Gov. Shumlin counts on regulatory board for VT health care protection

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By Jon Street | Watchdog.org

HEALTH CARE HEADACHE: With Vermont Health Connect still in trouble, some question whether government can be trusted with health care decisions.

BURLINGTON, Vt. — More questions and concerns are being raised as problems persist with Vermont Health Connect, the federal health insurance exchange required under the Affordable Care Act, also known as “Obamacare.”

That’s prompted some to question whether the government is really capable of looking out for the interests of health care consumers.

Rep. Paul Poirier, I-Barre, has introduced a bill that he says would resolve any issues between consumers and health providers. Poirier’s bill would create a new state office, the office of health care advocate, which he said would be the equivalent to the Department of Public Service in matters related to utilities.

“We have made a change in terms of who represents the public in terms of health care,” Poirier said. “As we’re moving toward a single payer health care system, we’ve created the Green Mountain Care Board, and that board is charged with creating everything — how we’re going to pay for [a] single-payer [system], what the benefit plan is going to be, and everything else.”

Vermont is the first state to implement a government-run system of health care, which will be known as Green Mountain Care. The new system is set to take effect in Jan. 2017.

While Gov. Peter Shumlin seems convinced the Green Mountain Care board can handle such concerns, Poirier isn’t so sure.

“They’re a regulatory board and one of their primary goals is to protect the solvency of insurance companies, (but) sometimes protecting the solvency of insurance companies comes at the expense of higher rates for consumers,” he added.

Poirier, who has spoken with the governor on the topic, said Shumlin recognizes the need for some kind of public protection in matters of health care, but is counting on the Green Mountain Care board to do the job.

Vermont Watchdog reached out to Shumlin’s office multiple times, but spokeswoman Sue Allen offered no response by time of publication.

“I and some of my colleagues believe that just because the state of Vermont becomes the insurance company for the state of Vermont doesn’t mean they’re going to act any differently than an insurance company does,” Poirier said.

That’s why this new “powerful position,” as Poirier said he envisions it, could intervene on the public’s behalf because the “chief health care advocate” would be given “automatic party status” whenever addressing the regulatory health care board.

The chief health care advocate, or the person in charge of the independent office, wouldn’t be considered part of the administration. Rather, he or she would be elected to the position by the Legislature.

“They could file their own motions in front of this [Green Mountain Care] regulatory board and bring their own motions forward by saying we’re not spending enough money out of every dollar on providing care, the administrative costs are too high, whatever they deem is appropriate for protecting the rights of consumers and the benefits of consumers,” Poirier said.

In addition, Poirier said the health care advocate would reach out through surveys and public meetings to better gauge what the public cares about.

And as far measuring the health care advocate’s success, Poirier said that conclusion would be “subjective,” but added its success would ultimately be determined by how effective it is in affecting the health care system, which is supposed to meet the needs of Vermonters.

What would be the cost for all this? Poirier said the advocate would receive an $100,000 annual salary. The total annual budget for the entire office with its 25 employees would amount to about $2 million in its first year.

Darcie Johnston, president and founder of Vermonters for Health Care Freedom, thinks that’s too much. While Johnston said having someone to look out for the interests of Vermonters is important, Johnston suggested the need for a position such as health care advocate is indicative of what to expect under a “single-payer” health care system, set to take effect in 2017.

“If we have to fund a consumer advocate to protect Vermonters from government’s misdeeds at that rate for just the [Vermont Health Connect] exchange right now, can you imagine what we’re going to need once they’re in charge of the whole thing?” she said.

Johnston also questioned why Shumlin hasn’t proposed anything to fix the botched rollout of the exchange, alluding to damage control efforts by Massachusetts — albeit costing that state an extra $10 million.

“If the exchange is in chaos and dysfunction, then people will be so frustrated they’ll think that going to government-run health care and getting rid of the exchange will be better,” Johnston said.

Contact Jon Street at jstreet@watchdog.org and find him on Twitter @JonStreet.

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