On July 13, gubernatorial candidate Peter Galbraith announced a $220 million plan to provide free primary and preventive care for all Vermonters. The plan has no deductibles, co-pays or premiums and is financed by a 2 percent payroll tax on employers. Galbraith was joined by supporters, singe-payer advocate Dr. Deb Richter and Grace Cottage Hospital CEO and Campaign Treasurer Roger Allbee.
“My plan allows Vermonters to see a primary care doctor without having to spend one dollar on premiums, co-pays or deductibles. It means doctors can spend their time on patients rather than on billing and paperwork. It will lead to a healthier Vermont as health problems are treated sooner when they are less costly,” said Galbraith.
Galbraith is the only candidate for governor with a plan for public financing for health care. Earlier this month, Matt Dunne proposed a plan for primary care but did not include financing and would apparently keep premiums paid by the employee. Sue Minter has said she will explore several ideas as governor but has not said how she will pay for them.
“My plan for universal primary care comes with a way to pay for it. As a Senator, I was the only elected official to introduce legislation to pay for single-payer and what we learned from the single-payer fiasco is that a health care reform without financing is not serious,” said Galbraith.
Under Galbraith’s plan, executive compensation at health networks serving Vermonters would be capped at $350,000 a year. According to the most recent IRS filings, the CEO of the UVM Health Network made $1.9 million while his counterpart at Dartmouth-Hitchcock made more than $1 million. In 2012, the trustees of Dartmouth Hitchcock approved an increase in executive compensation from $12.3 million to $16.3 million. In 2013, the top ten administrators at the UVM Health Network were paid a combined total of $8 million.
“Million dollar salaries are not appropriate for publicly financed non-profits,” said Galbraith. “It is a fiction that these enormous salaries are market-based or independently determined. The Green Mountain Care Board has failed to exercise oversight of what is, in essence, public money. Taxpayers should not pay for the outsized salaries of non-profit executives.”
Galbraith’s plan would require the same reimbursement for the same procedures. Currently Vermont health insurers reimburse the academic hospitals at two or three times the rate to independent doctors for the identical procedure. His plan also ends provider discounts to large insurers, a practice that effectively prohibits entry of new insurers into the market and contributes to higher rates.
“Vermont’s health care market is a dual monopoly between the two largest providers and Blue Cross/Blue Shield. Unless properly regulated—and clearly there has been inadequate regulation of cost—monopoly markets cost consumers and taxpayers,” said Galbraith.
Galbraith’s plan provides primary care, pediatric care, gynecological care, mental health care and substance abuse treatment, free to the patient.
Competitors issue platitudes
After Galbraith announced his plan, Democratic and Republican opponents issued responses. Dunne’s campaign dismissed Galbraith’s concerns about million-dollar administrator salaries as “a nice sound bite.” Dunne served as a trustee of Dartmouth Hitchcock when the trustees boosted the salary of CEO James Weinstein over the $1 million level.
Republican Phil Scott said it would not “make Vermont more affordable or grow the economy.”
“Explain how spending $8 million on the salaries of just 10 administrators will help make health care more affordable for working Vermonters,” Galbraith countered.
Dunne’s campaign dismissed Galbraith’s concerns about million-dollar administrator salaries as “a nice sound bite.” Dunne served as a trustee of Dartmouth Hitchcock when the trustees boosted the salary of CEO James Weinstein over the $1 million level.
Galbraith’s Campaign Manager Ian Moskowitz responded to the Dunne campaign’s characterization, saying: “Matt Dunne may consider million dollar salaries appropriate for publicly supported non-profits, but Peter knows these outsized salaries cost Vermonters millions in unjustified health care costs.”
Republican gubernatorial opponents criticized Galbraith’s plan in a segment on WPTZ, with Republican Lt. Governor Phil Scott saying it would not “make Vermont more affordable or grow the economy.”
“I hope Republicans Phil Scott and Bruce Lisman will explain how spending $8 million on the salaries of just 10 administrators will help make health care more affordable for working Vermonters,” countered Moskowitz. “Peter Galbraith’s plan has sensible cost control measures; salary caps on top administrators, not paying inflated fees to academic hospitals for services; and ending price collusion between Blue Cross/Blue Shield and the monopolistic health care providers,” he said.