Reporting from Statehouse 3/18/10

Yesterday was a busy day at the statehouse . We met with gubernatorial candidate Deb Markowitz, attended Dr. Hsaio presentation and met with Advocacy groups. At noon 10 members from the Healthcare is a Human Right Campaign met with gubernatorial candidate Deb Markowitz. We started off with each telling their story of how they came to get involved in the campaign.. Walter talked about losing his job and his insurance while seriously ill and having to negotiate to get the treatment he needed. Cindy, who has worked hard all her life now finds herself deeply in debt because she needed to use her credit card to pay for treatment and medications and she had health insurance. Patrice is deeply concerned about how she will have health insurance, once she graduates from college this spring.
Markowitz, spoke of how important the personal stories are. We updated her on the campaign and talked about the principles and why it is so important that Healthcare is a Human Rignt. We asked her directly if she would support the campaign. She said that she feels that it is a moral question and we have a moral obligation to ensure healthcare for all. And she agreed to send out a campaign message that she endorses the Healthcare is a Human Right Campaign,

Dr. Hsaio gave a detailed presentation on what a single payer system is and what Taiwan single payer system did right and what they did wrong. He pointed out that the concept of single payer has been around for 20 years or so since the Canadian plan . He stated single payer has been found to be the most effective way of lowering health costs and managing the rate of inflation while providing universal care. And the reason why it has failed to happen here is that it in his words "would disturb the status quo". When asked if we could make it happen here in Vermont, he said he believed that it could be done. Dr. Hsaio acknowledged that Vermont has been a leader in developing healthcare programs but these are only bandaids/ building blocks and what we need is to look at the structure holistically. He uses the example of making a quilt... you have to have a design in mind to know where and what pieces are needed.

After the Hsaio presentation, the Healthcare is a Human Right Campaign met with other advocates. It was a great meeting, with all agreeing that the just passed version of S.88 needs to be amended. Two major concerns re the bill as passed were the make-up of the board and who the design consultant would be. Advocates discussed the need for a board at all and concluded that it be taken out of the bill or that the make-up of the board go back to 3, with the governor having one appointee, the senate leader, one and the speaker of the house, one. Discussion then turned to who was going to design the options Someone said that the legislature could actually name the person that they want to do the work. So it was decided to ask that that Dr. Hsaio's name be put in the bill as the person to design the options.

There was more discussion on other concerns in the bill and all agreed that each of our groups would continue to work on getting the language in the different sections of the bill clarified / strengthened. See our list of below:

THE HEALTHCARE IS A HUMAN RIGHT CAMPAIGN

PROPOSES THE FOLLOWING CHANGES TO

THE S.88 STRIKE-ALL VERSION 2.2

as recommended by Senate Health & Welfare Committee on March 12

March 16, 2010

1. The right to healthcare: The bill's language should clearly entitle Vermont residents to healthcare services, not use ambiguous terms like "access." It makes sense to use the terms “human right” and “public good” in the principles section, rather than simply the findings, so that the expert designing the system understands clearly the principles around which the system is to be built. This also means that the package of healthcare benefits needs be determined based on need rather than on 'available funds'. In addition, language calling for "cost-sharing" (deductibles and co-payments) must be removed because cost-sharing creates systemic barriers that hinder access to care. Cost-sharing is contradictory to the bill's principle that systemic barriers must not prevent people from accessing necessary care.

2. Deadline for universal coverage: The bill needs to be strengthened by including a deadline by which universal healthcare will be achieved.

3. Legislative control of the design process: The make-up of the board with two legislative appointees, two gubernatorial appointees and a fifth person chosen by the majority of these four gives too much legislative power away to the governor. This provision should be changed so that there is no board, but just an expert creating the design or design(s) (see # 8 below).

4. A qualified expert: The bill should include language that specifies that the expert hired has experience internationally designing healthcare systems for countries.

5. Comprehensive benefits: At least one of the plan designs must include long-term care, including home and community based services (not just nursing home care) and healthcare related transportation costs. Medicaid includes coverage for transportation costs.

6. Broad-based taxes as financing: There must be language requiring consideration of progressive, broad-based taxes for the financing system.

7. Accountable Care Organizations: These can exacerbate unproductive provider behavior, cause unnecessary administration, or both. This form of organization should be allowed in no more than one design.

8. Design Cost Efficiency: It would much more cost-effective to have the expert design a single-payer system only. We know this is the most efficient, so there is no reason to waste taxpayers' money to design any other system.