The time is long overdue for this great nation to provide all of its citizen with good and accessible health care. As a public psychiatrist practicing in public clinic settings over the last 15 years I have seen how lack of insurance and underinsurance has led to extensive suffering for both individuals and their families.
In my experience the hard-working middle class has been the worst affected. They make too much to be eligible for programs for the poor, but have no health coverage through their employer or are self-employed and unable to afford the ever increasing premiums. Persons who have coverage through employment are experiencing skyrocketing premiums or are sacrificing increases in pay just to keep health insurance.
Meanwhile the giant corporate insurance industry continues to increase the price of coverage while ratcheting down reimbursement to providers and increasing the deductibles paid by their enrollees. This allows them to pay out less, require consumers to “have more skin the game” (i.e. be more knowledgeable of and invested in the cost of their health care by having to pay these deductibles and co-pays) and then reap record profits for their shareholders and massive salaries for their CEOs.
Because of the clear investment corporate interests in Washington have in maintaining the status quo (or even better promoting reform that would require all citizens to purchase insurance coverage from them!) we have been left without much hope of even a public option let alone single payer health care in the national arena. That leaves the states holding the responsibility of developing alternative plans that will provide good health care for all its citizens while addressing cost. Fortunately President Obama has indicated a willingness to allow individual states to develop their own solutions to this complex problem.
I believe here in Vermont we are in a unique position to lead the way in developing an ethical and moral system of care that eliminates corporate profits from the equation. I believe that doctors will flock to practice in the state for the pleasure of returning to care as it should be for all persons regardless of insurance or ability to pay and business will thrive when health insurance is no longer the responsibility of the employer. With the help of international experts in the field we have a path to follow. Let us all lead the way yet again and get behind a single payer system for every Vermonter.
Dr. Donna Kiley lives in Jericho.