I'm not complaining but.....

[Carolyn Branagan]

It was the most difficult week I have ever spent in Montpelier! Really. Hours of floor debate, dozens of amendments, speeches (none of them mine) , harsh conversations in the hall designed to change votes (don't worry, I can hold my own) ........all this and more as three important bills moved from committee to the House floor and finally to the Senate.

First, the Miscellaneous Tax bill came up. I did a lot of work to get rid of a $6 million tax on dentists and add a tax provision that helps a furniture company in the northeast  kingdom stay in business. Sadly, the tax school tax reduction I proposed did not survive. 

The Universal Health Care bill still has a lot of problems. I am very worried this bill will become law. Elderly residents will be advised to not continue supplementary policies to cover the gap left by Medicare coverage, but there is no indication Green Mountain health will cover the gap. The same goes for Medicare part D patients who now qualify for Vpharm, we don't know if their coverage will continue or not. Employers who offer employee health care plans will have to pay into the state plan too. One third of the Northwest Med Center doctors who attended a meeting last Wednesday night indicated they will leave the state if this bill becomes law. The bill is trouble and should die in the Senate or be drastically rewritten.

Last was the Appropriations bill. State spending is up 7.7%,  but when federal funds are added, the budget figures look like spending is down more than 3%. 

I appreciate input from all of you. Contact me at cbranagan@leg.state.vt.us. 

It's too cold here to sugar, so this afternoon I'm making doughnuts.  Sally Sweet gave me the recipe about 20 years ago.  Always comes out great.

Rep. Carolyn Branagan
Franklin-1. Fairfax/Georgia
Vermont House of Representatives   

[fletchtb]

Unfortunately in the case of the universal healthcare bill, I think Vermonters are going to have to learn from the mistake of this law's passage. The result is not going to be pretty as good doctors leave the state, as our taxes go up, and as the quality of healthcare declines, but I don't think there is any way to stop this train wreck.

[Thor]

Carolyn,

     Even when the doctors pack up and leave, the Dems will still believe that everything is fine. Hell, they may even think that they can offer free college to anyone who will become a doctor and live in Vermont! They can get the rich people to pay for it! But what they need to realize is that after all the doctors leave, the next batch of folks heading out of state will be the ones who are footing the bill all the time. I love it here, except for being represented by Sanders, Leahy, Welch, Shumlin and the rest of the redistribution crew who just love to have their hands in our wallets.

     Hope those doughnuts turned out great today!!

[mkr]

Oh Carolyn, thanks for all you do and keeping us up to speed!

Homemade Doughnuts and Sally Sweet's recipe MUST be delicious!  I am surprised you didn't get a call and a surprise visit from my Dad (Henry) as they are his favorite! ~Mary Kay

[JLB]

Hang in there~!    You are doing a really great job!   Thanks!

[Chris Santee]

I hope you (we) have a better week this week.

[j_gluck]

Carolyn,

I would be interested in knowing where the doctors at NWMC are getting their info about the Healthcare bill. According to this article -  http://vtdigger.org/2011/03/22/200-docs-from-39-states-say-they-would-move-to-vermont-if-single-payer-is-adopted/ - and others I have read, a majority of doctors would welcome a single system that cuts down on paperwork and allows them to practice medicine.

The system we have now is flawed and broken and I commend the Governor for having the vision of a single-payer system for Vermont and working hard to make it a reality. Everyone needs to keep an open mind on this issue. There are many issues still to resolve, but that doesn't mean we shouldn't try to make this work.

Joel

[Travis]

We have heard for years how doctors and hospitals can't make ends meet because of the additional staffing they require just to deal with insurance billing and the low payments that insurance companies offer for their services. Was that all hot air to make us think they were underpaid? Because now that there are other alternatives being discussed we have doctors threatening to leave the state or quit practicing medicine altogether.

Personally, I am tired of having almost my entire annual raise go towards the increases in my health insurance premiums as has happened the last few years. In my opinion, the heath insurance companies are just an unnecessary middle man that is milking this country for every last dime they can steal. If Vermont adopted a universal health care system, I would expect that my taxes would go up. But not by any more than my health care insurance premiums already are. I pay thousands a year in premiums, and my employer pays about double that. I would have to believe that these premiums would more than pay for any additional taxes required. A streamlined single payer system should seriously reduce overhead and staffing needed to bill multiple insurance companies which should make doctor's and hospitals more profitable.

We are already paying for uninsured patients. Our medical bills and insurance premiums are all inflated to account for the people that can't pay. Most just show up at an emergency room (which costs more) where by law they must be treated. Just like stores have to charge paying customers more to account for shoplifters, we all pay more to cover the uninsured. By giving these people health insurance, it would provide them medical care outside of the emergency room.

Our current system is not only broke, but it is aggressively bleeding our country dry. How much more will we have to give up to afford health insurance as it exists today? I make a lot of assumptions here, but no more than are already in this thread. I do not have all (or any) of the answers, nor do I claim to. What we really do need is an open and honest debate on the subject without all of the fear mongering and hate speech that generally is involved with a healthcare discussion.

[Thor]

Great idea Travis with regards to the health care debate. Or better yet, how about leave it up to the individual. If you want in, you pay to get in. If I don't want in, I should not have to be forced in. Otherwise, I move my business out of state. I have my health care, I like what I have and I don't want to be forced into another system. This way, we don't have to even waste money having a debate!!

[cedarman]

"and the low payments that insurance companies offer for their services."

Medicare and Medicaid offer even LOWER reimbursment rates for procedures than most insurance companies.

If there was a single payer system that determined ALL rates, with no other companies paying higher rates to help cover losses, how good would the service at our hospitals be when they couldn't afford to pay doctors what other states pay, and couldn't afford to buy equipment, supplies, power, etc.

[Thor]

Cedarman,

     Don't try to make too much sense as they only hear what they want to hear!!

[Travis]

Cedarman,
That's why I asked the question. We've heard for years from doctors and hospitals that the insurance companies aren't compensating them enough for all of the extra people and paperwork required. But now 28% will leave the state if they don't have those same insurance companies to deal with. There is too much rhetoric and emotion in this discussion, and not enough facts for me to form an educated opinion. I just know that what we have now is broken.

And Thor, it doesn't make sense to me either.

[Carolyn Branagan]

Hi Joel and everyone,

I don’t know where Vermont Digger got its information. I personally have heard from at least 30 doctors, almost all are opposed to the bill. The doctors with whom I have spoken are mainly upset over the lack of information available on how the program would work and what the costs will be.
 
Today I got an e-mail from 4 doctors who practice together in Chittenden County. They are partners and own the building in which they practice. They have ‘extreme concerns’ with the fast moving Universal Healthcare System bill. They questioned the sustainability of private practices, whether physicians would choose to leave the state, the lack of funding, payroll taxes, reimbursement rates, and the inflated amount of administration costs quoted in the bill.
 
These docs said their concerns were based on their positions as small businesspeople in Vermont and as a Private Practice physicians. Yesterday they heard from a colleague who had taken a job at Fletcher Allen Healthcare because of fears that his one provider practice would not survive in the new Universal Healthcare System. Some doctors who wrote me said they were contemplating leaving the state because of concerns that their practice will not remain viable or profitable.  Many Fletcher Allen docs are discussing options to align with Fletcher Allen or leave the state because they worry that they will not be able to withstand this change. Doctors from Northwest Medical Center in St. Albans told a  group of Senators last week that a third of the doctors there  already have exit  plans, to leave the state.   

There are many other issues with this health care plan:
* the high price on liability insurance
* the decrease in reimbursement payments
* an increase in taxes
* reimbursements rates aligning with Medicare rates
* administrative billing costs
and other concerns.

I was very disappointed with the bill as it was presented on the House floor last week. Many questions went unanswered. It seems to me that in a country as rich as the USA, we should be able to provide health care for our people, but Vermont can’t do it alone.  And certainly not with this bill.   

Carolyn B.