Health Care Reform for Vermont, 2005
2. Spend public funds to educate Vermonters on how to stay healthy, and access information on how to shop wisely for preventive and acute care. 3. Repeal age-based community rating, which requires healthier young families with children and mortgages to pay the insurance bills of their older, sicker, but much wealthier parents. Allow insurers to offer discounts for healthy lifestyles (no alcohol, tobacco, or illegal drug use, etc.) just as auto insurers do for seatbelt usage and airbags. Continue guaranteed renewability. 4. Stop underpaying providers for health care services (Medicaid, VHAP, Dr. Dynasaur). When the government awards health care entitlements to selected classes of people and then underpays providers, the excess costs are shifted to private insurance customers, making private insurance less affordable, creating more uninsureds, and driving more people into government health care programs. 5. Replace guaranteed issue with a state high risk pool to pay the exceptional costs of the one percent of people who are uninsurable. Fund through general revenues and/or assessments on all policies. 6. Reduce government mandates that drive up the cost of health care, such as mental health parity, excessive substance abuse coverage, and mandatory pregnancy coverage. 7. Encourage Vermonters to create tax deductible Health Savings Accounts, coupled with high-deductible major medical coverage. (The 2003 Medicare bill allows HSAs, and the advantages pass through to the Vermont income tax through the linked taxable income.) 8. Convert acute care Medicaid into an HSA program, with the state providing sliding-scale subsidies for individual accounts, and recipients accumulating unused balances for future health care and insurance expenses. 9. Enact income-based recapture for unpaid medical bills of persons who choose to spend their resources on things other than adequate health insurance. 10. Tighten standards for medical malpractice to reduce physician and hospital exposure to suit.  |
