATI/VEPC credits and were just awarded another $1.6 million in VEGI/VEPC "incentives").
The CEO did mention health care costs, which is ironic because Austria has a tax-based national health care system while the governor continues to resist such an approach for Vermont. For his part, the governor said we need more "choices," which ignores the fact that Austria spends half as much per capita as we do on health care (and gets better results).
Instead of listening to what the company said, the governor went immediately to his canned talking points. This bespeaks a lazy intellect and a rigid ideology that refuses (or is incapable) of seeing the world as it is. We need leaders willing and able to analyze real problems instead of trying to fit everything into prefabricated boxes. The former is about solving problems; the latter is about serving vested interests.
DOUG HOFFER
Burlington
By Mell Huff
vtdigger
Wendell Potter alleges the health insurance industry did everything in its power to discredit the movie “SICKO”
Vermonters should be prepared for a campaign by health insurance companies to undermine public support for single-payer health care, an industry whistleblower declared at a Statehouse hearing Thursday.
Wendell Potter, who until 2008 was a public relations executive for CIGNA, said he witnessed such a campaign in 2007, when industry pollsters reported for the first time that a majority of Americans felt the government should play a more direct role in health care.
Industry leaders feared that the public would begin demanding the kind of comprehensive reform now being considered in Vermont, Potter said, and their fear was compounded by the release of Michael Moore’s documentary “SICKO.”
Potter told lawmakers and health care reform advocates at the Statehouse that as an industry insider at CIGNA he observed the orchestration of an extraordinary clandestine effort to discredit Moore’s film and the single-payer health care model it promoted.
In the spring of 2007, Potter took part in a secret meeting with other major insurance companies at CIGNA’s corporate headquarters in Philadelphia. In addition to an update from the pollsters, the meeting included presentations by an industry trade group — America’s Health Insurance Plans (AHIP) and a huge communications firm, APCO Worldwide, he said. The reason for the secrecy was to conceal the insurers’ alarm about Moore’s film and the shift in public opinion, according to Potter.
AHIP and APCO Worldwide presented the executives with a 23-page strategic plan called “Ensuring Accurate Perceptions of the Health Insurance Industry,” which Potter said was designed to neutralize the effects of Moore’s film.
Potter read from a copy of the “playbook” for how to control the message in a crucial dispute. The strategic plan advised:
“Reframe the debate: Mount campaign against a government-run health care system”
“Define the health insurance industry as part of the solution”
“Develop talking points …”
“Highlight horror stories of government run systems”
“Create an ad that would show Democrats’ likely response to a single-payer proposal; float the ad on the Internet and encourage conservatives to donate money to the allied organizations to support running the ad”
“Produce vignettes of victims of single-payer systems; distribute it on websites via conservative bloggers and YouTube.”
Audiences were targeted, he said, and “free market allies” identified — Health Care America, the American Enterprise Institute, the Heritage Foundation, the Cato Institute and other ideological sympathizers who “will have a vested interest in critiquing single-payer health care.” Unlikely allies, such as medical specialty groups, were also identified.
Given the extraordinary effort that the industry’s leaders invested into discrediting “SICKO,” Potter said single-payer supporters should expect that insurers are certainly aware of what is going on in Vermont. “They have probably already developed a much more comprehensive plan than this one to try to derail what’s going on here in Montpelier,” Potter said. “I have no doubt about it. They do not want you to succeed.
“You will not even be aware they’re behind it,” he added. “The industry’s communications strategists will want the campaign to be perceived as a grassroots movement arising to oppose lawmakers in favor of a single-payer plan.”
Sen. Richard McCormack, D-Windsor, remarking on the uniformity of the rhetoric of right-wing talk-show hosts, asked if it was coordinated.
“Absolutely,” Potter replied. Communications strategists give “messaging” to talk show producers, and lobbyists give talking points to friendly members of Congress and the media.
They spend large sums testing words with focus groups, and they’re experts at message discipline,” he observed. He noted that the phrase, “government takeover of health care” featured prominently in the 2007 SiCKO campaign. Then last year in the health care reform vote, almost every Republican who spoke about the bill on the House floor used the same phrase, Potter noted.
A key element of the strategy is to develop a simple message and get as many people as possible to use the same words over and over again. With enough repetition, some people will come to believe even assertions that are not true, he said. He cited the example of “death panels.”
Potter predicted that in Vermont, the health insurance industry’s strategy would include trying to influence the news media, and getting people to write op-eds and letters to the editor, to blog and to call into radio programs. “It will be the perception of a grassroots organization, but it will be organized behind the scenes by the insurance industry,” he said.
“They go to great lengths to launder money to avoid detection,” Potter said, tracing the money trail. A health insurance company will give a portion of a policy holder’s premium to AHIP, the trade group, which hires a public relations firm like APCO Worldwide to set up front groups like Health Care America, leaving no trace of insurance company involvement in the fake grassroots organizations, he said. And because it’s not mentioned on either AHIP’s or APCO’s website, he said, no one — except for people at the two companies — knows there’s a relationship between them.
Potter said you can find out some information about a “grassroots” nonprofit from its federal 990 form. You can also call the person listed as the media contact on the nonprofit’s website and ask where his or her office location is.
If the media contact for Health Care America is honest, Potter said, he will tell you that he’s sitting at his desk at APCO Worldwide, because he’s not — and never was — an employee of Health Care America: Health Care America and organizations like it exist only on paper.
Potter once tried to find the office listed on Health Care America’s 990 form.
“It’s one of these virtual office settings where people can pay money to have a real street address. They don’t have an office there, but they can use that address,” he said, “and if they want to have a meeting there, they can pay to rent a conference room. If you check to see how many people are at this address, you usually will see that there are dozens of people that share that same address.”
Potter predicted that next year — an election year — the health insurance industry’s political strategy will be to try to change the governor and the makeup of the legislature in Vermont, just as last year it tried to change the makeup of Congress. “They were successful in flipping the House of Representatives and reducing the Democratic majority in the Senate,” he observed.
“It’s going to be important to find out who’s behind the money that’s coming in to influence Vermont,” he said. “They will spend an enormous amount of money to influence the elections in 2012 here. There’ll be political advertising for candidates that are willing to deliver the industry’s messaging, and there will be negative campaigns against lawmakers who vote for single-payer legislation.”
Potter noted that the health insurance industry funneled $86 million in one year through the U.S. Chamber of Commerce to influence the health care reform debate. The U.S. Chamber and Business Roundtable are long-term allies of the health insurance industry, he said: The chief executive officers of Aetna, CIGNA, WellPoint and Humana are Business Roundtable members.
Shortly after the campaign against SiCKO was launched, Potter began working on a white paper whose purpose was to downplay the problem of the country’s uninsured. (They now number 51 million.) That summer he took a trip to Tennessee to visit relatives, and while he was there, he had an experience that turned the industry’s statistical abstractions into flesh-and-blood reality.
He was listening to the radio when he heard about a health care “expedition” in a nearby town. It was run by Remote Area Medical, a relief organization that flies doctors and other health care volunteers to under-served areas to provide medical care. (Originally they flew to Africa and the Amazon, but now 65 percent of RAM’s expeditions are to counties in this country, Potter said.)
The next morning, Potter grabbed his camera, borrowed his father’s car and drove to the fairgrounds where the expedition was being held. He was stunned by what he saw: people — some from as far away as Ohio — standing in soaking rain in lines that stretched out of sight; people being treated in open tents and animal stalls. They could have been people he grew up with. Most of them had jobs, but either their employers didn’t provide health insurance or else their plans had high deductibles.
Potter had become increasingly uncomfortable as he realized that insurance companies were trying to move people like these into high-deductible plans. Some policy-holders couldn’t afford to see a doctor or buy medications after paying their insurance premium.
One company in Maine, Potter said, is selling a plan with a $30,000 deductible. “That is where the insurance industry wants to take us all. They make money hand over fist when they can get us into these plans. Seeing what I saw was one of the factors that made me decide to quit my job.”
Potter says he’s not advocating a single-payer versus a public option. His goal is to make Vermonters aware of the propaganda campaign that will be unleashed on them, if not this year, next year.
“This is going to be a multi-year project for you all, and this is going to give the insurance industry and its allies a lot of opportunities to try to turn public opinion against what you’re trying to do,” he said.
“It’s almost stunning what you’re trying to do,” he added. You were the first to abolish slavery. Maybe you can be the first to abolish insurance.”
Potter’s visit was sponsored by Vermont Health Care for All, UVM United Academics, United Professions AFT Vermont, the AFL-CIO and Vermont Physicians for a National Health Program.
“This is not reformism and being incremental in the Obamacare vein by any stretch of the imagination because it is a change in our current system of looking at health care as a private commodity. Instead, these bills would establish health care as a public good and for everyone, regardless of age, income, job status or any other life circumstance.” — Ellen Oxfeld of Vermont Healthcare for All
Last week in the column it was mentioned that there were bills in the Vermont House and Senate that would provide for all of our primary care. I wrote: “Another incremental proposal includes H.207/S.88 which creates publically financed primary care to all Vermonters. According to Vermont Healthcare for All we could finance this for very little. Spokesperson for the group, Dr. Deb Richter, puts the cost at around “$160 million.” If this were to be paid for totally with a payroll tax it would roughly be double what the governor is asking for at 1.4 percent. However, if all of our primary care were covered by this state program, what do you think would happen to our insurance costs?” I’ve known Deb Richter for a long time, so I wasn’t surprised when she expressed her displeasure with my analysis. She wrote: “I gotta tell ya, I was very disturbed by this piece you wrote. Everyone is entitled to their opinion of course, but you ignored some basic facts in your analysis. It might have helped if you had simply asked one of us involved in the push for universal primary care what would happen to premiums under our plan. It turns out we have a law in Vermont that mandates premiums to reflect the level of risk. Under the universal publicly funded primary care program, private insurance would no longer have to cover primary care. Therefore, premium rates would have to go down by law. I was surprise to read your implication that they would go up.”
If anything, I was implying that rates would go down. If all of our primary care like routine visits for physicals, stopping in with a cold that just won’t quit, or that nagging backache; I have to believe that taking this basic care out of the hands of insurance companies would lower our rates, and what’s more, by making primary care a basic right would go a long way to making us all healthier and further lowering overall costs.
I also heard from Deb’s colleague Ellen Oxfeld who urged me to more fully explore the proposal. She wrote, “All studies show that free primary care at point of access is the single most important health care measure that can be taken for improving overall population health and right now, with almost 1/3 of all Vermonters underinsured, there are many who delay going to their primary care doctor which can result in a less serious condition becoming much more threatening as it is ignored.” Along with her critique of my column she sent along some materials in support of her arguments.
Perhaps the most compelling point in support of these bills is the fact that, though this is an incremental step, it does move us towards the goal of Act 48 of a universal publically funded healthcare system. For Governor Shumlin to simply say that we can’t move forward because of the cost is just wrong. The truth is that the longer we wait on reform the more it will cost. Like I mentioned last week, the governor wants to raise money with a 0.7 percent payroll tax to increase payments to doctors who treat Medicaid patients. His argument is that this will stop the “cost shift” to those of us with private insurance. While there is no guarantee that the governor’s proposal will lower our insurance payments, there is no doubt that H.207/S.88 will substantial lower our insurance cost by perhaps 10 percent.
According to the talking points, “Of Vermonters who went to the doctor once in the previous 12 months, most (61.6 percent) did not visit a specialist at all.” So if these visits were covered by the state primary care program it would take a huge bite out of our insurance premiums. Another concern is that we may be faced with a shortage of primary care physicians. By having a program where practitioners are paid per patient instead of per visit we would be making a significant investment in primary care. That first in the nation investment would be a huge draw for doctors to set up practice in Vermont.
While I understand what the administration is trying to do with Medicaid, and the boatload of federal money we could leverage, I think there needs to be something promised for the rest of us. Perhaps by linking both proposals we would see something less than a 2 percent payroll tax while creating universal access to primary care, and solve the so-called Medicaid cost shift. That would be a worthy investment in our public health. Contact your State Representatives and Senators through the Sergeant at Arms at 802-828-2228 to voice your support, and for more info check out: vermontforsinglepayer.org. I hope in some small way this clears up the murky waters.
Contact Kurt Staudter at staudter@sover.net
Every Vermonter needs primary care. Whether it is to treat the flu, for a checkup, or to stitch you up after an accident, the Primary Care practioner is where most Vermonters access their care for most of their medical problems.
Primary care for all Vermonters independent of health insurance, employment, or income!
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Please write to the committee members and say you support the current draft of S53 as it just passed out of the House Health Care Committee, and which calls for public financing of primary care and no out-of-pocket costs.
For additional talking points click here.
ktoll@leg.state.vt.us
pfagan@leg.state.vt.us
kkeenan@leg.state.vt.us
mdakin@leg.state.vt.us
martyfeltus@gmail.com
rhelm@leg.state.vt.us
mhooper@leg.state.vt.us
bjuskiewicz@leg.state.vt.us
dlanpher@leg.state.vt.us
matrieber@gmail.com
DYacovone@leg.state.vt.us