Everyone in Vermont has a legal right to health care, not just a moral one. That legal right was enacted into Vermont law in 2011 in Act 48. That law says that the State of Vermont “must ensure universal access to and coverage for high-quality, medically necessary health services for all Vermonters.” (18 V.S.A. § 9371).

But Vermont has not kept that promise. Vermont does not provide health care for all. Over 187,000 Vermonters can’t afford primary care because their annual deductible is $4,000 or greater. So, they don’t see a doctor when they need to. And they suffer serious illnesses needlessly. Some die.

This isn’t just a moral failure. It’s a breach of a legal duty. And it is what economists call “failure demand” — spending big money downstream to fix harms we could have prevented with small money upstream. Every emergency room visit that replaces a primary care appointment. Every costly illness that a timely checkup would have caught. Thousands of Vermonters suffer from diabetes, hypertension, depression or heart disease because they could not afford a doctor who could have detected and prevented those chronic conditions.

Per capita, Vermont has the most expensive health care in the world. According to Blue Cross Blue Shield Vermont, average Vermonters spend 19.6% of their income on health care — almost two and a half times the national average of 7.9%. No wonder young people are leaving Vermont. No wonder businesses aren’t paying higher wages. No wonder our school budgets are exploding and property taxes are growing by double digits.

More than anyone else, Governor Scott is responsible for Vermont’s dereliction of its legal duty to provide the health care it promised in Act 48. In the nine and a half years he’s been in office, Governor Scott has not proposed implementing legislation. He has not called for a financing study. He has not explored a phased-in process starting with universal primary care. Governor Scott has done nothing to effectuate the law that grants all of us a legal right to health care.

Governor Scott has no plan for health care in Vermont. Under Governor Scott, our legal right to health care has languished, while more and more Vermonters get sick or die needlessly. Governor Scott has failed us. Health care is his to lead on, and he has done nothing.

As Governor, Amanda Janoo will lead the effort to implement our legal right to health care in Vermont. Not only has she made this promise; but she also has the experience and expertise to get it done.

Amanda was born, raised and educated in Strafford, Vermont — a town small enough that decisions about it are still made by neighbors in a room together. She earned a master’s degree in development studies from Cambridge University, where she studied directly under the renowned Ha-Joon Chang, whose work documents how every wealthy country built its prosperity through deliberate economic policy choices. She was a Fulbright researcher in India. She then spent nearly a decade as an industrial policy and economic systems expert for the United Nations Industrial Development Organization, the German Development Agency, and the African Development Bank, helping to design economies that serve the people who live in them. She has done this work across Africa, Asia, India, Europe and the United States.

It’s not that she has all the answers. Rather, she knows how to ask questions and listen. She knows how to bring together ministers, business owners, farmers, workers, civil-society leaders and legislators and put their collective wisdom to work on the problem.

The countries that have successfully built wellbeing economies — Iceland, New Zealand, Finland, Scotland, Wales — are small nations. Vermont’s size is a strength. It enables us to grow productive relationships among leaders from all sectors and develop innovative ways of solving problems.

Some say Vermont is too small to afford universal health care. Iceland has 400,000 people. Malta, 574,000. Montenegro, 626,000. All have state-funded universal health care. Don’t tell me we’re too small. We have enough money. We just need to marshal the will.

If we nominate and then elect Amanda Janoo to be our next governor, Vermont will turn the corner. We will be on the path to the universal health care to which we already have a legal right — and to the Vermont we know we can be.

Mike Palmer

Cornwall