Health Care Reform: S.88 and Looking Ahead

(In keeping with the GMD policy of promoting first-person diaries by candidates for statewide office to the front page, here is the latest from Peter Shumlin: – promoted by Sue Prent)

As the end of the legislative session approaches, it’s time to look back at what has been accomplished in health care reform and the critical road ahead.  I was one of the sponsors of the original S.88, which would have committed the state to a single payer system and set up a process for designing and implementing it.  A single payer system is the most fiscally responsible and conservative way to create universal access to health care in Vermont.  By eliminating the profits and paperwork of insurance companies and pooling our funds, we can support a health care infrastructure that is accessible and available to everyone, and that is rational and controls costs.

S.88, the health care bill, has taken many twists and turns during this legislative session. Unfortunately, the bill does not implement universal health care in Vermont. That process will have to wait until Vermont has new leadership in the governor’s office. However, fleshing out all the details in the design of a health care system is important work that needs to begin as soon as possible. Thus, the three studies ordered by S.88 are the cornerstone of this legislation.

As the measure made its way through the legislative process, I saw several places in the bill that needed strengthening.  

First, one of the early drafts was quite vague as to the qualifications of the consultant who would be hired to conduct the studies. I feared that this left open the possibility of hiring a consultant whose expertise was insurance regulation, health care utilization analysis, or delivery system modifications. What we needed, I felt, was someone who had a track record in actually designing successful universal health care systems, and in advising governments in making the transition from private to public financing. Working with other senators, I was able to modify the language of S.88 in this regard.

Second, when the health care bill came back to the Senate from the House, it had quadrupled in length!  Working again with like-minded members of the Senate, I made sure S.88 would not implement unproven innovations, such as the insurance payment schemes suggested by the House, until after the health system studies were complete. That way any fundamental shifts in how we pay for health care, or deliver it to patients, would be based on sound evidence, and would be subject to debate in the public arena before implementation.

Many Vermonters have expressed to me their frustration at how little ever gets accomplished in the drive for universal health care in Vermont. I agree with them. It is wrong that tens of thousands of Vermonters have no health insurance, and that tens of thousands more are underinsured, and that health care debt is one of the leading causes of personal bankruptcy. And so the fact that the legislature will now study universal health care, rather than implement it, may seem disappointing to some people.

However, I believe that what we are doing in the legislature, is laying the groundwork for real progress next year.  We now need to elect a governor who has the courage to lead on health care reform. There have been momentous debates in the past-same sex marriage and Vermont Yankee come to mind-but health care will take an even greater effort. To make real change, we will need a leader who can stand up to the powerful special interests and unite business, the medical community, and people from every corner of the state around the need for publicly financed universal health care.  If elected Governor, health care reform will be one of my top priorities.  

6 thoughts on “Health Care Reform: S.88 and Looking Ahead

  1. Peter, while it is better to be late to the game than never being in it, let’s face it this game was Racine’s from day one.  Nice try, but no cigar, Peter.  Go Doug go!!!

  2. I have to respond to the first comment (“Better Late Than Never”). S.88 began as a single payer bill.  Peter Shumlin was a co-sponsor of this bill and Doug Racine was not. So, the fact of the matter is that Peter Shumlin has been an early and consistent supporter of single payer.

    In Doug Racine’s committee the bill was actually watered down to a study bill, and the commitment to single payer was removed.  So, even though it is good that the bill passed, it is not factually accurate to say that Doug Racine has been an active proponent of single payer.

    Peter Shumlin was an early supporter of single payer, and as he says in his blog, he still supports single payer. I have not heard Senator Racine commit to single payer even now.  So, while it is good that S.88 has passed, I think we should be aware of who is actually supporting publicly funded health care for all. It is simply factually inaccurate to say that Peter Shumlin was “late to the game” and that Racine was on track from day one.  

    The truth is that Doug Racine chaired Senate Health and Welfare, and this is the committee that actually watered down the original S.88.  I think it is good that we will get the studies out of S.88, and I also think Senator Shumlin and others made some good changes to that bill to keep in on track and focused.  It is not true that he was “late” to the game — because as I said, he was a co-sponsor of the original and much stronger bill.

  3. Oxfeld: Doug Racine was also an original sponsor of S.88.  Peter and Doug both were if I remember right.  And in whatever form it came out, I am happy that we got it passed, however it was done.  It now has to get past the guv, if that is possible.  

  4. By the way, there were 15 co-sponsors to the original single payer version of S.88.  With one more co-sponsor, there would have been a majority — enough to pass the Senate in its original single payer form.

  5. Strange, I thought that Racine was on that list and I did not have the time to look it up when I put it up.   Somehow, I remembered seeing his name on there.  Anyway, whatever the case, he, along with Shumlin, sheparded this version through a seemingly impossible maze and it was passed.  It may not be single-payer, but at least it is something.  I just hope that the do-less governor does not veto it, then there would have to be an override session.  

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