Committee considering publicly financed health insurance

MONTPELIER, Vt. -- A plan is being developed in a House committee that would establish a publicly financed health insurance system covering every resident of the state and funded by payroll or income taxes.



Although it would be significantly different, the plan would be similar to the single payer system that exists in Canada and many European nations.



The House Health Care Committee began reviewing the first draft of a bill Friday that would set the state on the path toward a system that provides health care to every citizen of the state. The plan would be overseen by a state board that would recommend to the Legislature and the governor what benefits would be covered and how much it would cost.



"We're striving for an integrated system of care," said Health Care Committee Chairman John Tracy, D-Burlington.



Gov. James Douglas immediately dismissed the proposal, saying it would lead to health care rationing and too much government bureaucracy.



"It's moving in exactly the wrong direction," Douglas said. "Vermonters don't want to stand in line and wait for a number for their health care."



Under the plan being developed in his committee, Tracy said, the new system could be in place as early as 2007. Primary care would be covered beginning June 30, 2007, and hospital care would come under the new system three months later.



A state board would oversee the entire health insurance system and there would be regional boards centered around the state's existing community hospitals to help run it.



The goal is to have a comprehensive universal system, although there would be the opportunity for people to buy private insurance for all of their coverage or to cover elective procedurs.



The key difference between the system currently being contemplated and the single payer system is that no one would be forced into the state plan, although they would have to help pay for it through taxes.



Tracy said he believed the taxes would be an incentive for employers and residents to drop private coverage and enroll in the new public system.



"We're (already) spending the money. We're trying to spend it more efficiently," Tracy said. The goal would be to raise in taxes only enough money to replace what people currently are paying for insurance. "It should be dollar for dollar on your premium," he said.



House leaders have been pushing for reforms to the health care system since they took office in January. But up until now, the belief around the Statehouse was that whatever would be pursued this year would be much less aggressive. The Health Care Committee decided, though, that incremental reforms might not make much difference and might actually introduce new problems.



The committee has not voted on the draft bill before it or the specific direction it is taking, but it incorporates many of the concepts that have been discussed. There are likely to be many changes before a final draft is voted on, but Tracy said it was time to get started on a bill.



"We needed to put something on paper," Tracy said.



Douglas said he would urge legislators to consider his proposal, which would adopt reform much more slowly, expanding insurance coverage to 20 percent of the estimated 64,000 people who don't now have coverage. He said he was confident that the House would understand that the draft it is now considering cannot be achieved.



"This idea has a long way to go, obviously," he said.