(Host intro) All this week in a series of stories and interviews, Vermont Public Radio examines the symptoms of the health care crisis and some of the possible cures.
Today, in our first report we look at Catamount Health Care.
That’s the new state program to lower the number of unsinsured Vermonters.
Despite previous initiatives over the past 20 years, about 65,000 people still don’t have health insurance.
If Catamount is successful, backers say it will reduce health care costs by giving these Vermonters timely care.
VPR’s Bob Kinzel reports.
(Sound of the Bridge Street Café)
(Kinzel) It’s a busy morning at the Bridge Street Café in Richmond. Dozens of people are ordering breakfast and getting refills of coffee.
Ben Wang has stopped by the Café. He’s 36 years old and doesn’t have health insurance. Ben is a part time instructor at the Community College of Vermont and is working to start his own business teaching English in foreign countries.
He was covered under his wife’s policy but several months ago they had to drop the coverage when she closed her business – if they had continued the policy it would have consumed one third of their income.
Wang has applied for Catamount because he says trying to get by without health insurance coverage is a too much of a gamble:
(Wang) "We would actually pay out of pocket for health care which wouldn’t be a whole lot unless something unexpected happens in which case we would go into debt and also I think be unable to certainly unable to pursue the careers that we are pursuing."
(Kinzel) Under Catamount, Wang will receive a comprehensive benefit package with a $500 family deductible. The cost of Catamount varies depending on a person’s income level. For an individual making roughly $19,000 a year, the premium is 60 dollars month. At the $30,000 income level, the premium is 135 dollars a month.
Wang says Catamount makes health care coverage affordable:
(Wang) "It’s a safety net really with our financial circumstance and with a child on the way really don’t feel like we can afford any kind of some unexpected medical emergency."
(Kinzel) Catamount is the state’s latest effort to cover the uninsured. Twenty years ago, Dr. Dynasaur was launched to offer coverage to many children, and over the past decade, state programs expanding eligibility in Medicaid have allowed more adults to receive health care benefits.
Catamount is a public – private partnership. It’s financed using federal funds, increased state tobacco taxes, premiums from participants and a fee on businesses that don’t offer health coverage to their workers.
Under Catamount, people choose between plans that are offered by Blue Cross and Blue Shield of Vermont and MVP.
(Sound from Rutland Emergency Room, held under.)
When he’s not at the Statehouse representing Mendon, Dr. Harry Chen is an emergency room physician at Rutland Regional Hospital.
In Montpelier, Chen is the vice chairman of the House Health Care committee. He says Catamount allows individuals to get appropriate care in a timely manner – that’s something he says many uninsured people don’t currently receive:
(Chen) "I see it every day on a daily basis I also work at the Free Clinic here in town so I see that also. Where people don’t get the routine care, the management of the hype- tension, so they end up being a higher risk for heart disease or stroke. I see people come in with abdominal symptoms that end up being colon cancer that potentially could have been prevented by a colonoscopy if they have proper health care coverage."
(Kinzel) Chen says Catamount is a way to reduce uncompensated care to health care providers. Since many of these expenses are currently shifted over to individuals with private health insurance — he says the success of Catamount could help moderate the growth of private insurance premiums:
(Chen)"So that’s one of the ways it reduces the cost shift and potentially bends the curve with health care….
(Kinzel) Not everyone is convinced that Catamount is the right approach. Dr. Deb Richter is a Cambridge physician who’s been directly involved in the health care debate at the Statehouse. Richter says Catamount is only a temporary fix because it doesn’t make systemic changes to Vermont’s health care system:
(Richter)"We’re not even getting at the problem that we started with, which was the fact that we have rising health care costs. This doesn’t get at this. This is just basically a plan to cover people who are previously uninsured so we’re not really solving the problem that we started with."
(Sound from Bridge Street Café)
(Kinzel) Back at the Bridge Street Café, Mike Timbers wants his two young adult children to sign up for Catamount. Since they’ve graduated from college, they’re no longer eligible for his policy. They’re working at part time jobs and don’t have coverage available.
It’s a common problem for many families. It’s estimated that 25 percent of all uninsured people in Vermont are between the ages of 18 and 26:
(Timbers) "You can’t afford not to have health insurance … They’re young. It’s not as important to them as it is to me. I don’t think they realize the potential consequences of not having health insurance and having something happen."
(Kinzel) Mike says he’ll breathe a sigh of relief when his two kids are finally enrolled in Catamount in the coming weeks.
For VPR News I’m Bob Kinzel in Montpelier.
AP Photo