Most of the work in the House this past week was confined to committee work, with only a handful of bills making their way to the floor. The Government Operations Committee has been putting in long hours on the always daunting task of redistricting (every 10 years based on census data). The Human Services Committee was consumed with developing a new mental health service delivery game-plan in the wake of the havoc caused by Irene at the State Hospital complex in Waterbury. And, Fish, Wildlife and Water Resources committee members were putting together a bill that would place a moratorium on fracking. I would anticipate that legislation on all of these matters will be up for floor action by the full House next week (Week 5).
Health Care – The House Health Care Committee also has a very full plate. Near term, the Committee must finalize the State’s approach to complying with Federal health care reform requirements. By 2014, Vermont must have its “i’s” dotted and “t’s” crossed on how the State’s “Health Care Insurance Exchange” is going to work within the Federal regulatory context. The bigger question of whether Vermont eventually moves to the brave new world of a so-called “single payer” system sometime in the future, also remains a hot topic. Very few, if any, of the folks I have spoken with have indicated that such a change could be brought on line prior to 2017. For me anyway, this begs the question – why are we still using a planning timeline that contemplates the new state system (whatever it may be) will be ramped up in 2014, when the 2017 date is the real world target we should be planning around?
One thing I think we all can agree on when it comes to health care is that this issue is incredibly complex. The number of variables, constituencies and inter-relationships makes Act 60/68 look like child’s play. Quite the busy flowchart, to say the least. This is why I was almost euphoric to find a one page spreadsheet on the subject last week that was not only comprehensible, but also had meaning. This one pager, developed by the Department of Banking, Insurance, Securities and Health Care Administration, shows that Vermonters spent about $4.7 billion on health care in 2009. Of that amount, 36.9% went to hospital care, 13.5% to physician services, 12.0% to drugs and supplies and 7.8% to administration-related expenses. When looking at how those costs were paid – 37.5% came from private insurance, 24.5% from Medicaid, 19.3% from Medicare and 14.7% from “out-of-pocket”. I know there’s a big story behind these numbers, but at least it paints a concise, understandable picture of scope, and of where the dollars come from, and where they go.
That’s all for now. (I was going to end with a Super Bowl prediction, but thought better of it after my political advisors reminded me that there are quite a few Giants fans in Manchester.)
– Jeff Wilson, Manchester, Vermont, State Representative