As Vermont moves toward a single-payer health care system, legislators must consider numerous infrastructure and fiscal changes. This week, a memo from one of the legislature’s consultants outlining suggestions to retool the health system revamp emerged.
Vermont’s proposed single-payer health care system — Green Mountain Care — is being reviewed by committees of the Vermont legislature. A four-page memo from legislative consultant Ken Thorpe was leaked this week. The Thorpe memo outlines insurance, administrative and coverage option alterations in the current transition plan to Green Mountain Care. The memo is being panned by critics, and even the agency in charge of the transition is unimpressed. Vermont Health Care Reform Director Robin Lunge describes it as a set of ideas, not a complete plan. “We have been encouraging the Legislature to engage with us around the analysis for Green Mountain Care. Dr. Thorpe’s memo builds on his previous work in Vermont related to Catamount Health. So from our perspective there’s not a lot of new information in that memo.”
Vermont Leads is a statewide public education campaign in support of the universal health care plan. Director Peter Sterling says Thorpe’s memo is problematic on several levels. “The key problem is that it diverges from the important principle of universality. Everyone will not have access to this plan. Secondly, because it’s based on the exchange, it brings with it many of the problems the exchange has. For example, there’s a three month open enrollment period for this plan. So if you’re a Vermonter who does not enroll in this plan in the three month open enrollment period you go without insurance for the year. And those are serious problems. Which is why we need a true universal, publically funded health care plan.”
Vermont Health Care For All Director Deb Richter believes Thorpe is presenting an escape plan for legislators too anxious over replacing premiums with a tax. But she says Thorpe’s plan will add costs. “This is going to add a $200 million tax to help more subsidize some of the private insurance. It’s not going to pay for health care fairly. We’d be better off doing nothing than to try to do this type of proposal.”
Vermonters for Health Care Freedom Founder and President Darcie Johnston is a longtime critic of Vermont’s transition to universal health care. She would like to see options debated, but finds no value in the Thorpe proposals. “It just confuses the debate. I think that was the goal of whoever is behind it. And by confusing it, keeps the pressure off the governor to come forth with a financing plan. Number two, there’s super-majority of Democrats. They don’t want to see, or don’t have the courage, to bring in free market reform. It’s all a shell game both by the Governor and the Democrats, and Thorpe who was hired by the Democrats.”
VT Digger health reporter Morgan True detailed the emergence of the Thorpe memo for the online investigative newspaper. He says it caught people’s attention due to its different financing mechanism and approach to getting to universal coverage. But he notes that no legislators have come forward admitting they requested Thorpe’s input. “One of the things that I heard from Mike Fisher, who is chair of the House Health Care Committee, is that Ken Thorpe could have written this memo for any number of lawmakers and it’s an idea that he’s discussed. What’s gotten some advocates and folks in the administration a little bent out of shape is the idea that you could get to universal coverage by just expanding subsidies. I think what also has some advocates a little upset is that this wouldn’t really be a huge departure from the system we have now. But if you look at the rest of the document, a lot of the initiatives around using managed care to reduce costs are things that Vermont’s already pursuing and are pretty widely considered components of lowering the growth in overall health care costs.”
Attempts to contact Ken Thorpe, the Emory University professor and consultant to the legislature who wrote the memo, were unsuccessful.