Brattleboro Reformer editorial

It’s heartening to know that as health care legislation makes its way through Congress, there are a lot of Vermont’s ideas receiving serious consideration.

As U.S. Rep. Peter Welch sees it, the experience he’s had with health care issues in Vermont has given him a perspective on the issue that few now in Congress have.

During a recent visit to the Reformer, Welch said that any health reform plan that comes out of Congress has to have three essential elements: insurance reform, extension of coverage and an affordable, federally sponsored public insurance option to compete with private insurers.

Welch defines insurance reform as setting standards for insurance companies that would be better for the insured (for example, the community rating system Vermont uses to prevents insurers from "cherry picking" the healthiest consumers while denying coverage to higher risk customers).

He also wants to require insurance companies to spend a minimum of 85 percent of their premiums on health care, to cut down on administrative overhead and exorbitant CEO salaries.

"We’re working hard to get all these things into the final (House) bill," said Welch. "But there’s also a big emphasis on quality of care and outcomes right now, and that comes from Vermont."

A recent report by the Vermont Program for Quality in Health Care found the state’s Blueprint for Health program, designed to lower medical costs for patients with chronic illnesses, has been so successful that it should be expanded. The report also found that Vermont has the most cost effective end-of-life care programs in the country.

With 75 percent of all health care dollars in Vermont linked to chronic illnesses, Blueprint’s emphasis on prevention and ongoing disease management programs has resulted in a higher rate of appropriate care being delivered to Vermonters at a lower cost. The program has worked so well that the federal Department of Health and Human Services wants to adopt elements of it.

"The Vermont experience with health care reform has substantially influenced the issue in Washington," said Welch. "In Vermont, we’ve already dealt with many of the things that people in other states are only now just starting to think about."

This offers some hope for Vermonters who think that the chances are remote that real health care reform will come out of Washington. But as we’ve seen with Catamount Health, having access to health insurance means little if you can’t afford to buy it.

The Legislature is likely to take up the issue next year, as calls increase for a study of the economic benefits for communities, businesses, schools and the medical industry of having a universal, publicly financed health care system in Vermont.

At Tuesday’s "People’s Forum on Health Care" in Brattleboro, six Windham County legislators said they would support a universal health care bill. A similar bill was passed by the Legislature in 2006, but it was vetoed by Gov. James Douglas.

Vermont should have the opportunity to come up with its own ideas, with the encouragement of the federal government. Senate President Pro Tem Peter Shumlin said Tuesday that the Obama administration should allow the state to establish a pilot universal health care system.

"Let’s show them how we can do it in Vermont, and the other 49 states will follow," said Shumlin.

We think we’re in a good position to do so, given our success in being among the states with the lowest number of uninsured in the country. If the feds can’t come up with a good plan, let Vermont have the chance to show the rest of the nation how it’s done.