Democrats Discuss Health Reforms

March 11, 2015

Valley News

By Rick Jurgens
Valley News Staff Writer

Hartland — About 20 people responded to a call from the Windsor County Democratic Committee and gathered in Damon Hall Monday evening to discuss how to keep the banner of health care reform raised during a period of state budget deficits and public skepticism fueled by the woes of Vermont’s health insurance website.

Deborah Richter, a doctor and chairwoman of Vermont Health Care for All, urged her listeners — including three Democratic state representatives and the recently defeated Republican candidate for governor — to support legislation that would provide every Vermonter with publicly financed care from a family doctor or other primary care provider.

The meeting was upbeat despite taking place in the shadow of the less than 3-month-old decision by Gov. Peter Shumlin — himself a Democrat — to abandon efforts to create a universal, publicly funded health insurance system.

“It looked like everything ended up too much to do at once,” said Richter, long one of the state’s leading proponents of a so-called single-payer health care system.

But primary care, as “the only sector to have been shown to improve the health of the whole population,” would be doable, Richter said. The strategy, she explained, was to “start with a sector, publicly fund it for everyone and premiums would shrink, not by a lot, but 5 percent.”
Each primary care doctor would receive a single payment every month for every patient, Richter said. And the price tag — an estimated $160 million to cover primary care for every Vermonter not already covered by Medicare or Medicaid — wouldn’t be a deal breaker: That amount could be raised with a 1.22 percent payroll tax, she said. The plan Shumlin dropped included an 11.5 percent payroll tax.

Expanding primary care would fill an important need, said Rep. Leigh Dakin, a Democrat from Chester, Vt., and a registered nurse: “Many people still don’t have a relationship with a physician.”

But maybe the payroll tax isn’t the way to go, said Rep. Alison Clarkson, D-Woodstock. Instead, she said, supporters should look for a funding mechanism that continues to decouple insurance coverage from employment.

While no one at the session suggested that primary care coverage had any chance of being enacted this year, Richter, who practices in the Montpelier area, said that she would like to see $100,000 appropriated to fund an actuarial study of the proposal. That money could come from the existing budget by diverting that amount from a proposed $1.5 million allocation to boost Vermont Medicaid payments to Dartmouth-Hitchcock, the large Lebanon-based hospital and clinic, Richter said.

Not surprisingly, D-H is “aggressively opposing” that idea, said Frank McDougall, D-H’s vice president for government relations. Vermont reimburses D-H at a rate that is 30 percent lower than that paid to Vermont hospitals, and the $1.5 million proposal is just a first step toward eliminating that disparity, he said.

Scott Milne, the Republican candidate who in November denied Shumlin a majority at the ballot box but lost the governorship in a January vote in the Legislature, attended the meeting with his son but did not join in the health care discussion.

“It’s good to listen,” Milne, a Pomfret resident, said after the meeting. He was noncommittal about Richter’s proposal, which he described as a “nascent idea.”

With Milne silent, no one else at the meeting voiced any doubts that the government needed to step in to expand health coverage and rein in expenses.

“The private system has had 200 years to keep costs down,” Clarkson said. “It hasn’t happened.”

Rick Jurgens can be reached at or 603-727-3229.