As the Vermont legislature opened recently, the full weight of Republican attacks on our public healthcare systems was laid bare for legislators and the public.
Due to federal cuts, healthcare for low-income children is at risk of being defunded, and our Federally Qualified Health Centers stand to lose millions of dollars in funding. Vermont’s free clinics, which saw an almost 10 percent increase in use in 2017, have already lost access to important funding sources.
Home health services and services for people with mental health needs, substance abuse needs, and developmental disabilities are at risk. Low-income women are particularly targeted through threats to deny Medicaid patients the ability to choose Planned Parenthood as their reproductive health provider.
Together, these attacks represent a storm in which low-income people, people with chronic health conditions, and those with disabilities are on the front lines.
In addressing these problems, we cannot forget that our healthcare system has been in a moral and human rights crisis since long before our current president took office.
It’s not new news that millions of people in the U.S., and thousands of people in Vermont can’t afford our co-pays, deductibles, and premiums. For decades, the prices charged by health insurance, hospital, and drug companies have prevented low- and middle-income people from accessing care and driven families into bankruptcy.
At the heart of the problem is a market-based system that treats healthcare as a commodity --- one in which executives and shareholders literally make money by denying care to those who need it.
In 2011, a broad movement for healthcare justice won passage of Act 48, establishing a universal healthcare system in Vermont. Act 48 states:
“The purpose of Green Mountain Care is to provide, as a public good, comprehensive, affordable, high-quality, publicly financed health care coverage for all Vermont residents in a seamless and equitable manner regardless of income, assets, health status, or availability of other health coverage.” (33 V.S.A. § 1821).
However, in 2014, former governor Peter Shumlin and the Vermont legislature abandoned that promise. This betrayal came despite studies showing that under Green Mountain Care, 9 out of 10 Vermont families would see higher net incomes, in addition to higher quality and more expansive healthcare.
In the midst of the current maelstrom, Act 48 provides Vermont’s elected officials with a clear path towards resolving the crisis at its roots.
Finishing the work of designing and implementing a publicly financed healthcare system would by no means solve all our healthcare problems -- some of which can only be addressed through ending systemic poverty, racism, and gender bias. It would, however, provide the foundation for a healthcare system rooted in values of equity and universality. Only through coming together can we raise the revenue necessary to provide essential healthcare services to all Vermont residents.
Unfortunately, it appears that some legislators are missing the forest for the trees, focusing on piecemeal reforms or band-aids designed to prop up the failing health insurance market. The All Payer / Accountable Care Organization model appears only to consolidate the monopoly power of UVM Medical Center, while failing to lower individual costs for patients. Meanwhile, our governor is pursuing a strategy of whipping up resentment among working-class taxpayers by attempting to turn some of us against our neighbors who have health insurance through union jobs in the public sector. Neither union nor non-union workers benefit from this race to the bottom.
Our response, instead, must be to raise the bar by fighting for all medically necessary care to be provided as a public good and a human right for everyone in our communities. While the current crisis is affecting people in all fifty states, it is only Vermont which has a universal healthcare system on the books. Act 48 provides the template and vision to get us through the storm and to build a more just and sustainable healthcare system for the generations to come.
Ellen Schwartz is president of the Vermont Workers’ Center and a resident of Brattleboro.