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January 13, 2010

Video: Sen. Bernie Sanders Speaks to VT Legislators in Favor of Statewide Universal Health Care

U.S. Sen. Bernie Sanders, who compromised on a federal public health insurance option for a bill that would dramatically expand community health centers in Vermont, told state lawmakers Tuesday evening that it's the states — not Washington — that will lead the nation in real health care reform.

Sanders addressed a joint meeting of the legislature's Health & Welfare Committee, which is considering several bills that would establish a state-level universal health care system in Vermont. (Read Shay Totten's Blurt post for more on last night's packed hearing).

A hoarse Sanders opened (above) by touting what federal health legislation moving through Congress would do: appropriate $10 billion to $14 billion more for federally qualified health centers, the community health centers that treat all patients regardless of income. For Vermont, that would mean opening two to three more community health care facilities — on top of the eight that exist today.

Sanders acknowledged he has "reservations" about the federal health reform bill as it stands now, but noted it gives states "extreme flexibility" to design health care programs that will work for them.

Sanders also back-patted Vermont for being "an aggressive leader" in expanding Medicaid and making sure "as many people as possible get into the system and [do] not get left outside." Sanders said Vermont stands to net an additional $250 million in Medicaid money under the federal health reform bill.

Sanders ended by calling this a "historic opportunity" to lead the country on universal health care, and received a standing ovation for his performance.

Wow sounds great, too bad no one's introduced a coherent bill that would accomplish any of this.

So, Bernie Sanders can make a good speech and raise the passion of his listeners. What else is new?

Second, federally qualified health centers are wonderful institutions. I was very involved with them while supervising the primary care program for the Vermont Department of Health. Any significant expansion of the FQHC program is still going to be confronted by the issue of primary care recruitment, however. Sen. Sanders deserves credit for pushing them at the federal level, but good intentions may not mean success in the long run because the incentives for speciality care (money, for instance) are too great to lead to significantly increased numbers of primary care providers.

Third, having written legislation in the U.S. Congress, I know the good, the bad, and the ugly of the process, and in my view, what we will see emerge in the health insurance bill will have some good, a lot of bad and too much ugly. The end result will be an even more complex system that will enable insiders to game the system for their own benefit and our detriment. (Sounds suspiciously like what has gone on and continues to go on in our financial system.)

Last, former House Speaker Sam Rayburn said, "To get along, you gotta go along." I generally like all three members of our congressional delegation, but in the end, they all are too comfortable in their present positions to challenge the congressional system in any meaningful way. The health insurance bill is just one example of going along to get along. Obviously, the Republican Party long ago jettisoned any sense of true commitment to our democracy (and they call themselves "patriots"). Democrats should not assume any moral high ground by claiming that, at least, they are not Republicans.

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