Gubernatorial candidates debate health care plans

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(Host) Governor Jim Douglas and Burlington Mayor Peter Clavelle faced off on health care issues Friday night in the latest in a series of gubernatorial debates.

VPR’s Nina Keck was there and filed this report.

(Keck) Nearly 200 people gathered at the Paramount Theater in Rutland to hear how the two major candidates for governor would tackle everything from skyrocketing Medicaid and prescription drug costs, to malpractice tort reform and long term care.

Challenger Peter Clavelle argued that all Vermonters deserve adequate health care and new leadership is needed to make that happen.

(Clavelle) “I think everyone in this room would agree that the health care system, the so-called system, in this state, in this country is broken. It’s badly broken. It doesn’t need to be fixed, it needs to be replaced with a system that will commit to health care for every American.”

(Keck) Clavelle said under his health care proposal, everyone in the state pays in and everyone benefits.

(Clavelle) “I think in the same way that if you live in a community and you’re served by a fire department there’s a reasonable expectation that everyone supports that fire department through their taxes. There ought to be a reasonable expectation that everybody should support their health care delivery system in the state of Vermont. I have proposed a plan, which would initially be voluntary but within three years there would be an expectation that all Vermonters – individuals, self-employed as well as small businesses – would participate in that plan.”

(Keck) Clavelle said people would contribute based on their ability to pay. Money saved in administration expenses and cost shifting would help fund the program.

(Clavelle) “About 25 cents of every dollar you pay for health insurance, those of you who are paying premium – you’re paying for someone else’s health insurance, that’s the cost shift. That’s the hidden tax that occurs today. So I think it makes a great deal of sense.”

(Keck) But how would such a system be enforced asked the moderator?

(Clavelle) “Sure there would be enforcement. In the same way there’s enforcement for the workers compensation laws. There would be an expectation that the business or the self employed individual would certify that they have insurance. The premium would be pegged to one’s income and their ability to pay. But the result would be the cost shift would end and the cost of health insurance would be more affordable to all of us.”

(Keck) Governor Douglas argued that no matter how health care is provided, if the cost of care and demand for services aren’t brought down, no system will work. Therefore, the governor said people who are making smart choices about their health – people who don’t smoke, who exercise and watch their weight – they should be rewarded with lower insurance premiums. He said Vermonters also need to become smarter health care consumers.

(Douglas) “So mandates don’t work. That’s not the way to reform our health care system. What we need to do is develop a plan that’s sustainable, that’s like the one I offered to reduce premiums for those in the individual market and incense small businesses to offer coverage, provide help to those who can least afford it. Not to impose a mandate. I know there are some employers in our state that have self-insured plans with very modest deductibles for employees who go to a physicians office and much higher deductibles for employees who go to the emergency room. I think an important way to help incent better choices and behavior on the part of the patients is through a device such as a health care savings account. That empowers the individuals to make decisions, to understand the cost of each individual item of care and to see the balance change as those decisions are made.”

(Clavelle) “A health savings account will help you if you’re healthy and your wealthy. It’s not going to address the problems of those folks who are going to the emergency room for health care services.”

(Keck) The health care jabs went back and forth for over and hour at the debate which was sponsored by the Vermont Medical Society, the Vermont Association of Hospitals and Health Systems, the American Association of Retired People and the Paramount Theater.

Douglas used the event to tout his accomplishments over the past two years and to reiterate that the best way to provide health care was by implementing a comprehensive approach with more choices and fewer mandates. But he stressed that there are no easy fixes and wondered how the state could realistically fund universal coverage.

Challenger Peter Clavelle said the current health care crisis demanded a more innovative approach. He said not only did he want to lead Vermont, but he felt Vermont could lead the nation in providing all citizens with high quality health care.

For Vermont Public Radio, I’m Nina Keck in Rutland.

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