VERMONT FOLLY: "GREEN MOUNTAIN HEALTH"

The real political news in Vermont has been buried under recent headlines announcing the retirement of Sen. Jim Jeffords: The Vermont House has approved the most radical health care proposal ever to gain majority support in a state legislative chamber..... From 1995 until late 2004, health care "reform" in Vermont consisted of Gov. Dean's constant expansion of Medicaid to higher income workers, known as the Vermont Health Access Plan. Since the plan's costs rose much faster than the revenues assigned to pay for it, Gov. Dean financed the expansion by progressively underpaying doctors, dentists, hospitals and nursing homes. His successor, moderate Republican Jim Douglas, ruefully announced in his 2005 inaugural address that the state was headed for a $270 million Medicaid shortfall by 2007. But the new, exceptionally left-wing legislature elected with him was eager to implement their platform pledge of a single-payer health system. House Democrats, with a working majority of 89-60, elected the very liberal Rep. Gaye Symington as speaker.

Rep. John Tracy, chairman of a new committee on health care reform, drove his committee hard to come up with a plan. The eventual bill declared that Vermont had no "clearly defined, integrated health care 'system,' " but instead, a patchwork of programs, inequitably financed, leaving some 60,000 Vermonters without access to care. The proposed solution was universal coverage for "essential" services as defined by legislative committee. The state's 12 hospitals would be subjected to a binding "global budget." Doctors and other providers would be compensated on a "reasonable" and "sufficient" basis, in light of bureaucratically established "cost containment targets." Private health insurance for essential services would be abolished. The new system would be paid for by $2 billion in new payroll and income taxes.

The plan overlooked a few sticky considerations. Many Vermonters go to hospitals in neighboring states: How could those hospitals be forced to accept Vermont's government payment rates? What about sick people migrating into Vermont to gain the benefit of the universal care? How could the state have "single payer" efficiency when Medicare, Medicaid and Veterans Administration care existed side by side with "Green Mountain Health"? The final version of the bill, which appeared on the House floor on April 20, didn't settle these questions. Nonetheless, the House passed the single-payer plan on a vote of 86-58. Gov. Douglas attacked the measure as potentially "devastating to our economy." "They are asking Vermonters to pay more taxes, but get less health care," he said....

Democratic Senate leader Peter Welch, though a longtime single-payer advocate, quickly sidetracked the radical House proposal. A proposal for more modest reform would avoid a certain veto battle, and the negative fallout for the liberal legislators who strayed beyond what even liberal Vermont voters want. The current Senate version features a new payroll tax to be paid by employers that do not offer health coverage and by their employees. Its price tag is only $40 million, a far cry from the House plan's $2 billion.

All of this would seem to be a tempest in a very small teapot, but for one thing: Over the past 30 years, Vermont, with a liberal majority, a hive of activist left-wing organizations, and a press corps largely hostile to anything smacking of conservatism, has become the nation's premier blue-state testing ground for virtually every imaginable liberal proposal. Putting single-payer health care in place in Vermont would be an enormous breakthrough for the left. This year its advocates are closer to victory than ever before. If they ultimately succeed, the reverberations will be felt from coast to coast.

More here






MORE BETRAYAL OF THE PUBLIC IN QUEENSLAND

Sexual abuse complaint in 1996 and still nothing done. Only the innocent were punished. Nice to have a government "watchdog" protecting you, isn't it?


An inquiry by the Health Rights Commission into serious clinical and systemic complaints at a public mental health unit headed by a struck-off senior psychiatrist took 4½ years and did not result in a final report. The commission's head, David Kerslake, yesterday conceded that the significant inquiry – which began after the referral of a complaint in January 1996 and culminated in a letter in July, 2000, to the Cairns District Health service – "took too long". "From the view of any of the parties involved, I would have expected it to be done more quickly," he said. "We have reviewed our processes since and they do not take that long now. It does not automatically follow when looking into a major complaint that you do a report at the end of it."

The investigations involving the integrated mental health unit and its then head, Keith Muir, began three years after he was struck off in New Jersey for having sex with two vulnerable patients and one year after he had been struck off, in 1995, in New York State. But Mr Kerslake defended the failure of investigators to detect Dr Muir's past, which would have prevented him becoming the most senior public hospital psychiatrist in far north Queensland had it been known. He said his investigators could not be expected to inquire outside their scope or to duplicate the work of the Medical Board of Queensland, which is meant to vet and register doctors from Australia and overseas.

The complaints by psychiatrist Annette Johanssen to the commission a decade ago included her assertions that Dr Muir had engaged in sexual misconduct himself by touching her thigh and the thigh of another woman staffer. The commission is not empowered to act on sexual matters between staff, but a separate Queensland Health investigation, which also failed to detect Dr Muir's past, exonerated him but found against Dr Johanssen. Mental health professionals said she left soon afterwards, largely because she had blown the whistle and subsequently been singled out and punished.

Dr Muir, who was appointed director of psychiatry at Cairns Hospital on July 21, 1992, and transferred in 2003 to Nambour Hospital, has vigorously defended himself against the serious findings and claims made against him.

Mr Kerslake said that at no time in the investigation were there "complaints about sexual misconduct involving patients at Cairns Base Hospital – and if there were, they would have been referred to the medical board". "We conducted a major investigation into clinical and systemic issues," he said. Responding to Queensland Health's statement that the investigation "did not complete", Mr Kerslake said: "We clearly wrote to the hospital and we clearly confirmed that certain changes have been made and we closed off the complaint."

More here

***************************

For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.

***************************