Commentary: Health Care Totalitarianism in Vermont

by John McClaughry (April, 2013)

“The legislature gave the Green Mountain Care Board the power to prohibit even private arrangements between doctors and paying patients. Withdrawing that power won only 44 House votes.”

In 2011 the Vermont legislature enacted Act 48, Gov. Shumlin’s Green Mountain Care law. A section little noticed at the time conferred upon the new Green Mountain Care Board the power to “set rates for health care professionals … to be implemented over time, and make adjustments to the rules on reimbursement methodologies as needed.”

At the time most believed that this power of the Board was necessary for the Board to determine how much to pay doctors providing services within  the “public-private universal health care system” created by the act – always, of course, in light of available appropriations.

Rep. Cynthia Browning (D-Arlington) has a PhD in economics, and a penchant for asking important and sometimes troublesome questions. She read Act 48 and noticed that the Board’s power to regulate prices charged by  medical providers extended to any service provided by any doctor in Vermont – even a service offered privately to a patient paying directly out of pocket.

On March 19 Rep. Browning offered an amendment to this year’s health care bill (H.107) to repeal the Board’s power to price-control – and thus exterminate – private medical agreements completely outside the coming single payer system. The liberal Democratic House voted it down 44-94. Only four Democrats voted for it.

The argument against the Browning amendment came down to this: if Vermonters with money could escape from Green Mountain Care, Vermont would end up with a two tier system – Green Mountain Care for ordinary people, and prompt, premium care for those who can pay for it. That would fly in the face of the sacred “principles of universal health care”, where everybody pays and everybody gets whatever care the system can afford to deliver.

Of course, one of those sacred principles is “(5) Every Vermonter should be able to choose his or her health care providers.” Apparently that principle has already gone down the drain.

It’s worth doing what the Green Mountain Care advocates resolutely refuse to do: look at thirty nine years of single payer in Quebec, just sixty miles north of Montpelier.

After years of health problems, including a hip replacement, George Zeliotis of Montreal got fed up waiting in declining health while the hard-pressed Quebec Medicare system delayed offering him treatment. So he went to his doctor, Jacques Chaloulli, and offered to pay him for health care. The government forbade it, and the two of them went to court.

In 2005 the Supreme Court of Canada struck down Quebec’s prohibition on private contracting between patient and doctor. The court held that prolonged waiting is a denial of the access to health care promised by the Quebec Charter of Human Rights and Freedoms.

The lead opinion in the decision identified the issue as being whether the prohibition is “justified by the need to preserve the integrity of the public system.” Justice Deschamps concluded that it was not, that long waits for medical care were Quebec’s form of rationing scarce health care dollars, that the practice resulted in needless deaths, and that the prohibited private health care would likely have saved those lives.

The province’s defense of its prohibition is precisely the rationale for totalitarianism: “to preserve the integrity of the (constipated, bureaucratic, unworkable) public system.” That thought would be familiar to the late fascist dictator of Italy Benito Mussolini, with his motto “everything for the state, nothing against the state, nothing outside the state.”

Gov. Shumlin’s grand scheme of “universal” single payer health care can “work”, on paper, only where the government completely controls the medical “universe”. By preserving the Board’s power to drive out any doctor-patient private-pay alternative to Green Mountain Care, the 94 defenders of Act 48’s power to destroy any and all private options have cast their lot with the forces of totalitarianism. The voters should emphatically remind them that the first word of our state’s motto is “Freedom”.

 

{ 1 comment… read it below or add one }

basketball gears for men September 21, 2014 at 8:53 pm

I enjoy what you guys tend to be up too. This kind of clever work andd reporting!
Keep up the good works guys I’ve added you guys to our blogroll.

Reply

Leave a Comment

Previous post:

Next post:

About Us

The Ethan Allen Institute is Vermont’s free-market public policy research and education organization. Founded in 1993, we are one of fifty-plus similar but independent state-level, public policy organizations around the country which exchange ideas and information through the State Policy Network.
Read more...

Latest News

A Response to “Who’s Really Politicizing Our Kids”

June 13, 2019 by Rob Roper The following is in response to a letter that appeared in the Caledonian Record on June 10th by Steven Isham.  To the...

VPIRG’s Plastic Agenda

June 12, 2019 By John McClaughry The plastic bag ban is sitting on Gov. Phil Scott’s desk. If he signs it, Statehouse Chronicle writer Guy Page reports, a working...

The Blittersdorf Special

June 11, 2019 By John McClaughry Remember the Champlain Flyer? That was Howard Dean’s commuter train that ran 13 miles from Charlotte to Burlington. After three years’ operation...

Roll Call! Senate Blocks Amendment to Remove Insurance Innovation from Bill (7-22), 2019

S.131 – AN ACT RELATING TO INSURANCE AND SECURITIES (BARUTH AMENDMENT) FAILED in the State Senate on April 3, 2019 by a vote of  7-22  . Purpose: The Amendment called for removing...

California Prison Drugs

June 7, 2019 By John McClaughry Steven Greenhut, writing in the Orange County (California) Register, makes an interesting point about drugs in prisons. He quotes a San Francisco...

Video