By DANIEL BARLOW Vermont Press Bureau
MONTPELIER – Sen. Doug Racine pitched his health care reform plan to the cash-strapped Senate Appropriations Committee Tuesday afternoon, facing one of his opponents in the upcoming Democratic primary for governor.
Racine, a Chittenden County Democrat running for governor, is looking for about $400,000 to design three major health care overhaul plans for Vermont. His plea for funding Tuesday landed before a committee chaired by Sen. Susan Bartlett, D-Lamoille, another gubernatorial candidate.
Despite the political overtones, the 45-minute conversation was full of good humor. But Bartlett made one thing clear: There is little extra money this year.
"I am sure we could spend $750,000 to design a single-payer system and people will still be unsure of how exactly it works," Bartlett told Racine and other members of his Senate Health and Welfare Committee.
Vermont is facing major budget problems this year, including a gap between expenses and taxes that has grown to more than $150 million, so Racine and his committee, which voted unanimously to support the bill last week, face an uphill battle to make the case for reform.
Racine said his proposal would create what he calls the Vermont Health Care Board, a body appointed by Gov. James Douglas and the Legislature, to fully design three health care models for Vermont.
At least one of those models would be a single-payer system, although all the options would adhere to a set of principles, including that it covers all Vermonters, cut costs from the current system while still retaining quality and be affordable.
The proposed study group would present the three fully-designed health care models to Vermont’s new governor and Legislature in January 2011. Racine said efforts by lawmakers to change the system have only resulted so far in minor tweaks that help, but do little to curb the rising costs of health care.
"We’ve been taking one step forward and two steps back," he said. "This is our effort to move this issue forward. We don’t want to start next year from the beginning all over again."
Bartlett questioned several aspects of the proposal, including the estimated cost – the Legislature’s Joint Fiscal Office calculated the price tag to be around $374,000 – and the number of people serving on the proposed board. Another committee member worried that a single-payer system could lead to health care rationing.
"We could move to a single-payer system, but that doesn’t solve all these issues," Bartlett said.
Racine agreed that a single-payer system, if that is the one chosen next year, would not be a magic wand to solve all the health care problems. He said the state needs to tackle the cost side of the issue, not just how it is paid for, including reducing administrative expenses.
"There is no perfect system out there," Racine said, noting that the scope of what single-payer health care systems in Europe covers vary from country to country. "That’s well understood. But there are systems out there that are cheaper while still retaining the same health care outcomes."
James Haslam, the director of the Vermont Worker’s Center, an organization that is pushing for a single-payer health care system, said he supports Racine’s approach. The organization’s Health Care is a Human Right campaign met frequently with Racine last year before the new legislative session started.
"This will move us forward," Haslam said.
The Senate Appropriations Committee did not come to a decision Tuesday on the proposal.
On Thursday, the Senate and House health care committees, during a joint session, will take testimony from Dr. William Hsiao, a Harvard economist who specializes in health care policy. That session, which is open to the public, begins at 2 p.m. in Room 11 at the Statehouse.
daniel.barlow@timesargus.com