‘No' to cost sharing
April 29, 2014
By: John Ransom, Readsboro
Perhaps the most important phrase in the Vermont Health Reform Law is "universal access and coverage." It means that all Vermonters have the right to an umbrella of health protection without barriers. This is a vital principle. As the legislature now considers the financing of this reform, it must not violate this core idea.
Yet some legislators are proposing "cost-sharing" schemes which require patients to pay money upfront for their care. These go by various names -- copay, deductible, coinsurance, out of pocket maximums, but they are all ways of financing health care on the backs of the poor and the sick.
They are actuarial anachronisms, carried over from auto and homeowners insurance, which have no place in health care. They do exactly what the law forbids: Placing barriers between people and their health.
I've seen a mother, young child in her arms, leave a pharmacy empty-handed because she didn't have $54 for the medicine her sick child needed. When cost-sharing discourages access to health care, it actually decreases the wellness of our most vulnerable, putting the lie to the term "universal."
Cost-sharing schemes share another characteristic: They can all be increased. When they are increased, that means the sick pay more for their care. Illnesses and accidents are randomly-occurring events; that's what "premiums" are for. The cost of Vermont's new system needs to be financed through taxation and public funds, not on the backs of the sick and poor.
Tell your legislator.