Let’s hope Vermont is looking at the coronavirus pandemic in the rearview mirror. Have we learned anything about healthcare?
Most people agree that Vermont did better than most states in controlling the spread of the virus, and now that 80% of the eligible population have received at least one dose of the vaccine, we are a national leader.
So what did we learn?
For one thing, it looks like if we make Vermont health care a public good that is freely available 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 weren’t free. We pay through taxes and we want those taxes to be fair. But if we’ve paid for the service collectively, we can reach a lot more people if the service automatically includes them – no co-payments, deductibles, or means tests to make things difficult.
In the rest of the health care system, the average citizen is burdened not only with premiums, but also high costs such as deductibles and co-payments, which often prevent him from using care. Not to mention that we have tons of different plans with different rules.
In contrast, when the vaccine was introduced, we saw that having a system that included everyone automatically made it so much easier to access. The vaccines show how effective it is to make healthcare a public good.
We learned something else from the pandemic. The people who worked so hard for the health of all of us weren’t high paid executives, but civil servants. It was people like Vermont Health Commissioner Mark Levine, whose commitment to helping Vermonters 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 the health care system or behind the lines collecting the data we needed to deal with the pandemic.
These dedicated individuals have been tireless in their efforts to keep the Vermonters healthy. They were frontline health officials or employees, not high-paid executives. UVM Medical Center recently hired a new director of strategic communications for $ 400,000 per year. That sounds like a “spin director” to me. Could such a position have contributed to the health of Vermonters as our health care workers did? That seems highly unlikely. How many more nurses could UVM hire for this amount?
The pandemic has shown us that if all Vermonters are involved and we treat health care as a law and a public good, we can achieve great results. Let’s take the next step. According to Vermont’s own state law (enacted in Law 48): “The State of Vermont must ensure universal access to and coverage for high quality medically necessary health services for all Vermonters. Systemic barriers, such as costs, must not prevent people from gaining access to the necessary health care. All Vermonters must have affordable and adequate healthcare in the right environment at the right time. “
We did not achieve our self-declared, legally anchored goal. Even before the pandemic, nearly 40% of Vermonters were uninsured or underinsured, and we know from national data that rates of uninsurance and underinsurance among poor and racial minorities are even higher than among the general population. This adds up to late health care, denied health care, and lost lives.
Every year there are laws proposing the implementation of Act 48, Vermont’s own roadmap for a publicly funded “Universal and Unified Health System”. (This session is H 276, which proposes a gradual implementation of Law 48, starting with primary care and then adding more services until all health care becomes a universal public good). H 276 has 44 co-sponsors. Yet, once drafted and sponsored, universal health care bills have recently been ignored by legislative leaders or committee chairs, despite grassroots support.
It is time to take this law off the wall, review it, and pass it. If we care about economic justice, racial justice, and the health of Vermonters in general, we must return to our own stated goals.
Let’s learn from the pandemic and make all health care a public good. Together, we spend $ 6.5 billion annually on health care in Vermont. But despite that price, many of us do not have access to health care due to cost reasons. The reason for this is that in today’s Byzantine healthcare system, almost a third of all the costs of paperwork, profits, and the complexities of creating obstacles to care are eliminated instead of ensuring access to care. A universal publicly funded system could use resources to cover all of them rather than diverting them into such waste.
Achieving this is not a pipe dream. Our lawmakers must make health care a priority when they return in January. We can’t wait for the rest of the country. As we did during the pandemic, we must lead and show that there is a better way. We need health care for everyone.
Ellen Oxfeld, of Middlebury, Vt., Is a board member of Vermont Health Care for All.
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