by Mickey Smith

     HYDE PARK – The Lamoille County Republican Party arranged for two speakers who have been touring around the state discussing their concerns with the changes Act 48 will bring to the state health care scene.
Act 48, Governor Peter Shumlin's plan to redo health care, has left many with questions about the funding and feasibility of such a sweeping change. Wendy Wilton, the treasurer for the City of Rutland, has been traveling the state questioning the finances of Act 48's Green Mountain Care Plan.  Morristown resident Marion Clegg set up the forum that was held on Wednesday, January 18, at the Green Mountain Technology and Career Center. Along with Wilton, Clegg brought in Robert Letovsky, Ph.D, a Montreal native who now is a member of the faculty at Saint Michael's College.
     Wilton's talk focused on the cost of health care, and her concerns about how the state will pay for Shumlin's plan. Based on information she has gathered, she created a five-year outlook which runs a deficit of $636,000,000 in the first year  and continues with an annual deficit of $300 to 450 million dollars. Her projected cumulative deficit comes in at just over $2.1 billion.
     Wilton said much of her information is based on educated guesses because not all the details have been worked out. She said she estimates the bulk of the money will come from a payroll and self- employment tax of 14.5%.
     She said when she began this process she knew something needed to be done, and hoped her concerns were wrong and this might be the answer. Instead, she said she realized there were a lot more questions still to be answered and she is concerned those answers are not expected to come before the next election.
She said through her studies she has noticed the insurance plans in the state that appear to be doing it right are the self-funded plans, that rely heavily on wellness and a personal investment by the recipient.  She said places that are self-funded, like IBM, have seen growth of 3-4%, while state and municipal programs are seeing increases closer to and into double digits.
     Among the questions brought up during the course of the meeting were: how will this affect union bargaining (will they be able to bargain for supplemental insurance not available to others); how will the self-funded programs be treated, will they pay twice or, more importantly, will a company like IBM want to remain in a state where a portion of their company has to have a separate insurance plan; what will happen with the influx of people coming in to the state to gain access to the coverage and how will Vermonters’ coverage be handled when they are out-of-state and visitors’ coverage be handled when in-state?
     Wilton said these are the types of questions to which Vermonters deserve answers, and so far they have not been received.


Dr. Robert Letovsky addresses the audience at a recent Health Care Forum offered by the Lamoille Republican Party.                                                         Smith photo
    
     The second speaker, Dr. Robert Letovsky (who warned right off the bat he's not a “real doctor”), spoke about his time in both Canada and U.S., where he has lived under both a free market and a socialized medicine system.
He said socialized medicine came to Canada when he was in ninth grade, and since then he has watched healthcare become a line item on the budget that competes with everything else for a percentage of tax dollars.
     With the money budgeted ahead of time, he explained,  Canada has to ration care in order to stay within the budget. This has resulted in 20 to 25 hour average waits for emergency room care and about 25% of the population not having access to a general practitioner. He said, in 2009 Canada graduated 280 new doctors and only 225 were granted permits to actually practice. Doctors in Canada are told how much they will be paid and where they are allowed to practice. This, he said is more easily accepted with the average cost of getting a medical degree being about $5,000 per year in Canada.  But, he questioned, how would a doctor here – with $300,000 in college bills take being told his field of medicine pays $21 an hour?
     Dr. Levotsky said when people talk to him about socialized medicine, he suggests they move to Canada for a year so they can: 1. pay their tax rates, 2. visit an emergency room there and 3. see the levels of estate taxes when someone dies.
     With Vermont's aging population and young people being driven out of the state because it is getting too expensive for them to live here, these facts, too, will drive up the cost of health care.
     Johnson’s Rep. Mark Woodard was the only local representative at the meeting. Woodard, a Democrat, serves on the health committee and said, during the meeting, he heard some valid points that he would like to get some answers to. He pointed out a lot of the information, though, was based on hearsay.
     After the meeting, Wilton agreed many of her points are based on estimates, but that is because there are no answers and you can't plan based on uncertainty.