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2011-01-21

Vermont Governor Peter Shumlin Moves to Create Single-Payer Healthcare System

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As the House votes to repeal President Obama’s healthcare reform bill, the state of Vermont is taking matters into its own hands. We speak with Vermont Governor Peter Shumlin, who is leading efforts to create a single-payer healthcare system in the state. He was voted into office after making single payer a cornerstone of his campaign. "If Vermont can get this right, the other states will follow," Shumlin says. [includes rush transcript]

Transcript

This is a rush transcript. Copy may not be in its final form.

JUAN GONZALEZ: The Republican-controlled House this week voted to repeal President Obama’s signature healthcare law by a margin of 245 to 189. Three Democrats joined with the Republican majority. House Speaker John Boehner said Republicans are carrying out their electoral mandate.

HOUSE SPEAKER JOHN BOEHNER: Repeal means keeping a promise. This is what we said we would do. We listened to the people. We made a commitment to them, a pledge to make their priorities our priorities. And when you look at the facts and when you listen to the people, this is a promise worth keeping. Let’s stop payment on this check before it can destroy more jobs and put us into a deeper hole.

JUAN GONZALEZ: Also speaking on the House floor, Minnesota Republican Michele Bachmann sought to portray the healthcare reform bill as a move toward socialism.

REP. MICHELE BACHMANN: Obamacare, as we know, is the crown jewel of socialism. It is socialized medicine. The American people spoke soundly and clearly at the ballot box in November, and they said to us, Mr. Speaker, in no uncertain terms, "Repeal this bill."

JUAN GONZALEZ: The vote, of course, is largely symbolic, with Democrats vowing to block the measure in the Senate, where they retain control.

AMY GOODMAN: As lawmakers in Washington argue about healthcare reform, the state of Vermont is taking matters into their own hands. Vermont Governor Peter Shumlin is working with state legislators to create a single-payer system. Governor Shumlin made the creation of a single-payer system a cornerstone of his campaign and hopes to have a plan in place by 2014. He is a first-term governor in Vermont who was inaugurated earlier this month. He joins us now by Skype.

We welcome you, from Montpelier, Vermont, and want to talk about — as the House of Representatives in Washington this week repealed President Obama’s healthcare reform bill — of course, the Senate says they won’t go along with it — Vermont went a very different route. You had this rare joint session of the legislature with your whole congressional delegation, and you were addressed by a Harvard consultant, an economist, who laid out different proposals for single payer. You are leading this charge, Governor Shumlin. Why?

GOV. PETER SHUMLIN: Well, you know, I just see it very differently than the Republicans in Congress. I was elected governor to create jobs and to ensure that Vermonters have a better and more hopeful economic future. The biggest challenge for business in Vermont, or one of them, is the rising cost of healthcare. And I think what we want to do here in Vermont is to create a single pool, much like General Motors, Ford, Oracle, ensure that healthcare is a right and not a privilege, and use technology and other methods to contain cost. We want to have universal access. We want to be the first state where health insurance follows the individual and is not a requirement of the employer — I think that will be a huge jobs creator. And most importantly, we have to contain cost.

Here’s our challenge. Our premiums go up 10, 15, 20 percent a year. This is true in the rest of the country, as well. They are killing small business. They’re killing middle-class Americans, who have been kicked in the teeth over the last several years. What our plan will do is create a single pool, get the insurance company profits, the pharmaceutical company profits, the other folks that are mining the system to make a lot of money on the backs of our illnesses, and ensure that we’re using those dollars to make Vermonters healthy. So, a single pool that uses technology to ensure that we get rid of the waste and dedicate those dollars to making Vermonters healthy.

JUAN GONZALEZ: And how would the options that you are looking at differ on the issue that the Republicans have centered in on, the issue of individual mandates, that people must carry insurance?

GOV. PETER SHUMLIN: Well, you know, the individual mandate is going to be important to any success of healthcare. I mean, let’s look what we’re doing in this country, that every other single country in the world seems to have figured out. You cannot just have a system that is designed to reward providers and others for waste and inefficiency. You can’t have a system that is designed, frankly, to reward financially those that do the most to you and not necessarily keep you the healthiest.

So there are three things that we want our system to do. The first is, we’re wasting eight to 10 cents on the dollar in Vermont — frankly, in the rest of the country — chasing money around. No sane person would do that. We all know what we do. If we have insurance, we get the bill from our provider. Then the next envelope comes from the insurer. You wait for four or five of them to build up before you figure out what share you’re going to pay as an insured family and what share they’re going to pay. That is extraordinarily inefficient. We want to be the first state in the country that has the Green Mountain healthcare card. When you come out of your provider’s office, you pay your co-pay right there on the spot, just as you would never leave the grocery store without paying your bill there. That saves eight percent, we estimate, according to Dr. William Hsiao, right off the top. Then we want to use the same technology to have our health records on that card so that providers can actually know what the last provider did to you when you show up. That will get rid of the duplication and the waste in the system. And finally, we want to be the first state in the country that rewards providers for keeping you healthy as opposed the number of tests and procedures that they run you through, which happens to be the current system.

The current system in America is unaffordable. I think Democrats and Republicans can agree on that. If we stay on the current course, we will be spending the lion’s share of our income on healthcare. It will bankrupt our businesses. It puts us at a competitive disadvantage with all of the other countries who have figured this out.

My vision is that if Vermont can get this right, the other states will follow. Now, I’ve spoken with the President. We work together with our congressional delegation, with Secretary Sebelius. We need some waivers to make this happen. And what they’re saying is, "As long as you’re not lowering standards," which we’re not, "we want to work with you. We want the states to be laboratories for change." So, it’s an ambitious goal. We understand the land mines that lie out there, the special interests and the folks who are profiteering from our healthcare system, but we’re going to give it our best shot and try, lead the country.

AMY GOODMAN: Governor Shumlin, why doesn’t it conflict with Obama’s healthcare proposal? What are the waivers you would need?

GOV. PETER SHUMLIN: Well, the biggest waiver we need — and, you know, we have an incredible congressional delegation, Senator Leahy, Senator Sanders and Representative Welch — but the biggest waiver we need is to ensure that by 2014 we can get the waivers that we need to implement this plan. And really what we want to do is — we’re not asking for one additional federal dollar. All we’re asking is that we are able to pool our federal dollars into our existing system here in Vermont in a uniform system. And I think that will appeal, frankly, to more conservative members of the Republican Congress. What we’re saying is, give us local control. Let us go our own way. We’re not asking for more federal dollars than any other state. What we are asking is that you let state rights stand up and let us design our own system, using those federal dollars as we see fit. And I think that will appeal to, frankly, some of the Tea Party governors that I have just been elected with.

AMY GOODMAN: Talk about that. Talk about an alliance with governors who are saying that the federal government should not be involved with this, that this is breaking the backs of the budgets of states all over the country.

GOV. PETER SHUMLIN: Well, you know, every governor has their own particular state to fight for. Vermont’s challenge is different to some of the other states. We happen to be proud of the fact that, because of Governor Kunin and Dean’s leadership, we’re the first state in the country, through our program called Dr. Dynasaur, that insures all of our children. We’re also a state that insures almost everybody at 300 percent of poverty. So, as governor, healthcare is the biggest and least sustainable part of my state budget. We’re the biggest healthcare provider in the state. So, you know, in some of the other states, they don’t have as generous programs. They approach healthcare differently, and they should probably have some flexibility where they need it, as long as they don’t reduce standards. I support them having flexibility, too.

My challenge is this: it’s about cost. And I have watched some of the most capable politicians in America, from President Obama, President Clinton, Hillary Clinton, Howard Dean here in Vermont, both on a state and federal level, fail in designing a system that contains cost. That is what drags us down. I believe Vermont can be the first state in the country that shows how to get cost containment right.

JUAN GONZALEZ: Well, and how would the options you’re looking at affect employers directly, both the larger employers and the smaller ones, those who currently provide insurance or perhaps more generous insurance to their workers? How would it work with the employers?

GOV. PETER SHUMLIN: Well, it’s my belief that it’s not an employer’s responsibility — and this might surprise you as a Democrat — but not an employer’s responsibility to provide health insurance to their employees, any more than we ask them to pay for their employees’ car insurance, life insurance or fire insurance on their home. What I want to design is a system where healthcare is a right, and the healthcare follows the individual. If we can take that burden off of the backs of our employers by using a broad-based funding mechanism, as in a payroll tax, other broad-based revenue sources, to replace the current dollars, we will be doing our employers a huge favor. I believe that the states that we currently lose jobs to — frankly, like New Hampshire to our east, who has no income tax — those small businesses will say, "Hey, wait a minute. If I can get rid of my biggest rising cost, which is health insurance to my employees, by moving to Vermont, that looks attractive." So, I think it’s a jobs creator. We have to do it.

But the important part is not how we pay for it. The important part is, can Vermont be the state that figures how to contain cost, because, frankly, the rising cost of healthcare will bankrupt America. And that’s what the Republican Congress, I believe, has all wrong. The jobs destroyer for us is the rising cost of healthcare. That’s what’s going to drive jobs out of their state. That’s what’s going to break the banks of the middle class. And we’ve got to get this right. If we keep seeing healthcare costs rise eight, 10, 12 percent, 20 percent, higher, much higher than the level of incomes in America, you know, our goose is cooked. We will not compete.

AMY GOODMAN: Now, Governor Shumlin, you are a businessman yourself. You founded with your brother Putney Student Travel. I want to ask about another business, one of the most powerful businesses in the country — it’s the insurance industry — and how they’re responding. I was just reading a piece by Russell Mokhiber, who is head of the Corporate Crime Reporter. He says Vermont’s biggest insurer, "Blue Cross Blue Shield — with 75 percent of the state’s health insurance business — signaled [that] it might be interested in taking Hsiao at his word." He’s the Harvard economist that Vermont hired who addressed that joint session of the legislature. The Blue Cross-Blue Shield lobbyist in Vermont said, "If there’s a single payer system, we’d like to be the single payer." Your response, Governor Shumlin?

GOV. PETER SHUMLIN: Well, he’s a smart insurance executive, and he’s got it right. Listen, here’s why we can do this in Vermont, why we have a better shot than perhaps anywhere else in America. Today is the anniversary of the Supreme Court decision that allows corporations to spend unlimited cash to influence our elections. What is different about Vermont is that our legislators are not in the pockets of special interests; they’re in the pockets of their constituents. Now, there’s a very simple reason for that. I was president of the Senate. My last campaign cost $2,500. My counterpart in New York’s campaign, the president of the Senate just across the lake, probably cost multiple millions of dollars. My point is, we have a citizen legislature in the state. We are not beholden to the special interests. We fight for our constituents in their best interest. And frankly, our insurance companies are smart enough to know that. So, I think that — you know, we all know that what’s destroying democracy is the extraordinary influence of corporate money. The folks that are making money off the system then elect the politicians that make the decisions about their economic future. So we have a real opportunity here, and I think our insurance companies are smart enough to see that we’re going to make progress, and they want to be the company that has the single payer.

AMY GOODMAN: Well, Governor Shumlin, it’s a perfect lead in to our next segment, which is precisely about Citizens United. We’ll be speaking with the head of Common Cause. But before we do that, Vermont certainly is not foreign to firsts —- the first state whose legislature voted to legalize gay marriage. You are also pushing -—

GOV. PETER SHUMLIN: And I sponsored that bill, by the way.

AMY GOODMAN: Sorry?

GOV. PETER SHUMLIN: I say, I sponsored that bill, by the way.

AMY GOODMAN: As the speaker of the legislature of the House.

GOV. PETER SHUMLIN: As the president of the Senate, I was the lead sponsor.

AMY GOODMAN: President of the Senate. So, you did this. Also, you will — are pushing to shut down Vermont Yankee, which would make you, Vermont, one of the first states to shut down a nuclear power plant. And yet, you, Governor Shumlin, as a legislator, were known as the legislator of Vermont Yankee.

GOV. PETER SHUMLIN: You mean a while ago, yeah. Well, you know, let’s talk about nuclear power, if you wish. You know, the aging — our biggest challenge, as we all know, is to ensure that we pass our planet on to our kids with a planet that’s livable. And with climate change — and, you know, we see the climate change happening in Vermont, because we’re close to the ground, we’re farmers, we work the land — we understand the challenges that we have. Our challenge as a country is to acknowledge that our aging nuclear power plants will not perform beyond their designed life.

We have one, only one, in Vermont. It was designed to be shut down in 2012. My feeling was, for the many years that I represented the district where the plant lives, that — and I was born and raised right in back of the plant — that we had a commitment to keep our promise and run it for 40 years. That 40 years is up in 2012. It’s old, it’s tired, and it should be retired. And, you know, it’s leaking tritium. We are the environmental state. It’s a hazard in many ways. So, I did make the decision, as Senate president, to vote to have it shut down. We won that vote, and we expect we will retire it in 2012. I think that more states, including New York, will find that this fantasy that we’re living under, that we can run our aging nuclear power plants beyond their designed life without problems and without safety issues, is fantasy.

JUAN GONZALEZ: Well, and you’re saying — you’re specifically saying the old nuclear power plants.

GOV. PETER SHUMLIN: That’s right.

JUAN GONZALEZ: Do you have a position in terms — because, obviously, the Obama administration wants to expand the use of nuclear power, as do many in the Republican Party, as well. You’re not opposed to the general expansion of nuclear power, just the need to shut down the old ones?

GOV. PETER SHUMLIN: Well, you know, I am committed to helping, in every way we can, to get off of our addiction to oil as quickly as we can. And I actually think that, frankly, that’s the jobs opportunities for us in America. As we make the transformation from an oil-based economy to other technologies, we have huge economic opportunities. I want Vermont to harvest some of those, in producing windmills and producing solar panels and other things that are going to power this next energy future.

Having said that, this is not a debate in Vermont about nuclear power; it’s about the aging nuclear power fleet that we’re nurturing in this country. And, you know, it’s really a different issue. So, I haven’t weighed in on new plants. I have real concern about what we do with the waste and all the promises that have been made and all the promises that have been broken. You know, I’m a governor who has a high-level nuclear waste dump on the banks of the Connecticut River, when the federal government told us that all of that waste would be gone when their license was up in 2012. So, I have concerns about the waste, but I also am very committed to ensuring that we get off of our oil-based energy sources. We must, or we won’t have a planet that our kids can enjoy.

AMY GOODMAN: Vermont Governor Peter Shumlin, thank you for joining us.

GOV. PETER SHUMLIN: Hey, thanks so much for having me.

AMY GOODMAN: Thank you. Governor Shumlin joining us from Montpelier, Vermont, the capital of Vermont. This is Democracy Now! When we come back, we look at this first anniversary of Citizens United.

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