Bill to design new health care model approved

Times Argus (Vt.), April 8, 2010

MONTPELIER – Senators voted 28-2 Wednesday to hire consultants to design a new health care model for Vermont, one of which would include a single-payer system.

Approval of the bill is a victory for Sen. Doug Racine, D-Chittenden, the chair of the Senate Health and Welfare Committee, who made it his goal this year to set Vermont on a path to a new health care system.

Racine, a gubernatorial candidate, said the state's health care spending is on an unsustainable path and is now expected to hit almost $6 billion by the year 2012. His proposal would fully design several new options for the state.

"This is an essential next step for the state of Vermont," Racine told his colleagues on the Senate floor Wednesday afternoon. "We need to get our costs under control and provide what we have promised … that all Vermonters have access to high-quality and affordable health care."

Racine said his goal with the bill was to move the discussion over the future of health care beyond the abstract and instead begin looking at the specific details of various proposals. His bill allocates about $300,000 to a newly-revamped Health Care Reform Commission to hire consultants and fully design up to three new health care models.

The bill states that at least one of those models must be a single-payer system, one where all Vermonters are included in a single pool run by the state government. That has some advocates – such as Burlington's Vermont Workers' Center – cheering Racine on.

"We know that this bill has changed a little since when it was first introduced, but we're still strongly supporting it," said James Haslam, the director of the Center. "It puts Vermont on the right path."

Racine conceded that he preferred his original bill, which envisioned setting up a new independent committee to study health care and help design the new systems. Under changes made to the bill by the Senate Appropriations Committee, that format was scrapped and the plans handed to the Reform Commission, a body of legislators and citizens who debate health care policy.

"The commission can still do the work," Racine said.

Racine's bill changed in other ways too. The Senate Appropriations Committee also successfully added an amendment to the bill – in a 21-9 vote on the floor – language that would give the Vermont government more authority over regulating hospital budgets.

That provision, sponsored by Sen. Susan Bartlett, D-Lamoille, the Appropriations Committee chairwoman and another gubernatorial candidate, places a 4 percent statewide cap on hospital budget increases over the next two years. There are provisions in the bill for certain financial exemptions from that cap.

Several senators worried that their hospitals would be shortchanged. Sen. Kevin Mullin, R-Rutland, said his county's main hospital would be hurt more than others because 72 percent of the patients they see are on Medicaid or Medicare. The 4 percent cap would effectively be a 1 percent cap, he said.

"I want to be on record supporting my local hospital," Mullin said.

Bartlett responded that the state government and school districts have been making tough budget decisions. She said "this isn't even the beginning of the hard stuff" when it comes to bring budgets in line.

"They should be scared," Bartlett said. "We're almost out of money. But there are protections in here. There are plenty of outs for a hospital that is in an extreme financial situation."

Only two senators – Sen. Randy Brock, R-Franklin, and Sen. Margaret "Peg" Flory, R-Rutland, voted against Racine's health care bill. Brock said he was worried that a single-payer system in Vermont would be a "magnet for those from elsewhere." Flory said the commission's mission would cost too much in a tight budget year.

"We're talking about a quarter million to a half million here," she said. "This is just another proposal that we probably wouldn't be able to do anything with for six more years."