OP-ED: Moving forward with publicly-financed health care and a people's economy
This week we witnessed Governor Shumlin giving up his role in Vermont's move to universal health care, as he caved to pressure from big businesses. His misguided decision marks the end of a politician's ambitious career, but not that of universal, publicly financed health care. The Governor's failure to deliver a common sense plan for shifting from private to public health care financing reveals the powerful opposition to completing such a shift, as evidenced once again in recent comments by the National Life Group and other big companies. Shumlin's decision was political, not economic.
Vermont can and must move forward — with or without Shumlin — to secure the human right to health care for everyone. Without guaranteed access to care, the human rights crisis in our state will continue unabated. Too many people suffer from poor health, financial hardship, and agonizing choices between filling their prescriptions, putting food on the table or paying rent. Growing inequity in our state, which leaves one in every five young children in poverty, signals a much deeper problem, yet the market-based health care system has a lot to do with it. An insurance system that sells health care as a commodity to those who can pay exemplifies how our entire economy is set up to make money off of underpaid workers and channels profits to corporations that excel in avoiding taxation.
The Healthcare Is a Human Right Campaign set out in 2008 to build a movement led by people impoverished and excluded by the market insurance and economic system, with a view to changing what is politically possible in our state. When we first met with Peter Shumlin in 2009, he said he believed universal health care was not possible, yet as we succeeded in shifting public discourse, he changed tack to do what was politically expedient. Yet his support for universal health care always rested on a pro-business agenda that sought to maintain and expand an economy benefiting the few. As long as universal health care appeared to be aligned with lowering costs for big businesses, Governor Shumlin largely followed the road set out by Act 48. However, he did so without seeking public input or meeting required deadlines, instead discussing his plans primarily with his Business Advisory Council on Healthcare Financing. In successive state budgets, he pitted health care against education, social programs, a livable wage and paid sick days, cutting the budget by raising the specter of future health care taxes. When it became apparent that universal health care would only work when equitably financed, with big businesses paying their fair share, Shumlin switched sides again and abandoned his obligations under Act 48.
Universal, publicly financed health care is about economic change — it's about making our economy work for all people, not the few; it's about an economy with sustainable businesses that serve the people, not just profit interests, an economy that creates good, livable wage jobs and protects our environment. Shumlin has not been a champion of a people's economy. Now that he has shown his cards, it's time for us to show that we can do better.
Universal health care works by moving from private premium payments, deductibles, co-pays and co-insurance to public taxes. We already pay for our health care system — at least twice as much as countries with universal health care — which means no new money is needed. An equitable financing plan would be based on progressive taxation, so that both businesses and individuals pay according to their ability. No flat taxes that make small businesses pay the same as big, no caps on payments by the wealthy, no cost-shifting to individuals. Here's how Vermont can get a health care system, and ultimately an economy, that puts people first: We maintain the current 80 percent to 20 percent split between business and individual premium contributions; individuals and families pay what they can through income taxes; and businesses pay their share through a graduated payroll tax that starts at zero for the smallest businesses and goes up to 20 percent or higher for large corporations, maintaining their current rate of contributions. Companies with large wage discrepancies would be charged more than those that pay all their workers a fair wage.
Progressive health care financing would ensure that everyone gets the health care they need and contributes based on ability. It would also set us on track for an economy that works for all people. Low voter turnout at the last election showed us that people are disillusioned with the status quo and ready for change. We count on our elected representatives to act on that, just as we count on the Green Mountain Care Board to move forward with Act 48 in tandem with the Legislature. Our people's movement will show the way forward for publicly financing health care based on ability to pay, for equitably funded education, and for a state budget and economy that puts people and the planet first.
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