Column: Vermont health care plan adds perspective to Schweitzer's long-shot idea

2011-10-01T23:16:00Z 2011-10-01T23:21:08Z Column: Vermont health care plan adds perspective to Schweitzer's long-shot ideaMIKE DENNISON of the Missoulian
October 01, 2011 11:16 pm  • 

HELENA - Gov. Brian Schweitzer made headlines last week when he told reporters he's asking the feds to allow him to set up a "universal health care" program for Montana, using federal funds to underwrite a big health insurance pool that citizens could buy into.

Sound good? Maybe. But even the governor himself acknowledges his proposal is the longest of long shots, and could require state legislation - which can't even be considered until the 2013 Legislature, when he's no longer governor.

Schweitzer said Friday he's making the proposal because Montana will have to do something about the federal Medicaid program, which he said will "bankrupt the state" if it's not revised when it nearly doubles under planned federal reforms in 2017. Medicaid is the state-federal program that pays medical bills for the poor and disabled.

Yet in one state - Vermont - people are doing more than making suggestions. They've taken concrete steps to create a statewide health plan that will cover all its citizens and, they hope, cut down on duplicative services and contain the rising health-care costs that governors and other leaders know are out of control.

"The cost of health care is literally eating our budgets alive," says Vermont state Rep. Mike Fisher, who chairs the Vermont House Committee on Health Care. "At the current rate of inflation, we're not going to have any money to do anything besides health care if we don't address these needs."


How is Vermont doing it? Gov. Peter Shumlin, a Democrat elected in 2010, ran on the issue, and the Vermont Legislature passed legislation this year to set the process in motion.

Among other things, the legislation created the Green Mountain Care Board, a group of health care experts and business people being paid to work full-time on designing and developing Vermont's plan.

Vermont first plans to set up a health insurance exchange, as required by the federal health reform law, to offer private insurance plans starting in 2014. It then hopes to use the exchange to transition to a statewide plan that will cover any and all Vermont citizens - except those who choose to stay on private insurance or are covered by Medicare, the federal insurance plan for the elderly.

The state plan, dubbed Green Mountain Care, is scheduled to launch in 2017, if Vermont can get the needed approvals from the federal government. State officials hope it could be earlier.

Vermont is calling it a "single-payer plan," which usually means a taxpayer-funded plan where the government is the insurer for all. Details on its financing and what it will cover have yet to be worked out, however.

Robin Lunge, Vermont's state director of health care reform, says the single-payer approach has gained support because Vermonters believe it can squeeze out administrative waste by getting rid of duplicative billing and other financial functions, yet still cover everyone.

"We've had different studies on how to reform the health care system, and every study we've done has said single-payer is the most cost-effective way to do it," she says. "If (people) think it's going to save them money and cover everybody, people think it's the way to go."


Health care reform in Vermont hasn't all been a political walk in the park, however. Democrats firmly control the Legislature and support it, but the business and health care community is split on the issue and there's "a great deal of nervousness" about how everyone will be affected, Fisher says.

Back in Montana, it's been mostly a political non-starter or stalemate when it comes to big ideas on health care. This year, Republicans who controlled the Legislature proposed a number of "market-based" reforms designed to encourage people and small businesses to buy high-deductible, low-cost insurance plans, or make such plans more available.

Those plans either died in the process or were vetoed by Schweitzer, a Democrat. Republicans also killed any proposal related to federal health reform.

Schweitzer also hasn't presented any sweeping health care plans himself to the Legislature while he's been governor. Now, with 15 months left on his final term and barred from running for re-election because of term limits, the governor is floating a big idea, to use federal dollars and local community health centers to create a plan that will offer basic, affordable care for many.

He said Friday he hasn't talked with hospitals, physicians or community health centers specifically about his proposal. If it needs legislation, he said he might propose it for the 2013 Legislature. Yet he won't be governor then.

"We're just seeing how all of this unfolds, and how many Medicaid patients are pushed our way," he said.

Meanwhile, in Vermont, reform marches forward.


Copyright 2015 All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

No Comments Posted.

Missoulian Civil Dialogue Policy

Civil Dialogue Policy for Commenting on

We provide this community forum for readers to exchange ideas and opinions on the news of the day. Passionate views, pointed criticism and critical thinking are welcome. Comments can only be submitted by registered users. By posting comments on our site, you are agreeing to the following terms:

Commentary and photos submitted to the Missoulian ( may be published or distributed in print, electronically or other forms. Opinions expressed in's comments reflect the opinions of the author, and are not necessarily the opinions of the Missoulian or its parent company. See the Terms of Service and Privacy Policy for more information.

Our guidelines prohibit the solicitation of products or services, the impersonation of another site user, threatening or harassing postings and the use of vulgar, abusive, obscene or sexually oriented language, defamatory or illegal material. You may not post content that degrades others on the basis of gender, race, class, ethnicity, national origin, religion, sexual orientation, disability or other classification. It's fine to criticize ideas, but ad hominem attacks on other site users are prohibited. Users who violate those standards may lose their privileges on

You may not post copyrighted material from another publication. (Link to it instead, using a headline or very brief excerpt.)

No short policy such as this can spell out all possible instances of material or behavior that we might deem to be a violation of our publishing standards, and we reserve the right to remove any material posted to the site.

Add Comment
You must Login to comment.

Click here to get an account it's free and quick

Search our events calendar