VTDIGGER.ORG: Peter Galbraith: Toward a Health Care Solution

Editor’s note: This commentary is by Peter W. Galbraith, a former Democratic senator from Windham County. He did not seek re-election in November.

Gov. Shumlin’s decision not to proceed with a financing plan is disappointing to the many single payer advocates but should not have been a surprise. And, much more importantly, it should not end the effort to achieve universal coverage in Vermont.

In reality, Vermont could never have a single payer health care system. There were always going to be other payers: Medicare, federal employees, the military, participants in self-insured multistate (ERISA) employer plans, out-of-staters, and people who simply preferred to keep their existing health coverage even as they paid the single payer taxes. Under these circumstances, the per capita savings from a Vermont single payer plan would be less than a national plan, were such a thing ever politically feasible.

Most Vermonters have health care that they like and can afford, in part because someone else — an employer or government — pays most of the cost. Shumlin’s now defunct plan would have taxed the contented majority to address the problem of the uninsured and inadequately insured. By placing so much emphasis on the income tax (or mandatory premiums), the plan would have transferred some of the burden of health care from Vermont’s largest and wealthiest corporations (who provide health care to their employees) to their workers and to small business.

Even if Vermont won’t create single payer health care for everyone, we can still provide quality health care for those who are uninsured or underinsured. Last May, I proposed legislation to create a public option as part of the exchange created by the Affordable Care Act. The public option would establish a benchmark silver plan on the exchange (perhaps using the existing Blue Cross Blue Shield silver plan). Silver plans are the only ones eligible for federal subsidies that help pay premiums, but they only have a 70 percent actuarial value, meaning the plan only picks up 70 percent of the participant’s health care costs. Under my proposal the state would enhance the benchmark plan so that it paid 87 percent of the participant’s costs and would subsidize each participant’s monthly premiums. I proposed a monthly subsidy of $40 a month for an individual and $120 a month for a family.

Under my proposal the state would enhance the benchmark plan so that it paid 87 percent of the participant’s costs and would subsidize each participant’s monthly premiums. I proposed a monthly subsidy of $40 a month for an individual and $120 a month for a family.

Presumably every participant in the exchange would choose the public option since he/she would be getting 87 percent of her/his health care expenses covered for the price of a 70 percent plan and, in addition, would have a subsidy. Since almost everyone would choose the enhanced and subsidized plan, Vermont would end up with many of the same administrative savings that would have occurred under the single payer plan.

Legislative counsel estimated the cost of my proposal at $350 million. I proposed paying for it with a 2.2 percent payroll tax and by eliminating certain income tax deductions that primarily benefit high income Vermonters and which otherwise have no real policy purpose. Since every Vermonter would pay the tax, every Vermonter would receive the subsidy and enhancements, regardless of income. But, no one who is happy with his current health care would be forced into the new system. And, as a practical matter, most well off Vermonters have good insurance paid by their employers and would not be entering the subsidized pool.

Under this proposal, Vermont would not be taking over the state’s health care system but instead building on the existing Affordable Care Act. If the projections on needed revenue are wrong, the state is not locked into tax increases (as it would be under single payer) but can simply adjust the subsidies or benefits. And the public option can be created right now. It does not depend on an uncertain federal waiver.

The cost figures the governor released last week are not substantially different from those contained in a report he submitted to the Legislature in January 2013. In short, the handwriting about the likely fate of the single payer plan has been on the wall for quite some time. Instead of recriminations over what didn’t happen, let’s look to what can still be accomplished.

VT DIGGER: LEGISLATORS SHOULD OPT FOR AN OPEN BALLOT FOR GOVERNOR

Commentary by Peter W. Galbraith

Editor’s note: This commentary is by Peter W. Galbraith, who is an outgoing Democratic senator from Windham County.

On Thursday, Vermont legislators will choose our next governor. This is, arguably, the most important vote the Legislature will take this biennium. The public is entitled to know how their elected representatives voted. But, if past practice prevails, the vote will be taken in secret. The Legislature can fix this by making a simple rules change when it first meets on Wednesday.

Although Gov. Peter Shumlin edged Scott Milne by a few thousand votes, neither candidate received a majority of the vote and, under the Vermont Constitution, it falls to the Legislature to elect the governor “by joint ballot.” The Legislature has chosen to interpret the phrase “by joint ballot” to mean a secret ballot but there is no historical basis for such an interpretation.

In the 18th and early 19th century, voters cast their votes openly. Voters did not get ballots from town clerks but directly from their preferred candidate. And, because candidates often used different colored paper, it was easy to know how one voted. The secret ballot was invented in 19th century Australia to take care of the particular circumstances of a country inhabited by emancipated convicts. Thus, when the deputy clerk of the House tells members that the Vermont Constitution requires an Australian ballot, he cannot be right. When Vermont adopted its constitution, there was no Australia. Europeans had just discovered the land mass, had yet to agree on a name and there were no settlers.

In reality, the secret ballot will protect only liars — those who say they are voting one candidate but actually vote for another.

The Legislature can opt for openness when it convenes on Wednesday.

Immediately after swearing its members, the House and the Senate separately adopt rules for joint sessions. It is in order for any member to propose a rule requiring that the vote for governor be by open ballot. This then can be debated and voted on.

As always, there will be opposition to change. It will be argued, for example, that the Vermont Supreme Court has ruled in favor of a secret ballot. But, the only case on record is a 19th century case that affirmed the right of an individual voter to an Australian ballot and this cannot — and should not — be a precedent for saying that elected legislators are not accountable to their constituents for one of the most important votes of the biennium. Article 6 of the Vermont Constitution gives the Legislature scope to establish its own rules and it is highly unlikely that the Supreme Court would second-guess a decision in favor of openness. (And, if it did, the remedy would be to rerun the ballot in the Legislature.)

Representatives and senators cannot easily duck questions from constituents about their vote for governor. I suspect that almost every legislator has — or will have to — disclose her or his vote. In reality, the secret ballot will protect only liars — those who say they are voting one candidate but actually vote for another. We can speculate as to whether the liar vote will benefit Gov. Shumlin or Mr. Milne. In my experience, Vermont legislators are people of integrity so I don’t think transparency will have an affect on the outcome of the election. In any event, there should be no right — constitutional or otherwise — for legislators to lie to their constituents.

Vermont Watchdog.org ~ Galbraith: Shumlin could have given Vermonters gold for the price of silver

January 2, 2015 @ 4:00 am
Posted By Bruce Parker

MONTPELIER, Vt. — An outgoing Vermont senator says the health care plan he formulated is the only one left standing after Gov. Peter Shumlin ditched his single-payer agenda in December.

Peter Galbraith, a two-term state senator and former U.S. ambassador, spent the past legislative session working to provide Vermonters with universal health care.

Click on this link to read the article in its entirety.