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Hopefully Vermont is watching the coronavirus pandemic in the rearview mirror. Did we learn anything about health care?
Most people agree that Vermont has done better than most states at controlling the spread of the virus and now, with 80% of the eligible population having received at least one dose of the vaccine, we are the national leader.
On the one hand, it seems that if we make health care a public good in Vermont – available free at the point of service – many Vermonters will take advantage of this service and get the care they need.
Of course, nothing is really free. Even our vaccines were not free. We pay through taxes and we want those taxes to be fair. But once we’ve paid for the service collectively, we can reach a lot more people if the service automatically includes them – no co-pays, deductibles, or resource testing to complicate matters.
In the rest of our health care system, the average person struggles not only with premiums, but also high out-of-pocket expenses such as deductibles and co-payments that often deter them from seeking care in the first place. . This doesn’t mean that we have a myriad of different plans with different rules. On the other hand, when deploying the vaccine, we saw that a system that automatically includes everyone makes access much easier. Vaccines illustrate how effective it is to make health care a public good.
We learned something else during the pandemic. The people who worked so hard for the health of all of us were not highly paid business executives, but public servants. They were people like Dr. Mark Levine, whose dedication to helping Vermonters get through the difficult demands of this pandemic was seemingly limitless. And there were countless others whose names we don’t know who also worked tirelessly – on the front lines of health services or behind the lines to collect the data we needed to deal with the pandemic.
Recently, UVM Medical Center hired a new director of strategic communications for $ 400,000 per year. It sounds like a “spin” director to me. Could such a position have contributed to the health of Vermonters in the same way our healthcare workers did? It seems highly unlikely. How many more nurses could UVM hire for that amount?
The pandemic has shown us that when all Vermonters are included and we treat health care as a right and a public good, we can achieve great results. Let’s move on to the next step. According to the State of Vermont’s own law (passed in Law 48): “The State of Vermont must ensure universal access and coverage of high quality and medically necessary health services for all Vermonters. Systemic barriers, such as costs, should not prevent people from accessing necessary health care. All Vermonters should receive affordable, appropriate health care at the right time in the right setting. “
We have not achieved our own stated goal enshrined in law. Even before the pandemic, nearly 40% of Vermonters were uninsured or underinsured, and we know from national data that uninsured and underinsured rates are even higher among the poor and underinsured. racial minorities than in the general population. It adds up to delayed health care, denied health care and lost lives.
Each year, legislation proposes the implementation of Bill 48, Vermont’s roadmap to a publicly funded “universal and unified health care system”. (This session is H.276, which proposes a phased implementation of Bill 48, starting with primary care, then adding other services until all health care becomes a good. universal audience.) H.276 has 44 co-sponsors. Yet once drafted and sponsored, universal healthcare bills have recently been ignored by legislative leaders or committee chairs – despite grassroots support.
It is time to take this law off the wall, consider it and pass it. If we care about economic justice, racial justice, and the health of Vermonters in general, we must get back to our own stated goals.
Let us learn from the pandemic and make all health care a public good. Collectively, we spend $ 6.5 billion a year on healthcare in Vermont. Yet despite this price, many of us still cannot access health care due to the cost. The reason is that in our current Byzantine healthcare system, almost a third of all costs are spent on paperwork, profits and the complexity of creating barriers to care instead of ensuring access. taking care. A publicly funded universal system could use resources to cover everyone instead of diverting them to such waste.
Achieving this is not a pipe dream. Our lawmakers must make health care a top priority when they return in January. We cannot wait for the rest of the country. We need to lead, just like we did during the pandemic, and show that there is a better way. We need health care for all.
Ellen Oxfeld lives in Middlebury.
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