Vermont Tiger

Vermont's Schools: Good Enough?

a letter to the editor
 
This is not an opinion piece arguing or debating the details of how to improve Vermont’s education system.  This is the short simplified story of my family, and our joy, angst, and reservations about deciding to raise our children in Vermont.  I realize this is not everyone’s story, and I want to stress that there is only one reason I would share my family’s story in a public forum; and that is because many families like mine are struggling with the same decisions about their children’s future.
 
Although not everyone comes to live in Vermont in the same way, I know that our route resembles that of many people who would like to make Vermont their home as well. There are many prospective Vermont families who must debate if the sacrifices they make outweigh the benefits of living in Vermont.  I want what is best for my family, and I want what is best for Vermont.  I speak out only to encourage Vermonters to join the conversation about our states future, and to look closely at the realities of our challenges as a community.

About Those School Spending Figures

a letter to the editor

There is a constant barrage of opinions about school spending in Vermont.  The Picus Study and the Dover-Wilmington Study are the most recent iterations of these opinions.  It is important to note that tracking school expenditures in Vermont is difficult at best and almost impossible at worse.  This is due to the fact that 250+ school districts in Vermont use a variety of accounting programs and diverse charts of accounts.  Further, each district typically reports its data via one of the 61 supervisory unions to the state department of education.   While the data collection has improved over the years it is a long way from total standardization.  The need for one accounting system and a standard chart of accounts for all districts, web based and easily understood has been recognized for years.  However, every attempt to move in that direction has been thwarted at one juncture or another usually around financial or territorial issues.

About Those Test Scores ...

a letter to the editor

Gentlepeople:

Contrary to the recent release of state test results, assessment experts know that you cannot simply add and subtract the percent passing a test across different grade levels (4, 8 & 11). The standards setting process is independent for each of the grade levels and subject matters. Thus, there is no way of legitimately comparing a 40% pass rate at one grade level to a 60% pass rate at another. This compares apples and oranges. But, that's what the state did.

This gets extra funky the higher you go in the grade levels and as the comparisons span multiple grades. Subject      matter gets more diverse and human minds do not behave in such an orderly and linear way.

Furthermore, there is no external validation that says the cut-off point should be set "here" rather than "there." It's simply the judgment of some folks and the tests are designed to measure at that point.

What I (Never) Learned at the Health Care Forum

   a letter to the editor

by Perry Green

I went to a meeting at the Maple Street School in Manchester last Tuesday evening concerning our new State's Health Care Reform Law H.202, and left the meeting after several hours with the same questions unanswered as when I arrived.  On the way out I picked up a flyer titled "Green Mountain Care" and noted some carefully crafted statements such as:

"The Vermont Legislature passed a sweeping health care reform bill in 2011 at the urging of the Governor.  This legislation will impact all Vermonters and has prompted questions such as: who will be covered, what are the costs, how will it be funded, who will pay, and will it be feasible?  The legislation does not specify the universal program it sets the framework to establish, but leaves the details of such a system to a five member board to be appointed by the Governor at a future date.  Neither the Governor nor the Legislature presented a projection based on a possible plan design during the deliberation of the Bill, although the coverage and funding sources have been discussed openly by elected officials."

Change the Exchange

    you'll be able to choose your insurance plan in Vermont's new health care universe.  you can have six of one or half-dozen of the other

by Wendy Wilton

The universal care aspect of H.202 has dominated the headlines.  Yet, the health care exchange, required by federal law, will come first.  This part of the bill has had scant attention except from those who understand we will be living with the exchange starting in 2014 and perhaps indefinitely if single payer is not feasible.
 
The idea of the health care insurance exchanges as envisioned in the national reform was to increase consumer choices among private and possibly public options, and that is what most states are intending to do.  Except us.
 
The language in the current bill stipulates the BISHCA commissioner may allow more than one insurer in the Health Benefit Exchange, but is not required to do so, and to select two insurers to offer the same plan at a similar cost.  This is hardly consumer choice--it appears to be ‘single payer’ within a severely restricted exchange.
 
Most municipalities, like the City of Rutland, have moved to high deductible plans coupled with health reimbursement accounts (HRA) to save significant costs on insurance.  If these plans are not selected by the commissioner as the one or possibly two plans, then municipalities (and other employers) may be forced to return to more expensive plan designs--increasing costs for employees and increasing taxes.
 
Reform is absolutely needed in health care.  But reducing consumer choice and restricting innovation are anathema to meaningful reform.  The Vermont senate, now reviewing the bill, should expand the exchange as envisioned by the national debate.

Trillions, Billions ... Who's Counting

    single payer is too important to get hung up on a bunch of zeroes

To: Vermont Tiger
From: Edward Pomicter, MD
re: notes from a meeting on single payer

Last night (Tuesday, 5 April), Shelburne’s state representatives hosted a presentation to provide an explanation of H.202, the healthcare reform bill.  Mr. Mark Larson, Chairman of the House Healthcare Committee, and Mr. Steve Kimbell Esq., Commissioner of BISHCA, made a verbal presentation on H.202 and answered questions from the audience of approximately 80 citizens that was overwhelmingly skeptical of H. 202.  Unfortunately, the format of the meeting did not allow significant opportunity for the questioners and audience to rebut statements made by the panel that were sloppy at best; intellectually dishonest at worst.

Of note was a significant lack of solid information on particulars of the proposed system as the current legislation does not establish the system, only a set of goals and a framework for a committee of five people to follow in developing a single payer apparatus.

“Scribblings”

An Occasional Newsletter from the Legislature

by Thomas Koch

 
Fundamental to health care reform is the question of how we pay for health care.
 
Perhaps the most familiar system is the traditional and sometimes still-prevalent basis for payment known as “fee-for-service.”  You go to the doctor, who examines, diagnoses, and treats you and sends a bill to you, your insurance company, or both.  Often it’s not that simple; sometimes a diagnosis requires an x-ray, a CT scan, a blood test, or any number of other procedures.  And there’s a bill for each new procedure, some of which are ordered to rule out alternative diagnoses and achieve a greater degree of certainty in the process.
 
The fee-for-service system is widely criticized, to the extent that some people seem to believe it is the root of all evil.  The economic incentive, to be sure, is to order more tests, prescribe more drugs, do more surgery, and in general provide more care.  After all, the more you do, the more you can charge.  Therefore, the fee-for-service system is frequently cited as one of the principal causes of the rising cost of health care.

The Many Ills of Government Health Care

    a letter to the editor    

 by Edward Pomicter, MD                                       

In the end more than they wanted freedom, they wanted security. When the Athenians finally wanted not to give to society but for society to give to them, when the freedom they wished for was freedom from responsibility, then Athens ceased to be free. – Edward Gibbon

There are two distinct classes of men in the nation, those who pay taxes, and those who receive and live upon the taxes. – Thomas Payne

Nothing is easier than spending public money.  It does not appear to belong to anybody.  The temptation is overwhelming to bestow it on somebody. – Calvin Coolidge

Socialism of any type leads to a total destruction of the human spirit. – Alexander Solzhenitsyn

I object to the “healthcare reform” package that is being proposed for Vermont.  Perceived problems in healthcare will not be cured by additional government involvement in the system.  Below I have outlined some of my objections and reasoning.

Existing government intrusion into healthcare over the last 40+ years has disabled the natural balance of a free market system in bringing lower costs and higher quality.  As just a single example, the significant cost shifting of medical payments to private payers is the result of government intervention in the payment system as is evidenced by Medicare and Medicaid reimbursement rates below the cost of providing care. 

If society wants a certain amount of service, it is going to cost a certain amount of money as people need to be paid and supplies purchased.  There is compelling historic evidence that expenses will be reduced if free market forces are allowed to operate.  An example here in Vermont of this potential is the “not quite free market” experience of Vermont’s sole outpatient surgery center which operates in South Burlington.

The Future Has Arrived

by Tom Licata

In the tradition of the ‘great group-think’ that is Vermont, Montpelier plans and God, among others, laughs:
"Vermont’s population is aging. In the future there will be many more dependents and fewer wealth-producing workers. These workers will not be able to generate the tax revenue needed to pay Vermont’s projected expenditures for public K-12 education and human services. Increasing broad based tax rates is far more likely to cripple the state’s economy than to produce the needed revenues," said the 2006 Ethan Allen Institute’s “Off the Rails” report.
 
“Vermonters are still waiting for Montpelier to engage in the promised full-contact debate over the statewide property tax and the rising – not to say “out of control” – cost of education,” said the Jan. 29, 2007 VermontTiger.com.
 
"Economic activist Tom Licata presented Vermont’s economy as hurtling toward implosion during a Dec. 5 forum in Essex Junction and said only a long-range plan for job growth and economic development would ensure a viable future,"  said the Dec. 5, 2007 Essex Reporter.
 
"According to Licata, a businessperson with an MBA, a background in finance, and a concern for the future of Vermont, if legislators continue on their current path, it will doom the economy of the state. He came loaded for bear: a myriad of statistics and charts to support his theories," said the April 3, 2008 Shelburne News.
 
“We all knew this day would come...,” said Gov. Shumlin in his Jan. 25, 2011 budget address.
 
Montpelier continues to plan and God, among others, continues to laugh.
 

The Fix Isn't In ... Yet. But We're Working On It.

by John Primmer

In an event overflowing with irony, Vermont’s new Governor and its Congressional Delegation For Life held a press conference yesterday to announce that they had screwed up and were not going to take it any more.  Confirming Nancy Pelosi’s sagacious observation that Congress must pass ObamaCare to find out what’s in it, Senators Leahy and Sanders and Representative Welch joined Governor Shumlin in confessing that the awesome thing they did last year – namely cram a massive bureaucratic takeover of the world’s best health care system down the throats of the voters – was not perfect after all.  Why?  Because it contained a provision that delays their vision of hastening Vermont’s financial collapse by installing a single-payer health care system for our state alone. 

All four acknowledged that Vermont is among the leading states in terms of citizens’ access to health care, but still insisted that it was incumbent on them to do something to control costs.  They propose an amendment to ObamaCare to accelerate the process of not just standing around.  It wasn’t explained why our enlightened leaders didn’t simply apply for a waiver of any onerous provision of ObamaCare.  Hundreds of waivers have already been handed out to unions and corporations that supported ObamaCare.  Do our exalted leaders have less clout with this administration?

(John Primmer is a retired lawyer living in South Ryegate.)