What does Universal Mean to You?

When I made my pitch to the Speaker, hoping to secure a seat on the House Health Care committee, I promised to vote for the bill if it covered everyone and saved Vermonters money. H. 202, when it passed the House, set Vermont on a path to do just that.

When the Senate passed the bill they tacked on two amendments that are particularly troubling, and clearly violate the “universal” in universal health care. Keep in mind the title of the bill is “An Act Relating to a Universal and Unified Health System.”

The first floor amendment, offered by Sen. Galbraith, takes a big step to carve a few people out. With broad support, he excluded anyone enrolled in TRICARE (the VA system). The logic is simple, these people already paid for health care through their service to the country. What he fails to understand is that Green Mountain Care, our hoped-for single-payer system, may well want to enroll eligible people into TRICARE. For some Vermonters that would be the cheapest way to get health care. This is part of what Hsiao meant when he said a hybrid single-payer system.

We ought to figure out a fair way to finance Green Mountain Care without asking folks who’ve already paid their health care bill to pay again. But that can be done without excluding this population from the outset. They are Vermonters and part of guaranteeing that they have coverage means being able to work with TRICARE, not prohibiting it.

A more troubling moral change coming from the senate is the Brock-Sears amendment to exclude undocumented workers from care. Charming! It’s unclear what happens when an undocumented farm-worker shows up at the emergency room after his arm was half ripped off in an accident. We know Vermont doctors will care for this person. The Brock-Sears amendment leaves us wondering how that care will get paid for. One of the beauties of a universal system is that the cost shift is eliminated. Carving out this or any population reinstates the cost-shift and is a bad idea.

H. 202 is a long-term plan to get significant health care reform into reality for our state. We shouldn’t start out of the gate by excluding certain populations. And if we do, we should have the integrity to remove the word “universal” from the title. Many in the legislature are fighting to undo these last-minute changes. We should have an update by late Tuesday.

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