Restoring accountability to Green Mountain Care

The 85-page Green Mountain Health Care bill now before the Vermont Senate is quite possibly the most ambitious, complicated, and portentous piece of legislation ever to come before that body.

A trip through the lengthy bill reveals not only enormous tasks assigned to bureaucrats to make the plan move forward, but also an astonishing collection of boards and advisory committees obviously designed to keep all the "stakeholders" on board for what could be a long, bumpy and expensive ride.

As passed by the House, the bill declares that Vermont shall have a fully government controlled and taxpayer financed health delivery system.

This was formerly known as "single payer", until that term became a political liability as more and more Vermonters discovered what it stood for. Now we'll get a "public-private universal health care program" making "single payments" and enforcing its "global budgets" on health care providers.

The creation and management of this megasystem will be directed by a five member Green Mountain Care Board appointed by Gov. Shumlin. Once the Board establishes the roster of eligible patients, the package of approved benefits, and the schedule for what all medical providers will be paid, the cost of the plan can be calculated. The state will then call upon the taxpayers to foot the bill.

This bill of course doesn't specify how the state is going to extract the billions of tax dollars needed to pay those bills. The legislature's consultant Dr. Hsaio strongly advocated a new state payroll tax, at least 9.4 percent on employers and 3.1 percent on employees, to finance his plan, but higher income and sales taxes are still on the table.

The 2013 legislature will presumably have a say over which taxes are to be raised for Green Mountain Care. They will not, however, have any vote on the benefits or the eligibility or the costs of the grand plan. A major sales pitch for the Green Mountain Care Board, now being called the "Jedi Council", is that it is "independent" of such annoying political considerations.

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