Health reform: Doctor sees single-payer as the best medicine

By Nancy Remsen
Burlington (Vt.) Free Press, Sunday, March 6, 2011

For Dr. Robert Penney, a primary care physician who has practiced in Vermont for 25 years, there isn't any question about the need to reform health care.

"What we are doing now is just stupid and everyone says it's not sustainable," Penney said during a noontime break from seeing patients at the Pine Street office for Burlington Primary Care.

The skyrocketing cost of health care may be problem most visible to the public, Penney said, but he prefers to focus on the quality of the care that all the money buys.

"We ought to be healthier," he said. "If that is done well, it will cost less."

Penney said he believes a publicly funded health care system that eliminates the current financial fragmentation would be "more efficient and more fair."

"What we are doing now just doesn't make sense," he said. In his office of four part-time physicians and two part-time nurse practitioners, Penney said coping with the tangle of insurance requirements "diverts a lot of resources into areas that have nothing to do with patient care."

Penney argues that a consolidated health insurance coverage and payment system would allow primary care doctors "to take care of our patients and to help them take care of themselves, without the obstacles that we now jointly face."

He's not alone in this view. The 382-member Vermont Academy of Family Physicians, of which he is president, voted in January to endorse the conclusion of Harvard economist William Hsiao in a report for the Vermont Legislature entitled "Achieve Affordable Universal Health Care in Vermont." The report recommended that Vermont move to a single-payer health care system.

Penney is optimistic dramatic change is possible.

"This is certainly right now the best opportunity. We finally have a governor who is interested in health care reform," he said. "All the governmental entities are on the same page," he added, referring to Democratic leaders in the House and Senate.

Like many in the public, Penney tempered his enthusiasm about what government could accomplish. "The worry is they will really screw it up," he said. The big fear of a government-run system is that it will be a government-run system."

That's why Penney liked Hsiao's recommendation that a quasi-independent board make some of the critical decisions about health benefits and payments. Such a board would be a step away from the political arena.

Penney dismissed a concern that doctors would leave Vermont if it moved to a single-payer system.

"I think there will be a migration in here by physicians, particularly primary care doctors," he said. "It will be a much nicer place to practice. We could have a very attractive environment here. It could be unique in the country."