Ayer, Fisher take on health care reform this session

MONTPELIER — Two veteran Addison County lawmakers will play key roles in the Legislature’s health care reform efforts this biennium.
Sen. Claire Ayer, D-Weybridge, will serve as chairwoman of the Senate Health Care Committee, while Rep. Michael Fisher, D-Lincoln, has been named vice chair of House Health Care panel.
The news comes on the doorstep of the scheduled Jan. 19 release of Professor William Hsiao’s report on health care reform options for the state of Vermont. Hsiao, a professor of economics at the Harvard School of Public Health, was charged with studying and presenting three different scenarios for the Legislature’s consideration, including single-payer and private insurance options.
Gov. Peter Shumlin upped the ante on Thursday when he cited health care reform as one of his top five priorities for this biennium (see story, Page 1).
“The rising cost of health care for Vermont’s middle class and small businesses provides an equally daunting threat to economic prosperity,” Shumlin said in his inaugural address.
“That’s why we must create a single-payer health care system that provides universal, affordable health insurance for all Vermonters that brings these skyrocketing costs under control,” he said. “Let Vermont be the first state in the nation to treat health care as a right and not a privilege; removing the burden of coverage from our business community and using technology and outcomes-based medicine to contain costs. By doing so, we will save money and improve the quality of our care.”
Ayer, a registered nurse and four-term senator, takes the helm of a committee that will play a lead role in analyzing Hsiao’s report and translating it — with public feedback — into legislation that could result in sweeping changes to the state’s health care system.
Ayer served last biennium as vice chairwoman of Senate Finance and as Senate majority whip. During an interview at the Statehouse on Thursday, Ayer recalled weighing her leadership options prior to last November’s elections. She decided at the time that if she was re-elected to a fifth term with a Republican governor at the helm, she would run for Senate majority leader. But she determined that if a Democrat (Peter Shumlin) was elected governor, she would aspire to chair the Senate Health Care Committee.
“I knew that if Peter Shumlin won the election, he and our majority leader would do everything they could do to make sure all Vermonters have health care, in whatever form that takes,” Ayer said. “Once he was elected, I called and said I would like to chair (Senate Health Care).”
Ayer has already begun lining up meetings to take testimony and conduct research on what is likely to be one of the most complex legislative assignments of the 2011-2012 biennium.
While this is Ayer’s first term on the Health Care Committee, she is quite familiar with the subject matter. She has been an RN for 42 years and her husband is longtime Middlebury-area physician Dr. Alan Ayer. She has studied the financial aspects of health care as part of the Senate Finance Committee. She has served on the Legislature’s Health Access Oversight Committee, which ensures that the state’s existing programs are functioning the way they were intended.
The coming days will see Senate Health Care get up to speed on what Ayer said are the “nuts and bolts” of the current system, including updates on the performance of Catamount Health, Vermont’s current medical plan for uninsured and under-insured Vermonters.
Ayer noted her committee will have plenty of work to do aside from digesting and processing the Hsiao report.
“We already have a laundry list of things that have to be done according to the federal health care act,” Ayer said.
Part of Ayer’s job will include coordinating health care discussions with other Senate panels that have a stake in the reform effort — such as the Finance and Appropriations committees.
“We want to make sure there are no overlaps and wasted time and that we don’t leave any gaps,” Ayer said.
She is optimistic the state will make strides in health care reform this year, in hopes of passing a bill this biennium.
Meanwhile, Fisher will be working in the House to further the health reform effort.
Fisher was first elected to the House in 2000 and has spent the past three terms on the Health and Welfare Committee, most recently as its vice chairman. He was recently asked to serve as vice chair of the House Health Care Committee, and accepted after he said he was given assurances by leadership that reform would be seriously and aggressively pursued.
“I was excited by the opportunity,” Fisher said.
He is looking forward to the impending release of the Hsiao report.
“I believe it will lay out a set of opportunities for us to really move to a system that includes everybody and goes a long way to simplifying the bureaucratic and administrative end of things,” Fisher said.
Lawmakers last Wednesday heard renewed cries for health care reform from what Fisher estimated was a crowd of “many hundreds of people — including many from Addison County,” who came to the Statehouse lobbying for a single-payer system.
Fisher, like Shumlin, believes a single-payer plan has merit.
“I have always believed that if we could accomplish it, a single-payer system would make a lot of sense,” Fisher said. “There are some real complexities as to how to make it work in a state-by-state context, and that’s our challenge.”
Fisher acknowledged that lawmakers will be trying to bridge a budget shortfall estimated at around $150 million, and noted there will be some state officials and constituents who will ask how Vermont will be able to afford new health care reforms in that context.
But Fisher argues the state can’t continue on its present health care path.
“We can’t afford the continued growth in the health care spending in these times — $4 billion to $5 billion for 620,000 people,” Fisher said. “The inflation in health care is unsustainable.
Finances are a key to this.”
Fisher said he is already encouraged by the Shumlin administration’s efforts to organize staff to lend an ear, and a hand, to the upcoming legislative committee work on health care reform.
“I am optimistic that we are really going to take this bull by the horns,” Fisher said.
Reporter John Flowers is at [email protected].

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