By: Dr. Deb Richter, Vt for Single Payer Supporter

A new version of S.88 passed out of the House Health & Welfare Committee yesterday. The strong, focused 21-page bill that we supported and were pleased to have pass out of the Senate has an additional 84-pages attached. While our organization has been focusing on systemic health care reform, the House Health Committee has been working on the Blueprint for Health and other delivery system changes and these are what they attached to S.88. This juncture of two bills, one we can support and one we must oppose, puts us in a difficult position.

As a physician I have been following their work on the Blueprint and feel implementation of this will be detrimental to physicians and patients. For instance it may risk patient confidentiality by allowing a clinical team of people, not chosen by the patient, to have access to the patent’s chart. It adds multiple levels of bureaucracy and misses the most important point of health reform by including plans that “may” improve quality but show no evidence of reducing cost. In the coming days I will be talking to my colleagues as we review the details of the Blueprint and I’ll share additional concerns with you.

The connection of these two bills is even greater than the exact details of the Blueprint. By connecting these bills, we are ensuring that a true study of viable health reform options (including single payer) either will not be done or will be rendered useless. With all the details this bill proposes to implement, including the Blueprint, and with the studies being just one of many parts of the bill it is unlikely they will be given the resources, attention or focus required to obtain useful information. It will paralyze the process. Further, the studies will no longer only focus on financing, but will also have to include proposals for disease management, electronic medical records, medical homes, team management of patient care and many other things. This bill in some ways creates a whole new bureaucracy to manage patient care, and it requires each study to include all of these in its design.

Now S.88 is headed to the House Appropriations Committee and we are hoping they will allow some testimony and might even re-focus the bill. At this time we are not asking you to contact your representatives because we do not know how the bill will be changed before it reaches the House floor. We do know that if it passes the house a changed bill it will have to go to a conference committee, made up of Representatives and Senators, and at that time we will have another chance to make changes. It is our hope the bill will be greatly improved in House Appropriations and we will be able to support it when it reaches the floor.