Campaign Countdown: The future of health care in Vermont

Published: Sep. 26, 2018 at 2:28 PM EDT
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Campaign season is well underway, although it's been a quiet start. WCAX plans to help you get to know the major-party candidates for governor and understand where they stand on the issues over the coming days. Political reporter Neal Goswami recently sat down with Republican Gov. Phil Scott and Democratic candidate Christine Hallquist to discuss both candidates' visions for health care in Vermont.

Gov. Phil Scott and Christine Hallquist have very different visions for the state's health care future. Hallquist is proposing bold new plans, while Scott is urging a methodical path forward with existing reforms.

Reporter Neal Goswami: What is your vision for Vermont's health care future?

Christine Hallquist: Well, first of all, I think the vision needs to be that we get to approve Medicare for all.

Hallquist, the Democratic nominee for governor, is pushing a popular policy among democrats -- a universal health care plan paid by taxes that covers everyone. It's not a plan the incumbent governor supports.

"We saw the conclusion of that movie -- it wasn't pretty. It wasn't something that we could afford and I don't see that we'd see a different outcome in the future," Scott said.

Hallquist says she'll pursue a universal system with other willing states in order to increase the insurance pool and make it affordable. "No, of course we're not gonna get there overnight and we're not gonna get their on our own. We're going to do that by forming a union with other states in order to get there," she said.

In the short-term, Hallquist says she'll pursue a universal primary care system funded with tax dollars. "We'll figure out how to fund it, but the initial proposal was a 1.5 percent increase in payroll tax," she said.

By way of example, Hallquist says the electric utility she ran before running for governor would save one percent if the state went to a single-payer system. "That makes the delta half-a-percent, and I guarantee you we're gonna more than half a percent on our health care if people get there early," she said.

Scott says his opposition to Hallquist's plans is fiscal, not philosophical. "I think it'd have to be done on a national level," he said. The governor says the state already put plenty of effort into the policies Hallquist is seeking. "We've taken a look at what works, what doesn't. I think we've proved that single-payer, or Medicare-for-all, doesn't work for Vermont. You can't do it alone. We went through that exercise with Gov. Shumlin."

He wants to proceed with another reform effort that began under former democratic Gov. Peter Shumlin -- the all-payer model. It eliminates fee-for-service, the practice of paying providers for each procedure they perform and instead pays them based on health outcomes. "This all-payer model that we tried a pilot project on over the last year -- we've seen some success. We believe that it has some merit. We'd like to go a little bit further," Scott said.

For Scott, attempts to pursue Medicare-for-all, or universal primary care, could disrupt the major transformation already underway. "Let's not lose our focus on what's working right now," he said. "When you talk with Vermonters, as I do every day, what they want really is they want access to good, affordable health care when they need it, and that's as simple as that."