What is known about health care

March 04, 2012

Rutland Herald

A recent article in the Herald and Times Argus (Feb. 19) convinced me there is a lot of smoke blowing around in the conversations about the cost of changes in health care. Some is based on estimates and projections, and some is clearly purposeful misinformation. But it is all made up. The simple truth is nobody can say what it will cost because nobody knows yet what will be covered. But everyone knows costs will increase beyond our ability to pay if we continue with what we have.

There are things we do know for sure. It’s obvious to most people that if we want to control health care costs in a way that helps our economy, we need to separate health care from employment. Under the exchanges the Legislature is working on, if small employers need to drop coverage, their employees will be eligible for subsidies through the exchange. These subsidies include coverage for those with gross income up to $92,000 for a family of four. The subsidies will generally exceed the coverage that a small Vermont employer can afford. Based on income, approximately 86 percent of all Vermonters would be eligible for some amount of tax credit if they bought insurance in the exchange. This is not a “maybe” based on “estimates.” This is already in the Affordable Care Act (Obamacare).

Vermonters know this is a savings for the employer and employee. And these tax credits (upward of $400 million in federal funds per year) are good for four years; the last two years provide up to 50 percent of the employer’s premium contribution. This is fact. Those small employer tax credits will cushion the impact of the market fairness requirements of the Affordable Care Act and allow us time to carefully design our single-payer benefit and payment system.

We also know that if we cut insurance company paperwork and profits out of health care it will cost less. By now it’s clear most Vermonters understand it will be to our advantage to replace an insurance bureaucracy designed to make money for its wealthy investors by limiting care with one designed to provide care and prevention for everyone. Otherwise we would have voted for a different governor and legislators.