Locals add voice to single-payer health care debate

MIDDLEBURY — One by one, they took to the microphones on Monday in all corners of the state to give legislators an earful about plans to revamp Vermont’s health care system.
Though separated by the many miles between the 15 Vermont Interactive Television (VIT) sites, the dozens of speakers primarily spoke in a unified voice tinged with individual health care horror stories. Their message to Vermont lawmakers: Adopt a universal access, single-payer system.
“Please look at our faces and see us; we are your neighbors and we are people, just like you,” Weybridge resident Kathy Heitkamp told lawmakers taking testimony for new health care reform legislation.
Heitkamp, speaking from the Middlebury VIT site at the Hannaford Career Center, explained that she has had health insurance for half her life.
“When I was diagnosed with cancer, I was lucky; I had health insurance,” she said. “Right now, I don’t.”
Heitkamp said she currently has to pay her health care expenses out of pocket, while her husband can receive coverage through the Veterans Administration.
“We need a health care system that doesn’t put us in debt if we need treatment,” Heitkamp said. “Vermont and the United States are great places to live, yet we lack a fair and compassionate health care system.”
Heitkamp was one of six Addison County residents to deliver testimony on H.202, a bill that would lay the foundation for creating a single-payer and unified health system in Vermont. Around 20 area residents showed up for the hearing but were unable to deliver testimony given time constraints. The House Health Care Committee and Senate Health and Welfare Committee allotted two-and-a-half hours for feedback at Monday’s hearing, and that time was distributed — in two-minute increments — to speakers throughout the state.
Lawmakers also heard from Addison County resident Dawn Rich, who delivered her comments on behalf of the “working disabled.”
Rich urged lawmakers to pass a system that reduces paperwork currently associated with the Medicaid program. She stressed that long-term care and medication coverage should be protected for vulnerable citizens. But Rich emphasized her desire to see a health care system that would apply to, and function properly for, all citizens — regardless of income.
“We don’t like having to prove we are poor or wealthy; it is stigmatizing,” she said. “I want to be treated like everyone else and not stigmatized as a Medicaid-Medicare person.”
The Rev. Diana Scholl, who until recently served as Porter Hospital chaplain, described how insurance worries weighed on the patients she has strived to comfort.
Scholl said she has dealt with patients on “Cadillac” insurance plans and those who pay out of pocket or are inadequately insured.
“This very basic lack of fairness and equity is very hard for health care workers themselves to deal with,” Scholl said. “Some of the worst days I had were meeting patients who had to end their treatment too soon, or weren’t able to go to the next specialist for the next segment of treatment because their insurance company overrode their physician’s treatment recommendation.
“It was all about the money.”
Middlebury resident Judy Olinick urged lawmakers to allow Vermont to emulate what she said is common practice throughout the industrialized world.
“In nearly all other modern democracies, health care is considered a public good and a human right,” Olinick said. “Only here does loss of a job mean loss of health care for an individual, and often an entire family. Only here, does a single serious illness — even for those with insurance — often mean financial ruin and loss of one’s home and savings.”
Middlebury resident Monica Sanchez Webb urged lawmakers to include chiropractic care within the scope of services to be considered for universal access.
“Without chiropractic care, my options would be physical therapy, and lots of pain medications that would leave me unable to work and not be able to function or be able to drive or take my kids and family around,” Webb said. “It would cost the health care system a lot more money.”
She also noted that the availability of health care insurance can make or break a prospective parent’s decision, from a financial standpoint, on whether to adopt a child.
Jill Charbonneau, another Middlebury resident and president of the Vermont State Labor Council/AFL-CIO, said adopting a single-payer system could signal what she believes would be a positive change for the economy, which she said is now primarily corporate-driven.
“Let’s work for people, not for profit,” Charbonneau said. “The system is broken; let’s fix it.
Many attendees in Middlebury — and at the other VIT sites — held red signs bearing the message, “Health care is a human right.” They made sure to get the signs on camera in the background as speakers talked into the microphone.
David Schoales, a school board member in Brattleboro, spoke about how double-digit increases in health insurance premiums had driven the need for staff cuts within the school system.
“We need predictability and we need it now,” Schoales said.
Newport resident Cindy Parren recounted how she had been diagnosed with a brain clot at age 25. As an underinsured person, she said she could  not afford the ongoing $30 insurance co-pays, which she began putting on her credit card.
“I am medically bankrupt,” she said. “I don’t see a way out of it with our health care system and the current economy.”
While most of Monday’s speakers advocated for a single-payer system, a smattering of those who testified voiced concern with such a change. Among them were folks who feared Vermont would replicate the Canadian health care system, which some claimed offered inadequate and untimely care. Single-payer opponents claimed an increasing number of Canadians are purchasing supplemental coverage and coming to the U.S. for some procedures.
Businesspeople cautioned that they are already contending with annual health insurance premium increases in the 10-percent range, and don’t want to see those expenses go higher with a new system.
Other opponents said state government should not be trusted to take over administration of the health care industry.
Dr. Chris Soares, a Randolph-based ophthalmologist, said he is just scraping by financially with a small, rural office and three children in college. He frequently rides to work on a bicycle to save expenses.
“We already have a single-payer system that has failed, and it’s called Medicaid,” Soares said, adding, “please don’t make me ride to work on a unicycle.”
Taking notes at Monday’s proceedings in Middlebury were Rep. Michael Fisher, D-Lincoln, and Rep. Willem Jewett, D-Ripton. Addison County Sen. Claire Ayer, D-Weybridge and chairwoman of the Senate Health and Welfare Committee, heard the testimony in Montpelier.
Fisher, vice chairman of the House Health Care Committee, said the testimony will definitely give him and his colleagues some food for thought.
“The personal stories are so important,” Fisher said. “It’s good to remember that this conversation touches every one of us in a really personal way.”
Fisher anticipates House Health Care will vote out H.202 by the end of this week. He expects House Appropriations, Government Operations and Judiciary committees will review the legislation before it is voted on by the entire House. The bill would then move on to the Senate.
Passing H.202 wouldn’t guarantee that Vermont moves to a single-payer health care system. Lawmakers point to that happening sometime beyond 2014 — and that’s if all the political and funding stars align.
“This bill sets us on a path,” Fisher said.
H.202 would, among other things, establish a board to ensure cost-containment in health care,  create system-wide budgets, and to pursue payment reform; a “health benefit exchange” for Vermont as required under federal health care reform laws; create a public–private single-payer health care system to provide coverage for all Vermonters after receipt of federal waivers; create a consumer and health care professional advisory board; examine reforms to Vermont’s medical malpractice system; and modify the insurance rate review process; and create a statewide drug formulary.
Reporter John Flowers is at [email protected].

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