Editor’s note: This op-ed is by Peter Sterling, the executive director of the Vermont Campaign for Health Care Security [1].
Just last week Jeff Wennberg and his organization Vermonters for Health Care Freedom finally offered the public a look at what opponents of universal health care believe can solve Vermont’s health care crisis (WCAX’s “You Can Quote Me,” April 1, and Burlington Free Press, April 2).
I’ll set aside detailing the factual errors he made such as blaming “Vermont’s planned Canadian-style government-run system” for a $14 million increase in costs for Catamount and VHAP enrollees which is, in fact, due to federal law. I really want to kick the tires a bit on this proposed “solution.”
Mr. Wennberg said, “The state of Indiana is doing remarkable things that may offer real hope for progress here.” Indeed, Indiana’s reform is remarkable for the harsh limits it places on the ability of low- and middle-income people to get necessary health care.
The state of Indiana only offers assistance to childless adults with a yearly gross income between $2,400 and $22,400 through a health plan with an annual cap of $300,000. Meaning, if you get sick and the cost of your care exceeds $300,000 you have to pay for it out of your own pocket. This is a lot of money, of course — except if you get into a bad car accident or diagnosed with a serious disease like cancer. Just ask anyone who has been in a hospital for extended treatment about how big those bills can get. And I wonder where Mr Wennberg thinks someone earning $15,000 a year is going to be able to get the $25,000, $50,000 or more to pay for their cancer treatment above this cap. But that is one way to control costs — simply refuse to pay for necessary care.
Indiana has a waiting list of 49,000 people for its health care program because the state refuses to authorize money for them to enroll. The plan requires residents to be uninsured for six months before enrolling and to be kicked off the program for a year if a participant misses a monthly payment for any reason. Denying access to health care certainly is another way to control state spending on health care — but the cost shift that results is a large part of what got us into this mess in the first place: when the uninsured show up in the emergency room with no way to pay for care, the rest of us end up picking up the tab. And the costs are much more expensive.
Fortunately, Vermont’s programs, Catamount Health, VHAP, Dr Dynasaur and Medicaid, do provide solutions for controlling costs without waiting lists, rationing of care or forcing people to go uninsured if they have a financial emergency. Instead, Vermont’s public health care plans allow anyone meeting the eligibility requirements to enroll, stress preventative care and provide low out-of-pocket cost access to necessary treatment.
The results speak for themselves. Vermont’s uninsured rate is around 7 percent, Indiana’s is 18 percent (which would equal 112,000 Vermonters). There have been many studies ranking Vermonters at or near the top of national health rankings. For example, the United Health Foundation recently announced that in 2011 Vermont was the healthiest state in the nation; Indiana was ranked 38th.
Until now opponents of the governor’s plans for universal health care have not provided anything in the way of solutions other than worn-out mantras like “letting the market work” and “more personal choice.” Those may be fine for selling cars or soda but it’s pretty clear it does not, and never will, ensure that people can get affordable health care.
But Mr. Wennberg has now given us a first glance at what opponents of universal health care believe is the prescription for reform. And it exacts a harsh toll on low- and middle-income Vermonters while falling far short of curing what ails our system. Let’s hope the next solution they offer up will actually help everyone lead healthier lives without fear of going bankrupt in the process.
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