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Democrats and health care reform: Nowhere to hide

By Richard Davis

Posted December 15, 2006

Vermont Democrats now have veto-proof majorities in the House and Senate. In political terms, that is about as much power as a party can have.

Of course, party leaders will say that the numbers won’t always be high enough because all of their allies are not always of one mind and because they can’t guarantee veto power on every issue. Everyone needs a little cover, especially politicians.

So what does this political turn of events mean in terms of health care reform? In a private meeting with House Speaker Gaye Symington near the end of the last legislative session, I asked her if groups I am aligned with (mostly liberal activist groups) will be able to work with her on the steps to health care reform beyond the newly passed Catamount Health plan. She said, “Yes.” But, then she qualified it by saying that the Legislature would have its hands full implementing Catamount Health.

Well, the speaker and the rest of the Democrats now have nowhere to hide. Gov. Jim Douglas appointed Susan Besio to shepherd implementation of Catamount Health and she is doing an exceptional job. That means that the administration and all of the relevant government agencies will end up doing most of the work of implementation of Catamount Health.

House and Senate members will be watchdogs and fine-tuners of Catamount Health through their committee work, but it should not be a major task. There will be regular meetings and updates from Besio, but legislators will not have to roll their sleeves up as they did for the past two years while working on health care reform.

So, what should happen next? Here’s where things get interesting. Newly elected and reelected legislators are making it clear that property tax reform will dominate the coming legislative session. Talk of tax revolt is in the air and the mantra that Vermonters can’t afford to live here anymore will become the song du jour.

Gov. Douglas’ idea of property tax reform is to cap school district spending. Symington and other Democrats have made it clear they don’t support that idea. Rep. Rick Hube, R- Londonderry, is leading a Republican tax revolt, but he and his allies have yet to present a workable, concrete plan.

There is a solution to the high cost of property taxes. It’s called real health care reform, the kind of reform that actually transforms the health care system and that does not simply plug leaks.

As long as profits, competition, and market forces control the health care system, we will never see a level of property taxes that average Vermonters will be able to call affordable. According to numbers I complied a few years ago, towns in Windham County, as well in other parts of the state, spend 18 to 24 percent of their budgets on health insurance for their employees. The same numbers apply to school districts.

The way to significantly cut that high percentage of tax dollars that pay for the health insurance of teachers, school workers, and municipal employees is to create a health care system that either relies on payroll taxes or income taxes or a combination of both for funding.

It would work by creating a single risk pool of the roughly 40 percent of Vermonters not covered by government programs or self-insured plans. We could possibly include everyone else and make it an actuarially sound risk pool with federal waivers.

New health care taxes would assure that all Vermonters have access to a basic level of health care services and that they pay according to their ability. Studies indicate that Vermonters making less than $75,000 a year would pay much less than they do now for health care and that, even with new taxes, their overall costs would be less.

Assuming that municipalities and school districts had to pay an eight percent payroll tax for a new health insurance program (a figure many studies use), property taxes would decrease by about 10 to 15 percent.

That’s real money for real Vermonters. Those are savings that are sustainable because they would mean that we would have created a new health insurance system that would save money for all of us for many years.

Our new U.S. senator, Bernie Sanders, is already talking about having the federal government allow states to be laboratories for health care reform. Let’s have Vermont be a laboratory that produces an experiment showing the rest of the country how to lower property taxes and provide for health care for all citizens.

It’s not rocket science, it’s politics. Vermont Democrats have talked about real health care reform for years. They have made some progress, but they now have a chance to transform our society from a place in which too many people die because of political gridlock into a place where everyone has a chance to maintain health without the fear of going broke.
The lives of Vermonters are in the hands of the party in power. Will they use that power responsibly?

Richard Davis is the executive director of the Vermont Citizens Campaign for Health (www.universalhealthvt.org). He has been a registered nurse for 29 years in Vermont and writes a weekly column in the Brattleboro Reformer on health care politics. He lives in Guilford.