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You may also send your tax Deductible* donations to: Vermont Health Care for All * Vermont Health Care for All, Inc. is a 501(c)(3) non-profit corporation and your contributions are tax-deductible to the full extent allowed by law. Book For SaleAt the Crossroads: The Future of Health Care in Vermont |
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Frequently Asked Questions:
How can we trust the government to run a health care system? Government is not going to be delivering the care. Medical decisions are left to doctor and patient. As now, doctors, other health professionals and hospitals will remain private. Government’s role is to see that health care services are adequately reimbursed and to oversee the health care system as a whole. Second, a separate agency independent of the legislature would perform functions of health planning, create an overall budget, make budgetary decisions, negotiate reimbursement rates with doctors and hospitals. It would be like any other agency that oversees a public service. Third, because it is a public agency, problems would be aired in public. Nothing would be hidden or swept under the rug. The agency would be accountable to Vermonters. Accountability is a founding principle of a health care system. There is no overall accountability in our health care now. Won't we have rationing like Canada? Notions of rationing in Canada are highly exaggerated. There are problems with some services in Canada, depending on the province you live in. Canada spends one half what we spend per person. A universal health care system does not dictate how much we spend. And with twice as much to spend we would not experience the same shortages. What will happen to my taxes? Will my taxes go up? Yes, some may very well go up. But the more important question is: Will I end up paying more or less for health care? The answer to that is: Less. Every health care system in the world runs at far less per person cost than ours. No other system in the world pays as much a share of the public’s taxes into health care as ours. In a publicly financed universal health care system some income taxes and most probably an employer payroll tax would form the financing. That’s an increase. Here’s the decrease: no private insurance premiums for individuals or businesses, no health benefit charges against employees, no property taxes diverted to public employees health benefits, no share of state taxes diverted to public employees health benefits, no deductibles, no co-payments, no out-of- pocket payments. So the critical factor is: What is the net cost to me? It will be less. Private insurance works well for 80 percent of us, why not just create government-subsidized high-risk pool for the other 20 percent? The 80 percent account for only about 15 percent of the health care bill. 20 percent account for 85 percent of the health care bill. This is an important point. First, 20 percent and 85 percent are statistical categories that cross all social divisions. All of us are potential patients, candidates for the 20 percent. Second, medical services are shared services. If we want to share in their use, we must share in their financial maintenance. Allowing 80 percent of people to pay based on their current health does not take into account their status as potential patients. Their future use of the health care services depends on the services being paid for now. And the 20 percent cannot financially support the services now. The difference is large. It means the government has to make up the difference if we want to keep the health care services. Third, if we ask government to make up the difference we might as well finance the while thing through government. We'd gain administrative efficiency, we'd have a say, we'd all get coverage, and overall it would be far less costly. Recent and past polls show that more than half the doctors are in favor of a universal health care system. Doctors recognize that this would free them from the administrative costs they now endure to bill and collect for health care they provide. Doctors main concern is that a system might negotiate unacceptable reimbursement rates, their prime example being our Medicaid rates. A system would have to guard against this. Medicare rates, on the other hand, are generally viewed as sufficient by most doctors. A system that conformed to Medicare rates would likely satisfy doctors. How can we keep people from over-using the system? There's little evidence that coverage encourages people to overuse the system. Most people don't want care unless they really need it. The most expensive care is decided by doctors. Patients play a role but it isn’t decisive Once it is determined expensive care is needed there is little room to cut costs. E.g., a premature baby on a ventilator - you can't cut the time in half to save money. You can't give a patient half their chemotherapy to save money. That's where most of the expensive care is. Why should I pay for people who abuse their health when I take care of mine? You are already helping to pay for their care. If you want to influence their health habits, you need a health care system that implements long-term public health education for everyone. You pay one way or another. Right now you pay, but you can't change anything. With a universal health care system you pay, and you can change health habits. How will we keep outsiders from coming to Vermont for health care? Health care is not free. Vermont residents support the health care services through public financing. Visitors would have to pay either through their insurance or out of pocket. I have good insurance. Why do I need this? Benefits under a universal health care system cover all medically necessary care, and that includes doctors' care, hospital care, eye care, dental care, mental health care. If your insurance covers these now, it is a lot more expensive than under a universal health care system. You need it if you want to save money. I have good medical care. Will it change? No. Your medical care will remain the same I like my doctor. Will I have to change doctors? No. Your choice of doctor, nurse practitioner, and physician's assistant is freer than now. Won't this be just another bureaucracy? The current system has many layers on layers of bureaucracy because there are so many types of insurance. Differing insurance policies cover certain procedures and exclude others. Further, insurers reimburse caregivers at differing rates, making the whole system highly complex and difficult to administer. The goal is to reduce bureaucracy. A universal health care system does that because reimbursement rates are the same and the coverage for everyone is the same. Alternative care is put to the same standards as new medical approaches. If there is a body of scientific evidence showing that they work, they can be included. Can a business keep private health insurance if they want? Yes. The federal Employee Retirement Income Security Act (ERISA) includes a broad “pre-emption” provision that precludes states from regulating “employee benefit plans,” with some exceptions. There has been considerable debate and litigation over what constitutes state regulation of insurance (permissible) and impermissible regulation of benefit plans. ERISA does not apply to government plans at all, so state pension systems (covering government employees) are not governed by ERISA. Further, states are free to set up health plans, including publicly-financed universal health coverage. A state- financed universal health system that is financed through payroll, income or sales taxes and has no exceptions for employer coverage is an appropriate exercise of state authority. How can we contain costs in an aging population? We are one of the youngest populations in the industrialized world. All countries are facing the same question. Other countries have managed to cover all their citizens with comprehensive benefits for half the cost, on average, that we are now spending. It is a problem, but one better addressed in a universal health care system, which is able to look at health care as a whole to find solutions How can we contain costs faced with the introduction of expensive new technology? We could do a much better job with a universal health care system than we are doing now. A system is capable of assessing whether the new technology actually results in better health. Can we afford what everybody needs forever? No. But these are questions that the public as a whole must address and a universal health care system provides a way to make the discussion public. It is a societal problem. Why not make high-risk people pay higher premiums? That is punitive for those who suffer from inheritable disease. To identify others at risk would require a large, expensive bureaucracy to create criteria and apply them. In addition, a sudden accident - car, bike, industrial, agricultural – cannot be planned for. Won't this hurt medical research? No. On average other countries produce just as much or more medical research as we do, and it is government-subsidized. Most research in this country that results in significant discoveries is already financed by taxpayers I'm in favor of competition. Won't a universal health care system impede competition? Not where it counts. Where it counts is among medical services. Competition will be based on quality of care not on the lowest rate, because all rates will be uniform.
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